It was a really interesting conference. I was really moved by the four mothers who spoke of their OASI (Obstretic Anal Sphincter Injuries) on stage, as well as those in the audience.
The section on language around birth was incredibly interesting. Being told you're doing great and having professionals ask for your consent led to a more positive birth experience (unsurprisingly). The examples of actual phrases mothers were told were appalling but for anyone on Mumsnet I don't think they were that surprising - things like 'you have awkward nipples', 'you're not allowed to push', 'we're just giving you an internal, 'be quiet you're scaring the other mothers'.
Everyone criticised the idea that because someone had signed a consent form they had consented. The lawyers, surgeons, midwives and mothers all said consent had to be a two way process. This has changed fairly recently (2015) when Nadine Montgomery (who was supposed to be the first speaker but couldn't get from Scotland because of train cancellations) won a revolutionary case. Her son Sam was born with cerebral palsy as a result of being deprived of oxygen for 12 minutes. Her consultant did not inform her that because of her small stature and because she had type 1 diabetes and a large baby she was a risk of complications and that a c section was an option. The ruling made it clear that doctors must ensure their patients are aware of the risks of any treatments they offer and of the availability of any reasonable alternatives, rather than the previous 'doctor knows best' view. (This is a very oversimplified summary so do look it up.) Her son is now at university (with the help of a full time carer).
The speakers were saying that all women should be informed while pregnant (maybe at a 36 week or earlier appointment of their personal risk profile and the pros and cons of various options including forceps, ventuouse, c-section so that if any of these become necessary during birth the woman isn't hearing about them for the first time and her consent can be informed consent.
The overarching sentiment is that birth is an individual experience. Some you won't know until the day - how you handle pain, exhaustion, the position of your baby etc - but professionals know your height, your build, the approximate size of your baby (the size of the dad's head!) and therefore know if you are at increased risk of an instrumental birth and other complications.
We ended with a vote on the motion that informing women of their risk profile will lead to a rise in c sections. Both sides actually had similar arguments in that whatever happens you must let women choose what happens to their bodies. One side said it wouldn't lead to a rise in c sections because most women wanted a natural birth if possible, the other side said it would lead to a rise but was that a bad thing if OASI injuries could be avoided. The issue of cost was brought up as c sections are often said to cost more (around £2k vs £1665 for a non instrumental birth) but the fact is many births do have added complications. Women with OASI injuries explained that they needed counselling, repairs for prolapse, sphincter repair operations, which cost tens of thousands of pounds (not to mention in some cases their jobs, relationships and mental health).
@RachelBosenterfer and other Mumsnet users who were there, is this a fair summary? (It was lovely to meet you BTW).
What do you think - would knowing your risk profile and the pros and cons of c section, forceps, ventouse etc make you more likely to request a c section, and is that such a bad thing?