Caesarean for "stupid" reasons?

[GloriaInEleusis]

Following on from this thread, I just wondered how many people have caesareans for stupid reasons?

I've had two, one crash and one planned. Neither was for a stupid reason.

chibi, I alredy answered the IVF argument on the other thread.

IVF is needed when people are unable to conceive in any other way, just as a CS is needed when a mother is unable to give birth to her child any other way.

A medical need is easily defined as when medical intervention is necessary enable the patient the same as what most of us are able to do without intervention.

I still cannot agree that any unnecessary surgery should be offered to patients nor should it be paid for by the NHS.

imo, the most clinically relevent statistics are the Confidential Enquiry into Maternal and Child Health CEMACH because
CEMACH collects information from every hospital on all perinatal deaths using a specific notification form, the Perinatal Death Notification (PDN) in England, Wales and Northern Ireland.

Continuing and developing the enquiry?s perinatal mortality surveillance enables us to:

• Monitor changes in the rates, causes and risk factors associated with perinatal mortality
• Identify topics where it may be beneficial to carry out further more detailed studies
• Provide cases for detailed study in a full confidential enquiry and data for other studies
• Assist hospital Trusts, neonatal networks, Strategic Health Authorities and Primary Care Trusts monitor their mortality rates.

inthegutter yes i agree i am trying to illustrate the sweeping generalisations that are occuring here eg Csection must be bad thing by illustrating one counter opinion, there is a lot of anecdotal stuff being said, good evidence based clinical medicine is based upon data collection and analysis

so...... are we moving towards Csections for all???? With no choice about it because it's 'safer'? How far is the U.S. along that route already........

no nono i am simply pointing out about the many anecdodotal comments here implying csection inherently bad. thing about this is there are numerousopinions

Surely the fact that you were refused shows there must be some reason for the medics in charge not to think a CS was the best option.

Starlight - have you had a C section? Just wondered, because the other thing that strikes me, is unless you've had both CS and VB, how can you really compare which is 'better'?

Interestingly one of the world's biggest proponents of 'natural' childbirth, Michel Odent, argues that the risks from elective cesarean are massively exaggerated and that it is a very safe procedure for mother and baby in terms of mortality and morbidity. (Emergency CS is a different kettle of fish entirely)

However, this does need to be balanced with the fact that cesareans have long-term risks associated with them - there is the the increased risk of secondary infertility, the risk of uterine rupture which can occur during pregnancy, not just during VBAC, and the increased risk of placenta praevia, accreta, increta and percreta. The last 5 of these have increased substantially in recent years as the CS rate has increased and are extremely dangerous conditions. I think somebody once described cesarean birth as transferring virtually all of the risk to future babies, which is a no-brainer in an emergency situation, but IMHO it is very important that women are informed of these risks when requesting a cesarean.

What's really irritating me about this debate is that on the one hand those who are argiung against C section for maternal choice talk about empowering women to have natural deliveries in nice enironments etc (nothing wrong with that if it's what the woman wants) then say "Surely the fact that you were refused shows there must be some reason for the medics in charge not to think a CS was the best option."

So women can only be empowered to make a decision about birth if they chose the vb plan not if they consider all of the evidence and opt for c. section ? tHen they have to do as they are told and have a vb anyway?

On the off-chance that anybody is interested I don't actually have any major philosophical or ethical problems with women being "allowed" to have a CS for any non-medical reason. My concern is that in a socially-funded healthcare scheme such as the NHS, the priority should be the provision of safe, evidence-based, woman-centred, maternity services with one to one continuous support for all women in labour. I believe if this was implemented vaginal birth would be a more empowering, positive, life-enhancing experience and that the demand for elective CS would decrease anyway. If elective CS became a 'right' finances would be so stretched as to make this even more of a pipe-dream!

review of london maternity care thisthe guardian

my exp of mw was poor, found them aloof, distant, disinterested. my care considerably improved under consultant and medics, they were fab

i had mine at a badly rated London NHS hosp, and yes it was grim. private next time for me definitely

Very good post Daisy. Totally agree.

Oh, I quite agree, it's not a reality at all. But it should be and the irony is that if direct funding was increased to enable hospitals to provide this, the long-term effect would be a saving because there would be fewer emergency cesareans and instrumentals and fewer long-term complications as a result of botched births. The current system of payment by results means that hospitals are financially rewarded if they have a high CS rate.

I will be the dissenting voice of your survey and say that I preferred my third birthing method - I had a vaginal birth first, had two good, positive elective CS as I didn't want to do VB again after the first time and then a simply fantastic VBAC

Victorian, your ivf argument is based upon the assumption that getting pregnant is a medical necessity, which it isn't.

I guess having grown up in the states, I expect to get things in medical treatment that are beneficial to my health and not just things which are absolutely indisputable necessities. Caesarean, braces (as in teeth), verucca removal, etc. These things should be part of the health care. Surely we can find plenty of places to cut funding before we need to go after the maternity services. Like that IT system that is now into the how many millions?? And we are up in arms about some £500 extra for a caesarean?

Why can what Daisymoo describes not be a reality? Surely we should be working towards an ideal, even if we never quite manage to achieve it?
Interesting points from your friends who've had both CS and VB. Personally I had VB/CS/VBAC. I would definitely say my first VB was the 'best' birth, because it was in a midwife unit where I felt supported. Interestingly it was also the most painful....which goes to show that a painfree birth shouldnt necessarily be the ultimate goal.. feeling that you've had a positive birth is probably the thing to aim for. My CS was relatively pain free (Ok, recovery takes longer, but the pain was all very manageable). My VBAC was fairly quick, not too bad until the crowning of the head which hurt like f!, but overall NOT a good experience as I was in a big hospital, I saw about 10 different midwives so no continuity of care, and I felt like I was on a conveyor belt.

I think Daisymoo makes some good points here, especially with regard to future babies. This is one of the main reasons why Caesareans shouldn't be chosen for casual reasons, combined with the other medical risks and longer recovery period.

However, I'm still a firm believer that we should be so thankful to have Caesareans as a first choice in certain circumstances and an emergency option in lots of other situations.

I don't think it's paranoid to suggest that some women do have a slightly superior attitude in respect of natural childbirth and this does need to be challeged in a civilised way (which is what we are trying to do here despite some very passionate opinions).

I've had two vaginal births and one Caesarean so have no personal axe to grind either way. However it has irritated me in the past to have Caesareans described as "surgical removals" and by implication second class births, which they most certainly are not if they result in a gorgeous, healthy little bundle of loveliness.

Starlight: In my idea of an ideal world all women who wanted a CS would be 'allowed' one and all women who wanted a vaginal birth would be given the support to acheive this. But as we've already said, it's not an ideal world, and in a financially-stretched healthcare system those who wield power have to make difficult decisions over which should be prioritised and what is most cost-effective overall. Statistically speaking it isn't significantly more risky to have a vaginal birth than an elCS but it is signicantly more expensive in terms of immediate resources.

You're right, I was in a position to demand what I needed with my VBAC, but it isn't necessarily out of the reach of first time mums. I know of a first time mum who has really done all the same things I did in terms of informing and preparing herself, but you're right that it doesn't come easily on the NHS.

I really wish that the debate over CS or 'natural' birth wasn't so polarised, because I think generally we all want the same thing - equitable, safe, empowering birth experiences (CS or vaginal) for all.

I had a VB with dd, ended up 3rd deg tear, post op surgery for retained placenta, and further op 10 days post natal for post/n bleeding due to more placenta....if Id had a c/s it wouldve possibly been sorted all in one go...I am def. having a c/s with no.2 as nothing else can exit my body through that scarred hole!