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.

This is what was upsetting me earlier - it probably isn't intentional, but the whole 'if you had the information and did x,y,z you too could have a natural birth'.

I did NCT, massaged the bits, did the yoga, practised different labour positions, educated myself about all sorts of things, stayed at home as long as possible whilst in labour... and still ended up having an emergency CS.

The implication of all of the well intentioned advice (whether it is meant or not) is ' if you just tried harder you could have avoided it - you failed'. I really resent this because I never feel this way until someone decides that I need to hear about how it could have gone if only etc.

Chibi, as I said in my post; I'm in no way suggesting that a woman has failed if she needs a CS (I honestly don't believe that) Nor am I suggesting that if all women 'tried a little harder' they'd achieve a VB.
But I do believe that for some women a CS is avoidable.

I'm not of the mindset for making women feel bad about their choices or experiences. Shame on any woman who is.

think in many cases IF a c-section could be prevented it is because many (probably even most) hospitals and midwives have an outdated view of how child birth should progress and not because women are not being adequately prepared.

see
this guardian article

Yes, I would certainly agree that the fact that I went nowhere near the bed and gave birth holding onto the back of a chair was the biggest factor in my positive experience.

at fact being a factor. Tut Tut

Just want to clarify by saying that I live in Surrey and the Surrey hospital in which I gave birth to my DCs positively encouraged my moving around and giving birth standing up. I am sure, for all my rhetoric, that I would not have found it so easy had they objected.

Ok, given what you've since written, do you think you might retract the 'silly women' remark now?

I don't think that anyone can disagree that better education is likely to improve people's birth experience.

However, I believe that expectations should not be falsely set by statements like 'out of 11 of us, only 1 needed intervention'.

I would politely suggest that if women feel traumatised by an experience of labour requiring intervention, this is often not helped (before or after) by well-meaning women who have managed to have an uncomplicated birth who have raised their expectations of childbirth.

In short- good post chibi- totally with you

No, because I was saying it was silly to go into childbirth expecting it to be as you've written in your birthplan. Expecting it to be all natural and organised because that's naive and silly.
I was not saying it was silly to end up with a CS.

I had a fabulous natural experience and I'm grateful for the support I recieved to help me achieve that. But, I didn't go into it expecting that. I prepared myself (and DH) that it could be horrific. That I could need everything going inc a CS. That I could tear horribly etc etc. But I prepared as best I could to avoid that. But of course, like Chibi, you can prepare and still have a terrible time. I never suggested women like her were silly.

Suey, so why is it ok for women to go through pg with it never having been suggested to them that they shouldn't get on a bed. Why is it that most women are still giving birth (or attempting to)on their backs when guidelines say this is not best practice?

To clarify why I stated that only one of our group needed intervention; I was suggesting that if we hadn't followed her advice it could have been more. In another one of her groups 7 out of 10 may have needed intervention but that could have been 9out of 10 if they had all got on the bed. I'mnot suggesting if women do 'this' they willnot need 'this'. just that perhaps fewer will.

Chibi, if I have offended you or made you feel bad about your birth experience then I apologise. I am merely saying that blissfully wandering threough pregnancy expecting it all to go smoothly is not doing women any favours.

For the record, I did not have a terrible time. The labour was long + hard, but totally normal.

I think we need to acknowledge that despite good intentions, expectations and the rest, there are aspects of birth that are beyond your control. In many ways I think it can be a lottery of sorts, your baby can become distressed, it may hurt beyond your capacity to cope/long enough for you to be exhausted, or you baby (like mine) may get stuck in the birth canal. All the information and empowerment in the world may not help at this point, you may need intervention of some kind.

I am all for women being informed and feeling like they are 'in the driving seat' so to speak, but this is not going to be a cure-all. It especially can't ever be a stick to beat other women with.

As I've said before, I don't feel badly for having had a CS - except when it is implied that I could have avoided it if only...

Well, I'm sorry if you feel that I implied that. I hope my further posts have clarified what I was trying to say.

cushion, I bought into the whole active birth, pregnabcy yoga, birth ball, perineal massage, optimum foetal positioning NCT jazz.

I was induced for medical reasons (dd had a heart condition). I was the silly one trying to stave off pain relief for as long as I could. I still ended up with an em cs under GA for all my efforts and prep. In my mind I tried hard enough.

Good job on your Surrey hospital. Well prepared you were too. Fantastic you got the experience you want and WORKED for.

Spare a thought for the other women who have to battle less than ideal modern hospital conditions (my hospital were bussing women to the next hospital, they were so over-crowded they shut their doors), incompetent and apathetic hospital staff. For a lot of us, it is an uphill battle fighting the establishment. Silly me, expecting to get what I want.

cushioncover - I don't think many women do go through pregnancy blissfully expecting it all to go smoothly. I don't know where you got that idea from.

The women who are hoping for a positive vb experience are more likely to be the ones, like you, who have done their research, learned about the best labouring positions, learned what to do to help themselves.

I know I certainly did because after my first very difficult and medicalised vb (which I wanted to avoid)I really wanted a positive experience the second time round. But I ended up with an emergency cs anyway.

Sometimes you need a good supportive birth team and a lot of luck, which it sounds like you had.

probably the best preparation is a copy of the NICE guidlines to wave at any midwife who insists on strapping you to a monitor!

I genuinely meant what I said in the last 2 sentences of my post @ 17:40

Oh and my whole post @17:56

Just that for some it is avoidable and we should help them to make it so.

I genuinely meant what I said in the last 2 sentences of my post @ 17:40

Oh and my whole post @17:56

Just that for some it is avoidable and we should help them to make it so.

See how sincere I am!

cushioncover - I understand what you are trying to say.

It's just the comments like 'I am merely saying that blissfully wandering threough pregnancy expecting it all to go smoothly is not doing women any favours' that I don't really understand.

Most pregnant women are, at best, slightly concerned and, at worst, quite obsessed about labour and childbirth. I find it hard to imagine a woman who feels the way you describe about birth.

It's what happens in the hospital that sometimes changes everything you hoped/imagined would happen.

Meemar, that comment was said with a friend of mine in mind. She had her first baby last month. She's a project mamager whose life is very well organised and she had her DH drive her to hospital when her twinges became quite painful. She presented her MW with a beautifully typed and detailed birthplan and is now tired and shell-shocked after a 22hour labour which ended with forceps and a nasty tear.

She may have been able to avoid this, she may not have. I just think that when pregnant, she should have been encouraged in practises designed to avoid such an outcome (if possible)

I have met many women who were naive about what labour could be like. I've heard women say that they've been told to lie on the bed as soon as the arrive at hospital. Why? Many women go to hospital earlier than they need too. Few of these have any idea of techniques that may help them cope at home for longer.

I really believe that educating pregnant women both about what may happen to them during labour and about how they possibly avoid some of it (such as large tear) would help them approach it with more confidence and less fear.

I do see your point. However, I really think that it's the maternity services who require the educating (and funding) to help women have the type of birth they want, if the goal is to reduce the need for intervention and emergency section.

There is no point in women arming themselves with information, if, when they arrive in hospital, they are told to do things which totally contradict what they know to be best for them. When you are in labour you aren't in a position to fight, you are surrounded by professionals and decisions which seemed realistic in your birth plan may go out the window if circumstances change.

With DS1 I went into labour 5 weeks early. The labour stopped progressing. I knew I needed to be moving about, but was connected to a monitor and made to feel a nuisance for wanting to get up. The slow progression led to syntoconin drip, then episiotomy and ventouse. Because he was prem, I was worried and didn't feel able to argue that I didn't need constant monitoring.

With DS2 I was told in labour by midwife on reading my birth plan that I could not give birth on the floor. Despite being told by community midwife that I'd be encouraged to labour as naturally as I wanted. He ended up as an emergency cs anyway.

I think my point is that the support needs to be there within the birth setting. Without taking anything away from you I do believe you were lucky to have a) a supportive birth team and b) no complications that may have required intervention.

Sadly too many women don't have this experience.

I think CC's point is that, yes women do get a bit obsessive about childbirth, but that doesn't translate into properly preparing themselves for it Many women do 'drift along' because they think that they will be instructed what to do when they go into labour, that staff always do what is best for them and then they get a huge shock. Midwives are people too, they have to constantly balance best practice with what their unit decrees, they are overstretched and underpaid and subject to pressures we know nothing about. That's why preparation is vital, because there won't always be someone to tell you what you should do, only a ticking clock and a set of protocols that in some cases go actively against best practice, and only by being prepared and preparing your birth partner to advocate for you and help you decide how to proceed can you have much chance of getting the birth you want

Cushioncover, I'd agree with you that education can increase confidence and reduce fear and thus lead to a better experience.

However, none of the measures that you mention are a cast iron guarantee against any of the things they're meant to prevent happening. My friend did perineal massage for 2 months, episiotomy with the 1st and tore with the 2nd. I did it for 2 months and never even got to pushing stage.

I attended 2 lots of nct classes (hospital run and private). In the hospital one run by a mw from the hospital she showed us the labour rooms and reminded partners/husbands that their job as soon as getting into a room was to raise the bed so their wife/partner would not be tempted to lie on it. When I met 2 of the women from that antenatal class in hospital we had all had csecs for different reasons although I don't think major haemorrage due to placenta previa being rushed to hospital and baby out under GA is something that could have been avoided by perineal massage or remaining upright.

What if you have a pre-existing condition that means you have to be induced early and have CFM throughout active labour? I asked if I could get into good positions with a monitor on and it was all I could do to fight to be allowed to lie on my left side rather than my right? What do you do in a situation in which they're telling you do this or we won't know if the baby is in danger? In the midst of 4 contractions in 10 minutes with a max of 30secs in between is not the best time to make your case.

I did my research, bought a pink kit and worked through it and persuaded my dh to help with partner positions, practiced breathing and visualisation,read up on different pain reliefs and their effects on baby, mother and labour, exercised regularly and had a doula. And that was on top of controlling a medical condition sent haywire by pregnancy that could have had major adverse effects on my baby. I went in knowing it would hurt more than it might otherwise as I was being induced and I ended up with an emergency cs. Am I a failure because I let them induce me, let them monitor me and had an epidural when the pain got too much?

A relative who's a great grandmother told me that when she had her children, you were alone without your husband and were not allowed off a bed. She managed to have all of them without a cs. The practice of the nhs has moved on since then but so has the level of monitoring which allow them to pick up problems and the fear of litigation which cause them to do emcs faster than they used to ie when a baby is in distress.

Yes the methods you mentioned may assist somewhat in lowering the rate but what would have just as profound an effect is hospitals not insisting that women dilate 1cm per hour or else they are getting to failure to progress territory and forcing interventions for policy reasons.

But at a guess the women who've never heard of these things are not the ones haunting the childbirth thread on MN!!

ok cushioncover, i had you wrong and your 2 posts have clarified your position.
However, can you see that your previous post may come across in the way it did to me?

BTW, as i said in my previous post, i do believe that education is obviously a good thing- as long as it is not tempered with 'well if you do this you will have this experience' either directly or implied. it should always be, 'you will improve your chances of x experience rather than y.