High rates of intervention?

[LorlieS]

The C-Section rate is 40-something percent in my local NHS Trust. This seems remarkably high when considering labour and birth are in essence natural processes? Why might it be? What are rates like nationally I wonder?

I've had 8 pregnancies and 3 births. First birth - hospital induction (in hindsight should have declined). Second birth - "normal" delivery in hospital. Third birth (decade after second!) - "normal" delivery at home with no intervention (no internal exams, natural delivery of placenta etc) with an Independent Midwife.

@CormorantStrikesBack I suppose there's a lot more work involved with water births in hospital - cleaning up, temp monitoring etc, which I appreciate is difficult for already incredibly busy midwives.
Think my midwife advised hubby to check birth pool temperature frequently (not sure how frequently I just let him get on with it) but I do remember him doing quite a few kettle runs!

It's only terrible if many women weren't able to have a water birth despite wanting one for whatever reason such as lack of availability if pools are limited.

It isn't terrible if women make the choice not to have a water birth. Not everyone wants one, I know I didn't.

Yes but 1 of nearly 400 suggests that not everyone who wants one was able to have one given that many more than 0.25% express wanting to.

The only thing I wanted was an early epidural - it was in my notes from my first appointment. Luckily I got it - had a long sleep and then watched Wimbledon!

I suppose it depends how many pools are available such as if only 1 or 2 are available then you would have to be lucky for one to be free at the time that you need it.

I also wonder how many people start in the pool but then decide to get out to give birth so they may have laboured in the water but didn't have a water birth.

Or how many people change their minds when they are actually in labour such as deciding to have an epidural instead.

This was me too.

I was asked several times if I wanted to 'manage' with gas and air first. No thanks!

@Parker231 And that's absolutely your choice, assuming the risks were explained clearly to you before you made that choice?

We actually audited this at a hospital I used to work at. We were supposed to offer it to every suitable woman. We then went daily to the post natal ward and asked all low risk women who hadn’t had a pool birth if it had been offered. 95% said it hadn’t and most said if it had been offered they’d have wanted it.

we then went back and asked the specific midwife why they hadn’t discussed pool births. It was mainly a combination of thinking if a woman wanted one she would ask ( which isn’t the case) or lack of confidence. The education team did a lot of work and things improved.

Yes - I knew the pros and cons of the different forms of pain relief. For me the only one I considered was a very early epidural.

And that's absolutely your choice, assuming the risks were explained clearly to you before you made that choice?

Such a patronising tone OP. Were the risks of home birth explained to you prior to you making the choice you made I wonder?

This is the issue I have with threads such as this.

It is almost always assumed that intervention = uneducated and it quickly gets very smug and patronising.

@SouthLondonMum22 I disagree, I don't think that the presumption is intervention = uneducated. In some, not all cases, intervention may = misinformed, not uneducated.

I KNOW from first hand experience over a 20 something year career that the majority of obstetric interventions are not properly explained to women. The benefits, risks, or whats involved. Interventions and statistics are often discussed in a coercive way which can scare women into complying.

I won't hear otherwise. I see it day in day out. I listen to women, I read the notes, I care for women, I see the outcomes, I speak to the consultants.

There was no way I was delivering a baby without serious drugs so epidural was the only thing I considered.

In some cases, I can agree. But there also seems to be this thing that doctors and intervention = the enemy when in so many cases, decisions have to be made quickly and can often be life saving.

We are incredibly privileged to have access to modern medicine and I feel it can be taken for granted at times. Childbirth outcomes used to be woeful for both women and babies for good reason.

I do think we need to move away from natural = always good and intervention = always bad as long as women are of course, fully informed of their choices.

This is how I felt too.

This time there's no way I'm having twins vaginally. C-section is the only way for me.

I was the opposite with DT’s - had them without a c-section. Consultant approved - although small they had stayed in the right position throughout and baby number two didn’t change around after baby number one was born. Only 20 minutes between them. Was prepared to accept c-section if baby number two got out of position but all good.

My main concern is delivering the first vaginally and then needing a c-section for the second. I don't want to risk it.

@Parker231 Again your choice entirely, but may I ask why? If you'd rather not say that's fine 😀

Why I had an early epidural? Because I didn’t see any point of having any pain or discomfort. I had a good sleep through most of my labour and then watched Wimbledon as DT’s were born.

@ilostmyhearttoastarshiptrouper Well an NHS home birth wasn't possible and hospital would have meant not potentially having my husband me to witness the birth of his first and only child. The hospital said partners could be there only when "labour had been established." I checked what they meant by this and they said they would need to do a vaginal exam. I would not have consented to this at any point during my labour. An unecessary intervention carrying infection risk. A lot of women during Covid delivered alone as baby came quickly etc. So, in essence, "Yes Ms *, your husband can be with you providing you allow us to push fingers inside your vagina."

Homebirth was the safest option for my third low-risk pregnancy, having sought advice from both very experienced midwives and doing my own research.

Can I ask why an NHS home birth wasn’t possible? Because they don’t have to like your choices but they have to send a midwife if you refuse to come to hospital. As an nhs midwife I’ve attended home birth/pool birth of breech twins! 😆

@CormorantStrikesBack My Trust pulled all home births due to staff shortages. Covid - May 2020. No face-to-face antenatal care either.
Tbf It was a blessing in disguise!

This is why I had one too. Giving birth was just a means to an end for me.

Oh yeah, forgot Covid. I’d left the nhs by then so not sure what happened locally but probably the same.

But you do know there are increased risks to both you and baby with an epidural?