Why are so many women anti c-section?

[jivegirl]

Despite planning a peaceful waterbirth at home, I ended up having a very scary OP/ventouse delivery with my daugher nearly 2 years ago (delayed second stage, retained placenta, 3rd degree tear, plus internal tearing which had not healed after 6 months and required cauterising)

I have been offered a C-section and will see the consultant again to make my decision in just over a week. At present (35wks) bump is transverse, so the decision to have a section may yet be taken out of my hands. However part of me is secretly hoping the baby stays transverse so I don't have to justify having a section.

I can't understand why so many women seem to be anti-sections. It seems admitting a preference for a section is almost taboo.
I still get horrific flashbacks to delivering my daughter and can't think of anything worse than going through that again (my DP rates it as the most traumatic day of his life!! ) The thought of a calm, planned c-section sounds like bliss. Am I being naive?

I should also say that I will have excellent support from friends and family to help me cope with caring for an active toddler and a newborn in the weeks that follow - so I am sure I am luckier than many..

Would love to hear some opinions on this ladies!

"No, RF, in the world of fabsmum, there would never be any traumatic vaginal births."

Expat,your comments are nasty, personal and frankly so uncalled for.

I've acknowledged over and over again on this thread that some women have very difficult vaginal births. Did you just skip over those parts of my posts where I talked about that?

I've never denied that birth trauma exists or trivialised it.

I've said many times that women who are phobic about giving birth should have access to elective sections. I mentioned primary and secondary tokophobia.

"Also, in fabsmum's world, women who have fears about giving birth first time round shouldn't ever have the choice of having a csection - instead they should be patronised because of course, all they really need is counselling and support and their unfounded fears will go away."

No - I have said: women with both primary and secondary tokophobia can and should have access to elective sections. Why do you keep ignoring the fact that I've said this?

Why are you making things up, like I think all women who are phobic would be fine if they had counselling? I've never said anything of the sort. Or implied it.

If you'd asked me I would have told you what I really think - which is that women who are fearful should be offered counselling and the chance to have one to one care throughout labour from a midwife with whom they've established a relationship in addition to the option of having a c-section if this is what they'd prefer. The research shows that the emotional outcomes for phobic women offered counselling who go on to have vaginal births are no better than for women who have an elective section after counselling, so there's a very good arguement for making sure that ALL phobic women have access to elective sections and be encouraged to make an informed choice. But you didn't ask me did you? You just jumped to a very unfair conclusion and used it as a chance to attack me.

"In fact, women shouldn't have a choice about the mode of birth at all outside of medical necessity - they obviously don't have supreme right to their own bodies and are incapable of making an informed choice about what is best for them."

I've said nothing that justifies this nasty, judgemental comment.

All I've said is that there is a strong case on medical and financial grounds for not routinely offering elective c-sections for all low risk mothers on the NHS. There's nothing controversial about this view.

If we had an insurance based system as they do in most of the rest of Europe it would be different, but routinely offering all women in this country the option of elective section would bankrupt the NHS and lead to even more dangerous practices and more trauma for the majority of mothers having vaginal births, because of issues surrounding staffing.

You really are a piece of work expat and I'm not going to engage in any more discussions with you.

It's really horrible and hurtful being personally attacked for things I haven't said and don't believe - being accused of things that are absolutely anathema to me.

So there you go expat - you can have the last word. Enjoy it.

"No, RF, in the world of fabsmum, there would never be any traumatic vaginal births."

Expat,your comments are nasty, personal and frankly so uncalled for.

I've acknowledged over and over again on this thread that some women have very difficult vaginal births. Did you just skip over those parts of my posts where I talked about that?

I've never denied that birth trauma exists or trivialised it.

I've said many times that women who are phobic about giving birth should have access to elective sections. I mentioned primary and secondary tokophobia.

"Also, in fabsmum's world, women who have fears about giving birth first time round shouldn't ever have the choice of having a csection - instead they should be patronised because of course, all they really need is counselling and support and their unfounded fears will go away."

No - I have said: women with both primary and secondary tokophobia can and should have access to elective sections. Why do you keep ignoring the fact that I've said this?

Why are you making things up, like I think all women who are phobic would be fine if they had counselling? I've never said anything of the sort. Or implied it.

If you'd asked me I would have told you what I really think - which is that women who are fearful should be offered counselling and the chance to have one to one care throughout labour from a midwife with whom they've established a relationship in addition to the option of having a c-section if this is what they'd prefer. The research shows that the emotional outcomes for phobic women offered counselling who go on to have vaginal births are no better than for women who have an elective section after counselling, so there's a very good arguement for making sure that ALL phobic women have access to elective sections and be encouraged to make an informed choice. But you didn't ask me did you? You just jumped to a very unfair conclusion and used it as a chance to attack me.

"In fact, women shouldn't have a choice about the mode of birth at all outside of medical necessity - they obviously don't have supreme right to their own bodies and are incapable of making an informed choice about what is best for them."

I've said nothing that justifies this nasty, judgemental comment.

All I've said is that there is a strong case on medical and financial grounds for not routinely offering elective c-sections for all low risk mothers on the NHS. There's nothing controversial about this view.

If we had an insurance based system as they do in most of the rest of Europe it would be different, but routinely offering all women in this country the option of elective section would bankrupt the NHS and lead to even more dangerous practices and more trauma for the majority of mothers having vaginal births, because of issues surrounding staffing.

You really are a piece of work expat and I'm not going to engage in any more discussions with you.

It's really horrible and hurtful being personally attacked for things I haven't said and don't believe - being accused of things that are absolutely anathema to me.

So there you go expat - you can have the last word. Enjoy it.

'Expat,your comments are nasty, personal and frankly so uncalled for.'

Pot calling kettle black there, fabsmum.

Truly.

You've stated TIME AND AGAIN that women should not get elective csections without medical necessity.

Psychological reasons are not medical. They are psychological.

It is interesting how you declare those who do not agree with you nasty, judgmental and personal when you yourself have passed judgement repeatedly over women who exercise a choice to have a surgical birth and have also misquoted me and addressed me personally.

Please re-read the MN policy statement for what constitutes a personal attack. Disagreement does not.

I had a third degree tear with my first birth, took a long time to recover and to be honest, I am too scared of it happening again to face another vaginal birth, so I am having an elective c-section this time. If my first birth had been straight forward,then I wouldn't choose an elective section, but I am too afraid to give birth vaginally again and to risk fecal incontinence.

BTW I am sh*t scared of having a section!!

Wow -this topic certainly polarises people doesn't it!!

We've got the vote, our Mum's burnt their bras and still we have the audacity to proclaim what other women should do with their bodies.

Let's face facts - it is in the interests of Consultants who face complicated pregnancies and know what can wrong to do what they feel is the safest for mothers and babies. It is in the interest of Midwives who have fought long and hard to gain recognition and their own professional status to promote a style of birth they can be involved in (what some might call natural).

We are fed propaganda and a lot of bull sh&% about which is best.

The most ideal birth and the most natural one is the birth that delivers a healthy mother and baby.

I had an elective vaginal bypass and I am proud of it. I was not cajoled into feeling guilty (thought many midwives, health visitors and mothers did try) and both my baby and I are 100%. I had a choice and chose to make it. And if I had chosen to go the vaginal route that would have been my choice too...and also ok!

Let's acknowledge we are all different and what type of birth we want will also differ. And please do not throw statitics around as to which is the safest etc. They are often invalid and biased.

Jivegirl can I please say this; my C-section was calm, quick and very special. My recovery was also very smooth and I was walking along the river within 3 days and able to drive within a week - though insurance company ask you to wait a bit longer. I did not push myself just got on with it. I bf successfully and in 8 weeks when I have my next baby I have absolutely no hesitation in repeating a c section.

The taboo is all about power - midwives vs consultants... and to some degree money and staffing problems. At the moment midwives seem to be winning the propaganda war stigmatising c sections and those who choose them. Ignore this and do what you feel is right for you, your body and your baby.

Excellent post, Cil!

An emergency C-section is more dangerous than a vaginal birth. But I don't think an elective c-section is more dangerous.

I have met a number of Consultants through work and many have said to me that they would encourage their wife/daughter/girlfriend to have an elective c-section. These are consultants who do the repair work after vaginal births.

I don't have any statistics on this - but I was all for a vaginal birth with dd. Unfortunately it wasn't to be and I ended up with an emergency c-section which was fine.

However I commented that because of the trauma of the birth I am terrified of trying for a vaginal birth next time round but was worried because I understood c-sections to actually be more risky. I was told that if it was an elective c-section then I did not have to worry.

but an emergency CS is performed out of urgency and because Vaginal birth is too risky

yes , I agree scottishmummy - but a lot of people have posted that a c-section is more dangerous that a vaginal birth. An emergency c-section is more risky, though obviously necessary if the v-birth has become dangerous. But an elective c-section is not more risky than a v-birth.

I knew that I wanted an elective section even before I got pregnant.

It was the one positive that came out of having pre-eclampsia and HELLP syndrome at 32 weeks! I remember the consultant telling me as I signed the consent form that I could always have vbac next time and thinking "bloody hell, no way, not now I've got a dammned good reason not to." Not saying that maternal choice alone isn't a good reason btw, I think it's a perfectly valid reason.
I was also interested to read a paper in a recent Archives of Disease in childhood where a metananlysis hrevealed that elective section at term was just as safe for the infant as vaginal delivery, breathing problems after birth were very unusual so long as the baby was delivered at at least 39weeks gestation.

sticking up for fabsmum who has most definitely said that medical necessity in her view (and the view of the nhs) includes psychological reasons. I can't see what it is she has said that is so unreasonable tbh or where she misquoted expatinscotland unless it was when she was quoting expatinengland? but too tired from trawling through this thread to read it all over again to double check.

what about choice? the choice of a woman over what to do with her body?

the NHS pays for abortions. they are a choice a woman makes about her body.

why is the mode in which she may chose to give birth any different from any other choice she makes over her body?

I always keep in mind that "No one can make you feel inferior without your consent." I had two c sec (both emergencies) and I've had stupid comments such as : Did you know that it was a major operation and Women who chose to have epidurals don't know what they are getting into, and My wife was really against C sec at all cost (from a work colleague) but frankly I don't give a . I have decided a long time ago that these sort of comments are not worth affecting me at all. I have two gorgeous boys and I am head over heals for them, and I wouldn't change a thing about what happened.

Personally, I think part of the controversy surrounding cses is due to jealousy. I think some women secretly fancy a cs and when they hear someone else has had one, for no good medical reason, they get extra irate because a little bit of them would have liked one themselves
NOT ALL WOMEN before you all start telling me how much you'd hate a cs. SOME.
These wome then go on the attack of elective lady saying how pathetic she is being too posh to push etc, because in reality they're furious because they suffered and she hasn't. Their mindset is if I did it, you bloody well can too, why should others be allowed to duck out of it? Or they had a truly marvellous experience and genuinely can't understand the fears of another woman and genuinely want her to enjoy birth as much as they did - though a good vaginal birth depends a) on your physiognomy and b) on the level of care you receive, which, tragically, in this country is likely to be pretty dreadful
We react so strangely to any birth-related issue, I think it's one of the most profound experiences we can go through because it marks the life-shaking experience of transition to motherhood that we just can't react in the "she did it my way, I'll do it mine" way that we would apply to virtually any other decision.
FWIW I've had two cses both for breech one an emergency under GA (terifying in that it happened so quickly) and one elective, which was a very jolly occasion with lots of laughing and joking with the anaesthetist and our own music playing etc.
I didn't enjoy the recovery at all, hated the long stay in hospital (apart from the bfing help, more of which later) and found it very hard the second time round being in charge of a toddler I couldn't lift. I was so jealous of friends who'd had vbs who were running around the next day. Being stuck in bed unable to move with a newborn beside you is tough. But I managed to bf both for a year without any problems at all - in fact in the case of dd1 I suspect the fact I had a five-day stay in hospital was the key to successful bfing, as I nobbled the midwives at every opportunity to show me what to do. If I'd gone home the next day it would have been a disaster. Personally I think all first timers should be encouraged to have a vb but if a second timer has been traumatised then it's cruel not to let them have a cs second time, the misery of nine months anticipating terror and pain is not to be underestimated.
So if I were you jivegirl I would certainly go the cs route, you have nothing to be ashamed of and so long as you're aware you may be in pain and a bit immobile for a few weeks (which you obviously are) it sounds like you'll be so much happier being in control of your experience. Good luck

I don't think people are anti c-section per se. Its more about weighing the risks.
As a scrub nurse I see it as a major operation and have witnessed first hand on wards, before I worked in theatres, the complications that can arise from large abdominal wounds. Not only that, the length of recovery afterwards is probably not well thought out i.e. not being able to drive, carry more than a few lbs, inconvenience of struggling with a sore abdomen and looking after a newborn once DH goes back to work.

To put it in perspective a woman having a hysterectomy which is the same incision site would not even be allowed to hoover, lift, drive for 6 weeks. They tend to be in hospital for at least 4 days post op.
With both c-sections I was out of hospital in less than 48hrs and had a newborn to look after. Even the getting comfortable to feed, standing up and sitting down with one hand holding a baby can be tricky.

It certainly is best avoided if at all possible IME.

Hi all,

What a debate. I didn't mean to cause any arguments

Thank you to everyone who has posted their experiences, good and bad, about both natural births and c-sections. It's clear there is no easy choice to be made, and that every woman and baby is unique and sometimes the outcome is simply out of our hands.

I echo the sentiments of the various posters who have made reference to the high c-section rates being due to the hospital culture when labour is not progressing. The challenges facing midwives are all to clear. I am sure that all of us would welcome the chance to birth naturally, with 1:1 care from a supportive and knowledgeable midwife, and that in these circumstances interventions and the feeling of being at the mercy of hospital procedure. Unfortunately, the NHS doesn't have the resources, and I for one certainly couldn't afford a private midwife or doula.

Having said that, I also remember my midwife saying to my DP (over my head, whilst I was in a haze) that 'if something didn't happen soon they would have to move things along' (I had been at 2nd stage labour for 2 hours). When they eventually suggested ventouse I nearly bit her hand off - anything to get it all over with. Maybe I just wasn't strong enough

Spent half of this evening on a birthing ball with my legs in the air. If this little tinker doesn't move from transverse in the next week at least the decision will be made for me!

Claire

PS I am probably biased because I have seen a patient return to theatre with a severely infected wound, went to ICU and later died. I have also just had dd2 by EMCS 6wks ago and have had to go on anti-biotics due to a wound infection. Not only that, both my dds had horrendous chesty coughs for weeks after the birth, as their chests were not cleared through the natural process involved in childbirth vaginally. This means that you tend to end up with a baby who coughs lots and vomit feeds back in the early weeks Again, people don't think about the effects after the event.

I have not had a C section, only a VB which I sometimes think I am describing wrong because it sounds a bit traumatic (3rd degree tear, contractions for 36 hours) but was actually lovely.

I did not want a CS because I was paranoid abou the idea of an epidural or spinal block, and was worried about coping with newborn and wound.

My feeling is that CS, if medically necessitated (and you can stretch medical necessity as far as it will go, I include birth phobia) is of course the best thing and thank God for it. But the problem is not the CS itself, its afterwards. It loads all the risk onto the subsequent pregnancy. If there are no additional risks, why do medical staff get panicky about wound sites when women are on 2+ sections?

My problem is that I would be absolutely terrified of having a CS. If I knew I'd need a CS it would definitely put me off having another baby. So I completely understand that the thought of a VB may put off other women.

I don't have family support so I'd worry how I'd look after toddler and newborn. I also hate the idea of having to stay in hospital or even go to the post-natal ward.

Both times I was up, showered, dressed and home within a couple of hours. The fact that it was straightforward the first time gave me confidence for the second (and upcoming third) Now if the first time had been horrific, I would obviously base my next decision on that.

yep, and then if you get pregnant again (less likely after c section) when you go for vbac all the talk is of scar rupture, like it happens all the time (which in fact it doesn't) that is if you are lucky enough not to have placenta praevia ruling out vbac in the first place (again, more common after c section)

after my c section i did feel like a lot of people were looking down on what had happened (funnily enough some of them later went on to have c sections, not that I should have felt smug [guilt] ). it really really upset me. and sadly was not just in my imagination. I wish I could explain why it was so many people reacted that way. I don't think it's from envy though. I see the same kind of reaction to horrible stories like child abductions or child deaths with some element of parental neglect, even if tiny. everyone else piling in to point out where they went wrong and why they are much better parents cos they would never do that etc. must just be the way some people are wired to behave

I have no real experience and probably nothing ueful to add to the debate. I'm certainly not as well informed as some of the people on here.

In my limited circle of friends, the CS babies were all settled and slept a lot for the first few weeks and were placid etc. The VB babies cried a lot and were very unsettled eps. my DS who was a quite aggressive ventouse delivery (I was actually prepped for an ECS but they gave the ventouse a try).

While I think the recovery after a CS with a todddler would be difficult, I think handling a very unsettled baby in the same situation would also be difficult - an din some ways a lot more. I'm not saying for a second that all CS babies are placid and all VB babies are difficult. They may be, I don't know

Also, FWIW, I can see why people reacted badly to Fabmum's posts because nobody likes ot see women's choice reduced to cost but I do think she had a valid point if upsetting point about how the NHS has to work and she did mention from the start that phobia of giving vaginal birth counts a medical issue.

I have just had a c-section 6wks ago and my dd1 is 2.4. Trying to control a toddler is nigh impossible, especially if they throw themselves on the floor in tantrum because you can't lift. I am still picking up the pieces of my daughters lack of discipline while I was unable to lift her to put her in time out, pick her up to cuddle her, put her to bed due to her having a cabin bed, tuck her chair in at the dinner table, push her on her trike, take her to the park on my own because I couldn't run after her if she legged it................................We have had constant tantrums because as well as her new sister to deal with all her boundries moved.

Ah, birth. It's miserable whichever way you look at it. A choice of pain during, or pain after, and an option of whether you'd like he scar tissue in your bikini line or tucked away on your perineum. But you do get a lovely baby out of it so there are some up sides!

ladies ladies, stop fighting, the whole how to give birth palava is getting silly, spent most of evening reading this thread and surely the only thing that matters is a safe mum and baby whatever their choice, i desperately wanted a normal birth but after 4days in pain, failure to progress from 6cm after 36 hours, baby in distress and heartbeat fluctuating and doctors recomendation, had emcs under epidural which i also did not want. had nothing to do with my pain threshold, fear, phobia or to posh to push, i just had to for my childs life, would do it again. how i had my baby does not make me love her any less. it was painful but was fully supported by dp and mum, agree with skimty, lily was very calm, peaceful and fell into routine easily for those first few months and i know a couple of babies who are very unsettled in the first few weeks after vaginal birth. i would have a cs any day, but the problems have not really put me of natural birth, i think if it could happen that way next time i would be glad just for the experience. think every woman should experience natural birth, all part of being a woman with the ability to give life .

Can I just apologise, Fabsmum? I re-read the post that you had written that had annoyed me and realised I had misunderstood you. I thought you had said that you didn't count psychological reasons as a reason for a c-section but you had actually said that you did. That'll teach me to get into a debate when my brains not firing on all cylinders...