Interesting article in the guardian about obstetricians going for elective c-sections

[FairyMum]

www.guardian.co.uk/society/2008/jul/11/nhs.health1

This is interesting. My neighbour is an obstetrician who was very adament that her DD
should have an elective c-section. I also have two friedns who are GPs who both had elective c-sections privately and
say they would not even entertain the idea of a vaginal birth.

MNC, no mode of birth is going to come with guarantees, unfortunately.

oh, and, hiya, mears!

i'm 24 weeks along with this one and hoping for a waterbirth at Dunoon General, but we'll see if this ol' body cooperates this time round.

I got one of each in one birth! Does that make me greedy?

On a serious note, I wouldn't even know if the hospital didn't CC us on all letters they send about us, officially no one has told me!

Oh goodluck Hatrick thought it was soon but not that soon
MNC you will get some good opinions if you post again after a couple of weeks, if you can vary the question you will get lots of different ones, you could then use some of the info to aid the questions you have for your MW so you can get answers applicable to you
night all nice talking to you

TBM, a T shaped incision is considered more likely to break down. It counts as a 'classical' because there has been an incision in the vertical however small.
It would be usual to advise a repeat CS (the normal way, with the uterine incision the correct size this time) but I am certain you will find elective CS a better experience than your last. FWIW, a classical (up and down) cut is fairly common at 31 weeks. They shouldn't have to cut your muscles, just tug, but even so I know it takes aaaages for them to feel the same again.
HTH.

I don't think you can compare outcomes for vaginal vs elective c-section in the UK without acknowledging that many women who are labouring in NHS hospitals are labouring under very suboptimal conditions.

Elective c-section: half a dozen experienced staff all to yourself

Vaginal birth: one third of a stressed out midwife!

No wonder so many women think that elective section is safer (I personally don't think it is - even given the barriers put in the way of a safe, happy birth for so many women in our hospitals, but I understand how other people arrive at this conclusion).

If they ever do decide to offer elective sections on demand, I think we should all insist that those of us who wouldn't want one be offered the money to spend on the services an independent midwife instead!

am sure i am repeating what has already been said, but if women knew they were going to get to the labour ward, be met by a midwife they knew , who they got on with , who knew their birth preferences...

who could labour in nice , homely, comfy room with dimmable lights,a birth pool, bean bags, things to hang on etc... rather than a sterile looking room with a bed dominating

who could have a homebirth with the full support of the midwives and not have to fight for it

who could know that if they wanted an epidural, the aneasthatist would be available as there was more than one on site

who could know that they could have 3 birth partners if they wanted, who could have access to food and drink in the delivery suite, rather than having to disappear off to find it, or bring a packed lunch

and knew that they would be treated with dignity and care and respect

then i reckon the issue of elective sections would be reduced

becasue i thikn for many, it is the element of control that is retained when you choose a section .

i urge you all to look at the www.aims.org.uk site and support the one mother one midwife campaign

Hear hear lulumama!
That's one of my biggest problems with choosing to have a VB this time around. I can go through my birth plan with the CMW until we're both blue in the face, but once I arrive at the hospital I have no idea whether the MW or OB on duty will support me in it. And I'm not in the best position to argue my case! And having been "treated" without my consent and then lied to about it, my trust in the medical profession is not at it's highest.

I was also told by a GP that she had had three sections (during an appointment about my painful scarring following an instrumental birth). I think that the advantage of being a medical professional is that you know that your choices will be taken seriously, whether it's for a VB or a CS. Again, it's an issue of trust and control. Treating all women like stupid children must surely increase the amount of intervention needed.

Not just obstetricians. A lovely friend of mine who is a gp did a placement in high risk obs during her studies and it made her scared of childbirth. When she got pregnant she was determined not to ask for an epidural straight away, but was pretty intervention focused.

In the end she had a lovely straightforward 6 hour gas and air on her knees hanging off the bed delivery and i was extraordinarily pleased about that . I think that did change her perpective.

Of course I was going to give birth on hands and knees on my living room floor and ended up with induction and forceps

[stands behind lulumama's soapbox frantically nodding and giving the thumbs up!]

MrsNameChange I don't think anyone should be trounced if they decide to have an elective ceasarean, I might not agree with their reasoning but it's not my choice to make it's theirs. The reason I think this article is complete bollocks is that it seems to be saying 'Look, see, female doctors with knowledge all have elective CS and us poor saps have to put up with vaginal births and all the problems that can occur with this' as if it is some sort of huge conspiracy. Yet more scarmongering about a process that is scary to most of us however much we try to educate ourselves about it.

From my experience (I am not medical, my husband is and therefore I know quite a few female doctors who are having/had babies) this is simple not true about doctors choosing CS they have all chosen vaginal birth (even if they knew they were going to demand an epidural from the word go!).

I'm with Lulumama on this however, the impression I often get is home vs hospital when really we should be working to improve the services for both.

Well as a midwife I have had two great births, due to the fact that I am very well informed and had everything that lulu mentioned in her post.

Most of my colleagues who have had babies in the last few years have had normal births (mainly at home or in birth centres, the exceptions are an ivf preg in her forties, someone who had to have an em cs to save her baby when she stopped moving at 38 weeks, and someone who was induced early at her request and ended up with an em cs)

I must have worked with hundreds of mw's in the past 14 years. I know of 3 that I can remember who have had elective cs, one had twins, so that was definately understandable. One had become pregnant after about 7 years of infertility treatment, again can understand why she would not want to labour, the other one just wanted to have a cs. I once worked with an obstetrician who had 5 el sections. On the last one she had to have a hysterectomy and almost died, and I believe she told her women that she had had long term bladder problems, didn't stop her from booking women in for elective sections though.

Maxbear, if the obstetrician you mention had had 5 VBs, with the last one going wrong - would you think it acceptable for her to discourge her women from a VB? If not why not?

Also, why is it understandable for someone becoming pg after 7 years of infertility treatment to have a ELCS? What's CS got to offer in that case that a VB hasn't?

god i would luuuuuurve elective section

i have heard say amongst medical friends ( and my last midwife) that anaesthetists always have epidurals

'who could know that if they wanted an epidural, the aneasthatist would be available as there was more than one on site'

I think that's why a lot of people ask for them from the get go, tbh.

Because I know I waited hours in A LOT of pain - baby OP with her hand up over her ear cupping her head, first baby - for one.

agree expat - wholeheartedly

at the hosp i have booked in this time - they said it takes an hour to get an anaesthetist therefore we are telling them we need one at the outset - before we drive the 40 mins

reading that article freaks me

cynically i dont believe the 'its not about the pain' slant either

child birth hurts and watching all that pain has no effect on these women?

babyelephant, statistically it is much less likely that someone (who is otherwise low risk as this lady was) would have such huge life threatening problems after 5 vb's than after 5 cs.

I would say that if someone's reproductive system does not work to get them pregnant naturally then why should it work to give birth. Don't get me wrong sometimes people who have had ivf do have normal births, but often they don't, possibly due to obstetrician anxiety, possibly due to a lot of these mums being in their forties, I could understand why someone who has tried for such a long time would request a cs, especially if it might be their only child. A lot of the problems with caesarians are that they cause more problems in subsequent pregnancies, if it is likely to be your only pregnancy then it is much less of an issue isn't it.

I'm not against people having elective sections if they genuinely feel that that is the best option, however I do believe that most people who find out about all of the facts would go for a vaginal birth.

i read that article thought it was interesting. i suppose they only see the bad stuff though, but the incontinence thing was slightly scary

What is safer for the baby? elective section or vaginal? having had bad experience myself with a baby who nearly died during labour and sadly knowing people who lost babies or ended up with brain damaged babies after vaginal labour, I perceive the risk to the baby less with elective section. I am finished having babies, so doesn't really matter to me now, but I loved my elective sections. I felt completely safe in the hand of the surgeons. After a few bad experiences, midwives freak me out and I think there are many incompetent ones.

Fairy I know a few very scary Cbirth stories. One of the women was my cousin and it involved intensive care. I don't, however, want to list stories of Cbirths gone wrong for mother or baby. Statistically there is less risk with a vb than a cb.

I'm sorry that your vb was so awful.

Butterfly - I've heard that about anaesthetists too!! Let's face it - childbirth hurts like hell!!
The high you get after doing it naturally is incredible, but it still damn well hurts like nothing on earth!!
I had two natural births and one Csection under epidural. CSection was not painful. Siting the epidural, and the after effects of major surgery arent a picnic, but no way do they compare to the pain of giving birth. I still feel VERY wary about advocating the CSection route though, without sound medical reasons. The stats show that vaginal birth without instruments is the safest form of delivery.

Yes, I remember reading and doing lots of research into cs vs. vaginal and sort of know the stats. Even so I perceive an elective as far far safer. And I normally think people who base their views and opinions purely on acedotal evidence as soooooo silly. Silly me, but I would still go for an elective any day just to avoid the midwives.