Natural - v - Caesarean - a new thread

[JoolsToo]

sorry to be bossy but can we carry on here?

I'm for natural when possible

aloha, your experience sounds horrific...not least due to being on your own, which is totally unacceptable imo, but fairly common in nhs

Funnily enough, I thought I was totally over it, but after posting here, burst into tears again last night thinking about it
I certainly would never persuade anyone to have a section, and my friends do feel free to tell me about their birth experiences, good and bad, and I do know that people can and do enjoy vb, especially if well cared for. I wasn't particularly scared of going into labour myself, and I knew all the risks and benefits and even about possible risks that doctors don't talk about, but the reality was a huge shock to me. I even suspect that one of the reasons I was left so long was because they were hoping that this way I would have a natural birth by the back door, so to speak.

Aloha, you're bound to still feel upset, it was very recent. I know what it's like to cry at the memory of childbirth too, really I do (my 2nd was horrible). It's so awful that you were left alone by a callous midwife. Sorry if my posts have contributed to your feeling

This is probably going to be a bit rambly as am trying to BF while posting and brain has turned to soup

Have totally lost place on this thread so may be talking out of my hat (or other places) but one of the things that really surprised me was that the antenatal classes really pushed pethidine and were anti epidurals, when as far as I understand it (which may well be wrong)oethidine can affect the baby and the drugs in an epi don't (unless you have an LDE in which case it is basically pethidine anyway).

In re c-sections, I don't think surgeons do them for a laugh but only when they feel there is the need - there has been a case at my local hospital where a baby has been damaged because the mws were so keen to have a vb that they let the mum hang on too long. If consultants ARE too quick off the mark, I think mws are sometimes equally culpable in the opposite direction. But then I am prejudiced as my mw apparently tried to kill me by failing to notice raving pre-eclampsia.

And finally (hurrah!) am right with whoever said that attitudes to people with non-straightforward births contribute to PND - spent first days of ds's life lying in intensive care thinking I had blown entire birth process, bonding with ds, breastfeeding and everything else, all so far proven to be bs; what a waste of energy and stress!

www: i thought second births were meant to be easier

aloha, i'm so sorry that you're still feeling this so much, it's awful...surely there should be guidelines that state that women in labour shouldn't be left alone more than x (i'd say 10 mins) amount of time...mears???

morning paper, in fact, if you read carefully the link to the bladder knicking that you posted, a large percentage of the women that did have their bladder knicked were women who had already had one cs. So in fact the chances of getting your bladder knicked if it's your first cs is even less than that. So altogether a very very remote chance ...probably more likely to get hit by a taxi crossing the street...so perhaps one should stop crossing the street!

Anyway, I had the same awful traumatic first 40 hour labor (complete with evil mw's incompetent consultants and broken hospital) ending in a cs that aloha had. I had a successful vbac (only 5.5 hrs labor) second time around, but did have a postpartum haemmorage (unrelated to previous cs) and almost died. I do not intend to have any more children, but if I did, I would seriously consider having an elective cs this time. I don't think my 40+ year old body would be able to take the rigors of labor again. I think that if we push the boundaries of what nature intended (we were designed to have babies at 13 not 40), then we should take full advantage (if we want to!) of the medical advances of the last century and mitigate the effects of having pushed those boundaries.

About 20 hours into my labor, I was given a shot of pethedine and then was left alone for 12 hours! I dialated to 7cm during that time.
And I most certainly wasn't checked every 15mins after having my cs. I don't think I was checked more often than every few hours. Women who had a cs before me almost bled to death because no one check on her and her family kept asking the midwives why she was bleeding and no one paid any attention them them and they finally physically dragged a consultant in who realized that something actually was wrong...I agree with aloha...I would much rather have an elective cs than a possibility of going through that again.

I found pethidine only made me drowsy but each time I got a contraction - boy did I come round!

Following on from SofiaAmes interesting comments, is there any research that relates the increase in c sections in the UK to an increase in the average age of first time mothers?

I can't remember what the average age is now (know I've read it somewhere) - 29 or 30 I think.

Thinking about my personal circumstances, I do feel if I had been 25, not 35 I might not have had a c section the first time round. But, I've nothing to base that on except gut instinct.

Just spent the last 2 hours reading all these interesting posts and it's now way past my bedtime! I agree that labour can be a very traumatic experience. I attended NCT classes and the like prior to having my first ds, but I found the whole business of my body being 'taken over' by labour very frightening and I was totally unprepared for the intensity of the pain. When it became unbearable and I asked for pain relief I was told it was too late for pethidine , so was given gas & air, which just didn't seem to have any effect at all. I too felt as if I were being tortured. I remember thinking 'now I know what it must have felt like to be burned at the stake or stretched on a rack.' I just wanted it to stop. I was fortunate that the most painful stage of labour was fairly short and intense (about 4 hours). I now realise with hindsight that after the birth I probably suffered from PTSD for about a month afterwards; had nightmares, was very tearful and couldn't sleep as I kept reliving the labour experience.
My next labour was very different. Twin pregnancy; waters broke at 29 weeks. Mild contractions followed by induction of labour, followed by very intense and painful contractions, a failed epidural, contractions forced the twins into the birth canal together and I was told if I didn't have a cs now both they and I could die. So had a true emergency caesarean under general anaesthetic, followed a day later by the deaths of ds2 and ds3 from respiritory problems. I took a month to recover physically from the cs, and to this day (23 years later) the scar (6 inches and vertical) still itches from time to time.
Third labour was at 36 weeks with epidural (in case of another emergency cs) and was a very peaceful and euphoric experience compared with the other two. I didn't consider asking for a cs (I don't think they were available 'on demand' then anyway) and wouldn't have wanted one as, for me ,the previous one had been a horrible experience.
I really think a mother should have the kind of birth that she wants and that she feels is right for her and her baby. The birth of a child is such an emotionally important time for a woman. It shouldn't be spoiled by fear and pain. But I'm not sure that having a cs under the NHS should be a woman's 'right'. The choice should be there, but if there is no 'medical' reason then perhaps there should be a charge for the difference in cost involved. I'm sure most women that opt for a cs would be happy to pay for it rather than have a vb.

80smum, I'm so sorry about your babies. Sophables, second baby for me but different partner and quite a gap - first was 7lb in 1997, 2nd was 9lb 8 in 2003, quite a difference! Puffthemagicdragon, that RCOG report looks at the reasons for the rise in c sections but I don't think maternal age is mentioned.

It is truly scandalous that women are left alone in labour/after surgery, it really is. Is there still a chronic shortage of midwives?

80s mum, so sorry to hear about your babies.

My experience of diamorphine (virtually identical to pethidine I understand) was that I stopped dilating, and DS became distressed, so that I ended up on a Syntocin drip to get my contractions going again. In fairness, I had been told that there was a risk of that happening at an ante-natal class - unfortunately after a sleepless night and long pre-labour I clean forgot that!!! I do think that there is a valid point that pain relief can carry risks and/or not be successful, so that can be one advantage of avoiding pain relief - don't think there are any risks to gas and air???

Oh, 80's mum. That is a shocking and horrible story.

80smum, how awful! What a terrible story.

I cannot agree that women who choose sections should be charged for them. After all, if that was the case, surely the cheapest possible birth should be costed out, and anyone who wanted any more than that should be charged the 'excess' - so no more birth centres with pools, no more midwives, no birthing balls.. etc etc. Also, if you are arguing that any costs should be borne by the woman, then suppose a woman wanted to try for a vb after being informed it probably wouldn't happen by a consultant, and laboured for several hours attended by a midwife then had to have a cs, should she be charged extra too?

I have been mulling and mulling over all this. I was an active birth evangelist pre-DS, and know that it is the approach that feels right for me. I am also in complete agrement with Aloha and feel passionately about informed choice. In that context, bandying about of overall statistics are pretty much meaningless for individual women - CS's can be the perfect solution (for Aloha) or a devastating (Marina), vb creates similiarly diverse experiences. Safety stats will depend on the individual circumstances of the woman, her pregnancy, the skill of either mw and/or consultant - even on whether they are having good day, tired or whatever.

So, where do our strong views come from? I can't deny that there IS a moral hierarchy implied, along the lines of Aloha's bus journey analogy, and I would admit to suscribing to that pre-birth. Why? For me it may have a lot to do with the roots of 70s feminism when I was in my teens. I was deeply affected by the horrific reports of 1950s medicalised birth - the green gown, stranded beetle, legs up and enema version which sounded like humiliating torture. It affected me so deeply that I think it put me off the idea of birth altogether, and certainly fuelled my own vehement feminism. And then came 'Our bodies Ourselves' and Shiela Kitzinger, simultaneously accusing doctors of medicalising women into a male controlled birth process, and developing 'active birth' and a 'woman-centred' midwife led birth experience, with all the stereotypes that went with it. And, tbh, it was only this version of birth that I could bear to accomodate in my imagination. To the point where I refused to go on thhe ante-natal hospital visit or pack a bag in advance as a contingency for my planned home waterbirth. Lurking in my unconscious mind, 'feminist' women did it with breathing at home, others 'succumbed' to a male conspiracy.

Of course this is now as outdated as the green gown, and a ridiculous polarisation. The only way forward now is a woman-centred approach which enables the woman to take a strong active informed choice about her options and own particular circumstances. Birth HAS moved on, in hospitals, and all methods of birth are now, essentially, safe in the right circumstances. IMO there is still a case to be made for more dignity for labouring women in hospitals - and much of that depends on the will and resources for women to be listened to - whatever their choice. And I think we should make sure that the lurking 'moral hierarchy' is seen as what it is; an affront to a woman's right to make choices about her own body - -and an anti-feminist one at that!

Very nice post, Blu. I wonder though if in the majority of cases the "moral hierarchy" is founded on any feminist reading (whether outdated or not) or just not thinking before talking.

Oh dear, like in my case. I'm sure I could have phrased that better.

Agree with Aloha re if a woman requests a section they should not be charged for it. I think the majority of women who ask for one don't do so lightly, and if the doctors are doing their job properly, its being made v clear that cs is in no way an easy option. And, I can't see that this group of women are the reason for the significant rise in caesarean rates.

I do feel that part of the problem is the fear of litigation. If a problem presents in childbirth, the consultants are going to opt for the known risks of cs rather than unknown risks of continuing with a vb. So they jump in earlier than is perhaps necessary in a number of births. Many of the problems which can appear with a vb would resolve themselves naturally given the opportunity, but consultants don't want to take the risk that they don't.

I guess I hadn't thought the charging for it thing through. It was 3 in the morning when I posted!
Thanks for your kind words everyone btw.

So sorry to hear of your awful experience 80smum.

The charging issue is interesting, because of course that's the reason why the government is suddenly interested in this issue. Wasn't there a flurry of interest a few months ago, where it was suggested that women should not be allowed to have non-medically advised caesarean sections on the NHS, because they cost more than vbs and so therefore these women were sucking the NHS dry and killing cancer patients? (That was the general tone of the reports from what I remember - made me feel like I was single handedly responsible for killing half the patients in my local hospital!)

Obviously I don't agree with that - I believe that the taxpayer should pay for a woman's right to choose in this area of life, but I do think that there should be more resources put into maternity services so that the choices are genuine. A choice between a quick, safe and relatively painless operation and hours and hours of hell and humiliation with possible PTSD afterwards isn't really a genuine choice, is it?