C-sections 'a rational choice'

[AtheneNoctua]

I couldn't agree more.

news.bbc.co.uk/1/hi/health/8057785.stm

That's no say everyone should have one. Just those who want to.

Well I'm all for choice - but C-sections cost the NHS so much more than a vaginal delivery, perhaps if women want a section (for non medical reasons) it should be a paid-for option?

Sorry but I thought C-sections were riskier for both mother and child?

I would have one if absolutely necessary but the recovery afterwards seems so much longer and more painful than after a vaginal birth.

i disagree with the bit about cosmetic surgery not attracting criticism.

women should be able to choose mode of delivery as far as is possible, but there are cost implications to more c.s births

also don't like the implication that not wanting a c.s or opting for a homebirth is somehow foolishly rejecting modern medicine and technology

MWs dont attend homebirths equipemnet free.women giving birth in MLUs still have access to medical help. there are many shades of grey between homebirth good. c.s bad and vice versa

But surely the solution is to provide better care and support for regular births whre there are no complications neccessitating a section? Why complicate a very well designed system?
Besides, to use Africa as an exmple is totally disengenuous - women die there becasue of lack of attendants, poor hygiene, poor health, poor ante-natl care....

I don't agree at all.

Nowt wrong with a section when neccessary, but not for straightforward deliveries.

Agree with lulumama. I've had three natural births, and two of them were home water births. I was lucky that every thing went well. I dislike the implication that because I've had home births I am rejecting modern medicine. I did not reject modern medicine -I had two highly qualified midwives, monitoring equipment, resus equipment, and medication for pph. C-sections in many instances are life savers, and I would agree to having one if it had been medically necessary.

Have fun!

oh and my insurance company considered my home births better value for money then hospital births because I got refunded for them (ie. I was paid to have a homebirth)

I don't agree that you should be able to choose a section if you want one and more than I should be able to choose to have any unnecessary surgery just because I want it. I pay a lot of ta, but not that much, and I don't expect other taxpayers to foot the bill for my whims.

C-section as an option in cases where there is increased risk - absolutely fine.

Why should people be made to feel like they're naively shunning modern technology just because they don't want unnecessary interventions? The key thing here is the unnecessary bit - a lot of birth is medicalised these days which impairs the woman's experience of birth and bonding with her child. If it has to be done for safety then so be it, but this guy sounds very pro-intervention, very "I'm a doctor and I know more than these hysterical women".

any more, sorry

I had a C-section as both twins were breech but would have preferred a natural vaginal birth and would definitely aim for that if I was every crazy enough to have more children. That said, I don't like the negative tag that is sometimes attached to C-sections and the sense of having somehow 'failed' but actively encouraging women to opt for caesareans simply because they are more technological seems a bit weird to say the least... The article suggests women should have more choice but then seems to ridicule home births.

recenlty went through the c.s consent form and i really ,really feel it is serious stuff and not to be taken lightly.it is amazing we have access to safe,clean ,sterile operating theatres for c.s births where necessary..it was developed as a life saving procedure , and now it has become something regarded as a choice.

also need to ask why we are becoming so afraid of birth,that surgery is more and more necessary as a choice?

i honestly believe if women had one to one care throughout their pregnancies, and built up a relationship with their MW , a lot of the fear would dissipate and women would feel more confident. more MLUs ,birthing centres and home from home places would be great too. being in a hospital to give birth in a CLU does make it harder to keep things 'natural'.

understaffed and overstretched labour wards do have an impact anyway on the rising c.s rate

I have no problems with women opting for c-sections provided that they are provided with the information to make an informed choice. Prehaps there needs to be better ante natal care or one to one councelling to help women who are truely terrifed. However a woman is more than an incubator and if she is really fearful then prehaps she should have a c-section for social reasons on the NHS.

However I have not met anyone in real life who had a c-section because they were too posh to push. I have met plenty of women who ended up with c-sections because of shit inadequate care. Improving maternity care will never be achieved by bullying women into natural birth.

Yes, c-sections are safe, but its a major operation. I believe its also quite painful and it takes several weeks to recover.

Having had 3 sections and 2 normal births, I don't get why someone would choose c section for non medical reasons. I almost bled to death after my 2nd one and was rushed back to theatre for another op. Awful. I also found recovery awful. 6 months on my scar still hurts after 3rd one.

sorry, but it is my rite of passage, unless it is a medical emergency.

I've had a section and it left me scarred and took months to recover from. That's not to say the same outcome is impossible with a VB but it isn't something to go into lightly. And this guy seems to be saying it is.

I think a big issue is fear on the part of medics. I am a vet and often have to make the decision whether a section is necessary. There's a lot of pressure to make the right decision - attempting a vaginal delivery where there's not enough room can be catastrophic but you don't want to inflict unnecessary surgery on anything. The safe option is always the section but it takes a degree of skill and confidence in oneself to say "No, a vaginal delivery will be ok" - and at the end of the day, you don't know that for sure until you try. SO doctor's are being asked to make a huge judgement call and I suspect often "play it safe". Who can blame them?

I guess what's important is close monitoring and experienced staff. It all costs money!

"attempting a vaginal delivery where there's not enough room can be catastrophic"

But it very rarely is the the UK because women are carefully monitored in labour and have ready access to an operating theatre if a labour doesn't progress - which is the usual outcome if there isn't enough room for a baby to get out.

Even shoulder dystocia rarely results in catastrophic injury to babies in this country.

"The safe option is always the section"

Sorry - how can a c/s 'always' be a safe option when it's far more likely to end up with a woman needing admitting to intensive care or losing her uterus than after a vaginal birth?

No one is saying that everyone should have a section. Just that it is a sensible choice and women should not be discouraged from making it. And lets fact all the "advice" a pregnant woman gets in this country is very much slanted toward natural is good and surgery is bad. But, atually, surgery = safe is a ver logical conclusion.

If you prefer a natuarl home birth. That's fine too. But it is only one option.

If you want to start cutting cost for the NHS go ahead, but don't start and end with childbirth. We can cut out all those unecessary halth visitors and social workers. And then we can stop treating smokers and fat people because of course they caused their own problems and I just pay tax for them. And depression is all in your head, isn't it? And by all means no more bipass surgery for old men who don't excercise regularly.

gabygirl - I must stress, I am not a doctor! I am just saying that the fear of making that mistake must weigh heavily on a doctor.

And a section is seen as a safe option by many women, and evidently by the medic who wrote the article. Statistically it isn't safer, of course, but it does offer medics more control which I think many people tend to prefer.

It's absolutely outrageous that women in this country can't choose to have a c-section if they want to, after being fully informed of all the risks, of course.

I take Lulu's point about the consent form for c-sections, but what would a similar consent form for vaginal delivery look like, if it existed? I, personally, know two people whose babies have suffered horrendous complications as a result of vaginal deliveries - won't post stories as don't want to scare anyone. But women should be allowed to look at the risks on each side (and there are very serious, though fortunately unlikely in this country, risks on both sides) and then decide for themselves. Make no mistake - this would be the case if men had to give birth!

Brilliant article Athene. I had an elective CS. Very nice experience. I was home the next day and recovered easily within 4-6 weeks. My consultant as well as every one of the female theatre staff had had one also. I don't feel that the female body is always a "very well designed system" - my mother and Aunt both had natural births with major issues as a result of nothing other than a natural birth. As for individuals paying for elective CS - I don't smoke and rarely eat fast food, so what about all the lung cancer patients or gastro bypasses out there, that are not always needed because of something out of their control. I've had one elective CS, and I'll be having another. the NHS has way more problems than the cost of Elective CS's!

Athene - cross posted!! Agreed!

Cherrychoc do you honestly think that the nhs should hand out service/treatment according to cost?
Bye bye all those cancer/alzheimer/chronic disease sufferers then...

What about the increase in infertility following caesarean? Is that a risk worth taking if the CS is not medically required?

Having had one emcs, and debating what to do this time round, I'm erring more and more on the side of elective cs. I certainly do not see vaginal delivery as somehow more affirming, 'real', or more of a desirable experience.

Personally I didn't get pregnant for the experience of childbirth - did it to have a child.

Where are the figures/research/experiences to back up some of the assertions made on this thread? Eg that cs results in less bonding between mother and child, that cs is much riskier for mother and baby (in what ways?), or "it's far more likely to end up with a woman needing admitting to intensive care or losing her uterus than after a vaginal birth? "

What is this statement based on?

information regarding SC

Although American, it applies here too.