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Childbirth

Share experiences and get support around labour, birth and recovery.

Original poster

C-sections 'a rational choice'

314 replies

AtheneNoctua · 20/05/2009 13:38

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.

OP posts:
Penthesileia · 22/05/2009 20:16

I meant to put a after "pristine".

Penthesileia · 22/05/2009 20:19

Actually, I regret rising to blueshoes' bait, and apologise for any offence I might have caused to anyone in so doing.

I have stated in this thread that I believe CS is a rational choice. I believe women should be able to make informed choices about birth.

It's sad that people are reduced to sniping at each other; and I regret finally doing the same. Sorry.

I'm leaving this thread now.

Congrats again, Cote.

LibrasBiscuitsOfFortune · 22/05/2009 20:25

Please would people stop using cost as an excuse for denying women the choice of having a c-section. The NHS pays for a lot of procedures which wouldn't be medically necessary if a person had an ounce of willpower, if you are to allow the NHS to pay for these I don't see why the NHS can't cough up for c-sections.

LibrasBiscuitsOfFortune · 22/05/2009 20:28

Penthesileia I think it is possible to disagree with someones choice but still support their right to make their choice. I personally think people who deliver at home are bonkers BUT I would defend their right to have a home birth if they so wish.

bigstripeytiger · 22/05/2009 20:33

The arguement with C Sections is a bit different, because of the timing. At the time someone asks for a medically unnecessary section, it is, er, medically unecessary.
I presume that when you are talking about will power you mean treatments for diseases caused by smoking, obesity, alcohol etc. The difference with these it that by the time it is obvious treatment is required it is acutually needed, regardless of the cause.

So when someone asks for a section for no reason doing it or not doing it are both(pretty much) valid options. But if someone is bleeding to death from a gastric bleed as a result of chronic alcohol use then the doctor really just has to get on and treat it.

pmk1 · 22/05/2009 20:35

Penthesileia,
Congratulations on successful homebirth, seriously.
However, what about if you had post partum haemorrhage, or what if there was foetal distress and a paediatrician was needed urgently, or the child needed urgent admission to special care baby unit etc? One could argue that that is slightly selfish that the needs of the mother with a warm and fuzzy midwife are met, but potentially not the baby? And also, when a midwife is attending your homebirth, she can't be attending to another women in the next room keeping in mind the labour could go on for hours and hours?
Also, don't forget, in the early part of the last century, women campaigned tirelessly for the right to give birth in a hospital due to the attendant risks of homebirths. I'm anticipating you will argue that they are all community midwives, therefore that is all they do, however one cannot deny that one midwife looking after 3 women in a hospital is a far more efficient use of her time? Perhaps this is why the care is so crap within NHS.... but anyway, if you thought of all those things - fine, but each to their own.

blueshoes · 22/05/2009 20:39

bigstripeytiger: "blueshoes How can you say that the baby is more at risk in a home birth than a hospital birth, and the acknowledge that both are equally safe for the baby?"

I said nothing of the sort. I believe that a home birth is more dangerous for a baby if something goes wrong in the birth. Would never consider it unless I can minimise it by living within spitting distance of a hospital.

Penth, laceration of a baby is much much lower in the calm and soothing theatre of an elective section. Another scare cs risk? Far better than a trial of vaginal birth (VBAC in my case) ending up in emergency section. Which happened in the case of my first birth, crash under GA, because I was so adamant I wanted no pain relief there was no time to put in a spinal.

bigstripeytiger · 22/05/2009 20:42

So Penthesilia is risking her baby, even though the risk is the same in home and hospital?
If the hospital doesnt carry the risk of, as you say "post partum haemorrhage, or what if there was foetal distress and a paediatrician was needed urgently, or the child needed urgent admission to special care baby unit etc? " then there are other risks that are special to hospital arent there, Im guessing that unnecessary intervention and hospital aquired infection will be contributing to that.

But then on the other hand you say she is selfish for staying at home, getting individual care, and not exposing herself to suboptimal hospital care?

So is she selfish for staying at home and getting worse care or for staying at home and getting better care?

bigstripeytiger · 22/05/2009 20:44

blueshoes, studies say that homebirth is as safe as hospital. You might not believe that, but that is the evidence we have.

pmk1 · 22/05/2009 20:51

I do believe homebirths monopolize the time of the midwife, but since a midwife doesn't do a lot more at home than she would do in a hospital, that's a side issue. I think the main concern for me, would be the immediate care of the baby, and access to urgent treatment and care etc which isn't available at home.

pmk1 · 22/05/2009 20:56

Bigstripeytiger, Whilst I could see that the incidents of complications in a homebirth may be similar to a hospital birth, I am meerly emphasising the potential for significantly worse outcome, should an adverse event occur which could be catostrophic - I'm looking at the big picture here.

pmk1 · 22/05/2009 20:59

Anyway, this has turned into a homebirth vs hospital birth thread, and I think it's going around in circles, so must say cheerio for now

bigstripeytiger · 22/05/2009 21:02

The risk of the baby dying is the same in both home and hospital birth.

BigBellasBeerBelly · 22/05/2009 21:05

The interesting thing about homebirths is that they are really only suitable (i guess) for the sort of people who like the idea of homebirths.

If someone told me I had to give birth at home i would be utterly terrified. I would panic. I would not be able to relax, I would think something awful was going to happen and everyone was going to die. I like hospitals. They are safe and full of lovely professional types and equipment. They relax me. That is the sort of person I am.

So if I had a homebirth, even if it went fine i would be traumatised because I would have been utterly terrified.

So it's more complicated than the stats. Homebirths are better, maybe, for the sort of people who like homebirths. Not really very conclusive.

I suppose the converse is true for people who don't like hospitals...

blueshoes · 22/05/2009 21:11

bigstripeytiger, it is not just baby death I am concerned about. It is brain injury as well.

My baby went into distress during labour. This would not have been detected if I was not continuously monitored. It was such a emergency I was put unconscious under GA immediately after signing the consent form and dd was born within 11 minutes of the decision to do a cs. She was whisked straight into NICU. I was in a hospital.

Now tell me a home birth is safer for dd.

pmk1 · 22/05/2009 21:17

exactly blueshoes......

bigstripeytiger · 22/05/2009 21:25

This is the most recent study.

BJOG

It showed no difference in mortality or in admissions to neonatal intensive care.

blueshoes · 22/05/2009 21:29

bigstripeytiger, your link does not work.

I am not interested in that 100 women had home births and 100 women birthed in a hospital and the same number of women's babies died or were admitted to SCBU.

I am only interested that if my baby were the one admitted to SCBU, he/she had the best chance of survival with minimal brain damage.

Once again, in my scenario, you say I/dd would have been better off if I had given birth at home?

bigstripeytiger · 22/05/2009 21:57

Try this one.

BJOG

Who can say if you would have been better off in home of hospital? You did what you did, and its not possible to go back and re-run in in a different location.

The evidence is that everything else being equal it doesnt make any difference if low risk women give birth in home or hosoital, though within those figures I expect there will be people who have babies at home who would have been better off in hospital, and people who have babies in hospital who would have been better off at home.

I expect that, as a previous post discussed, what the woman feels comfortable with is important.

I agree that it doesnt make a lot of sense that they are the same, why dont all the hospital facilities and staffing make a difference? Thats probably the question we should be asking.

blueshoes · 22/05/2009 22:06

bigstripeytiger, you must be deliberately avoiding the question. As if there was any chance, knowing what happened, that I would have 're-run' the birth at home! I and dd was much safer being within 11 minutes of a surgical birth in a hospital - fact.

The degree of brain damage is hardly measurable at birth for the purposes of a study. And it is the degree of brain damage, not whether she was admitted to SCBU or not, that I am concerned with.

dinny · 22/05/2009 22:07

my third baby is 12 weeks old and after 2 quick and stitch-free labours, I had a really long labour and awful tearing/stitches....just so relieved dd2 arrived safely though

am not having any more children, but if I did I would pay for an elective

bigstripeytiger · 22/05/2009 22:11

What question do you think I am avoiding?

blueshoes · 22/05/2009 22:16

Whether it was safer for my baby to have delivered at home in the light of my need for a crash section due to dd's distress.

bigstripeytiger · 22/05/2009 22:20

Like I said, how could I know?

On average the risks are the same. Within that broad figure there will be differences.

As I know nothing about you I have no idea why you are asking me to speculate?

blueshoes · 22/05/2009 22:46

I have stated the facts in my posts. If you prefer not to read, that is fine. If you prefer to live in the world of statistics and probability, that is your prerogative, but it is no use to women who make real decisions.

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