Meet the Other Phone. Only the apps you allow.

Meet the Other Phone.
Only the apps you allow.

Buy now

Please or to access all these features

Childbirth

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

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:
LadyThompson · 22/05/2009 08:50

I am very pleased for Cote as I have been following her story. Congratulations!

Just to throw another story into the mix, I had an elective cs in November, privately, (the baby was transverse though I would have wanted one anyway) and my scar is more or less invisible. I couldn't feel more positive about the birth. Interesting, my wonderful obstetrician had had two sections herself.

BonsoirAnna · 22/05/2009 09:06

I don't think an obstetrician cannot deliver a baby. But I do believe that obstetricians deliver babies (and monitor pregnancies) using different techniques to MWs - because that's what obstetricians and MWs both claim, IME!

BigBellasBeerBelly · 22/05/2009 09:33

However an obstetrician could deliver a baby "midwife style" if they wanted, while a midwife couldn't deliver a baby other than naturally without years of training.

FWIW I am consultant and midwife shared care at the mo and at my ante-natal appointments exactly the same checks have been done and exactly the same questions asked.

MrsHappy · 22/05/2009 09:34

I agree with that Anna.
I know a few OBs socially who will admit that they really have seen comparatively few unmedicated, unassisted births, because those are not what OBs are for. They tend to get involved in births because things are not right.

MWs on the other hand are the experts at promoting natural births, spotting problems early and calling in the doctors if need be.

They are both very qualified, but have different skills.

BonsoirAnna · 22/05/2009 09:37

Lots of obstetricians cannot and will not deliver a baby "MW-style". I'm not saying that you cannot find an obstetrician out there who cannot, but that that is not their bread-and-better and lots cannot and don't want to.

FWIW, here in France where births have for a long time been obstetrician-led in the vast majority, there is a growing movement towards MW-led births due to growing pressure away from the medicalisation of birth. Obstetricians here (IME) do not know how to deliver "naturally/MW-style". They cannot, and do not, want to do it and the hospitals and clinics they deliver in are not physically equipped to allow them to do so in any case.

Penthesileia · 22/05/2009 09:38

AtheneNoctua: your generalising remark about MWs mismanaging VBs is unfair. Yes, some MWs are less professional and competenet that we would hope; this is equally true of doctors, obstetricians, etc, and hundreds of posts on MN will testify. You are clearly biased towards CS - not, as you imply in your OP, in favour of "choice". To tar all MWs with the same brush is wrong.

There are fabulous midwives out there. 3 of them attended my amazing homebirth. I still think of them a lot, nearly a year later. In fact, I'll be sending them each a card to thank them for the fantastic are they gave me, and continued to give me weeks after my DD's birth.

WRT the OP. It's a tricky issues, obviously. CS is a rational choice insofar as, in the developed world, it pretty much eliminates the terrifying, albeit relatively rare, risks which attend VBs, e.g. brain damage to the baby, etc. If you were presented with the follow info, "a child born by CS will not suffer brain damage; a baby born by VB could", then you would be rational to choose a CS. All the advantages of VB: the effect on the baby's lungs; the exposure to the mother's bacteria; exposure to labour hormones; etc; are pretty much rendered negligible by modern medicine, I should think. There's no way of denying that, I suppose. The 1 in however many thousands chance of damage to the baby is clearly a major factor in influencing people's reason. If CS were available as a choice, no questions asked, I imagine we would see Brazilian levels of uptake.

I think the fact that luck is such a huge element of birth (and I say this as someone who was very lucky with her birth experience: homebirth, no tearing, no side effects, etc.) would compel people to choose the option where luck is factored out.

Penthesileia · 22/05/2009 09:41

Tsk: competent

and

"as hundreds of posts..."

and

"care they gave me"

and

"following"

Must preview!

BigBellasBeerBelly · 22/05/2009 09:43

Anyways that's by the by really. I don't think anyone can really argue that a midwife is as qualified as an obstetrician, so there's no point in going on really!

As with all these debates which seem to rage on and on, it's useful to remember that both natural and CS birth are very very safe methods of delivery in this country. There are risks with both but they are very small.

Anecdotally of the people I know who have given birth about 50% had a good experience and 50% ended up pretty traumatised. Of the people i know who had CS it's about the same. Unfortunately without a crystal ball it's impossible to say which women are in which group - if we did we could offer them CS...

Personally I think the real reason for not offering it as a choice is financial - the NHS is not a bottemless pit of money and that is why natural birth is pushed. Same reason as epidural is frowned on - bring an anaesthetist into the picture and the price of the birth rockets. And as the NHS is on short funds that is they way it has to be.

Some women will always feel more comfortable doing things the way nature intended, some will always feel happier surrounded by doctors and equipment, that is just the way it is. Neither is right or wrong. it's just horses for courses. And I believe that women who are really terrified of natural birth should be given CS as a choice - I don't see what there is to gain by witholding it.

Penthesileia · 22/05/2009 09:44

Oh, and...

CONGRATULATIONS COTE!!

Glad everything went well this time.

BonsoirAnna · 22/05/2009 09:46

You are far too cynical BigBella! Epidural has lots of risks of its own - it's not "frowned on" IME but, quite rightly, mothers need to be aware that if they have an epidural they are statistically at greater risk of longer labour and of forceps and/or ventouse and/or episiotomy. Which are all pretty horrible!

BigBellasBeerBelly · 22/05/2009 09:47

"given birth vaginally" FGS not just given birth...

StarlightMcKenzie · 22/05/2009 09:49

This reply has been deleted

Message withdrawn

didoreth · 22/05/2009 09:49

BigBellasBeerBelly, I'm a medical student and I've just finished my obstetric attachment, so I've had all the training I'll ever get in obstetrics (unless I become an obstetrician) - believe me, you wouldn't want me to deliver your baby.
Midwives are differently qualified than obstetricians - they are experts in managing normal deliveries, and see far more normal deliveries in their careers than an obstetrician, who will see all the deliveries where there are problems. I'm sure I've read somewhere that obstetricians are much more likely to opt for elective c-sections, and midwives more likely to choose natural birth - not surprising given their different experiences of birth.

Penthesileia · 22/05/2009 09:51

BBBB: they withhold it, I would guess, for the reasons I give: namely, people would overwhelmingly choose a CS over a VB. Not because they are "to posh to push", although, having read some of the horror stories of tears and fissures on MN, I would dare anyone to say that being "too posh to push" is not actually a reasonable concern.

But as you say, CS brings its own horrors too.

Birth is unpredictable and dangerous. CS perhaps eliminates more of the dangers for the baby; but it certainly doesn't do the same for the mother.

BigBellasBeerBelly · 22/05/2009 09:54

It's in the lap of the gods though isn't it, once you get going. No telling who is going to have an easy birth and who is going to end up so traumatised that they decide to have no more children.

I just think it's a shame that so many women go through such a terrible time when there is an easier option available. Which might have meant they weren't still dwelling on what happened years later.

Although maybe I am biased - my experience was that I was induced, forced to do things i didn't want to, not offered any pain relief at all and told I had a low pain threshold.

When they put the spinal block in it was the best thing that had ever happened, the CS was quick and easy, DD was lucky in that she lived due to the prompt intervention, my recovery was easy and straightforward and I BF easily for the next 14 months.

I think that I have good reason to be quite pro CS.

I find it annoying when people who are very pro VB see themselves as "right" and people who have had positive CS experiences are "wrong".

Everyone is different both emotionally and physically and what is right for one is not right for the other.

And I do believe the reason things are v pro drug free natural birth on the NHS is due to cost.

Penthesileia · 22/05/2009 09:54

What's wrong with me today!

Too posh to push!!!

Penthesileia · 22/05/2009 09:56

I agree: it is cost. As I said, if people were given the choice, they would probably choose CS. And this would cost the NHS more.

StarlightMcKenzie · 22/05/2009 09:57

This reply has been deleted

Message withdrawn

BigBellasBeerBelly · 22/05/2009 10:00

didoreth you agree that midwives are as qualified as obstetricians? And that an obstetrician couldn't deliver a baby?

Bloody hell things have changed a bit these days.

I have heard the statistics you quote re midwives and natural births and doctors being more gung-ho intervention-wise. But to say an obstetrician couldn't deliver a baby vaginally without resorting to forceps etc is just a really odd idea.

StarlightMcKenzie · 22/05/2009 10:00

This reply has been deleted

Message withdrawn

BigBellasBeerBelly · 22/05/2009 10:09

Well the midwives were not very helpful (to put it mildly) and the medical team were calm, helpful, understanding and utterly professional.

The midwives made the decisions that led to it all going wrong though are apparently highly qualified, as qualified as a consultant doctor. Strange then that they were utterly unprofessional and didn't seem to have the first idea what was going on. They looked panicky when things really kicked off, and just told me it was my fault. Not terribly reassuring.

I was vomiting copiously but when I asked for a new bowl to be sick in as the existing one was nearly full, i was simply glared at.

That's neither here nor there though.

The fact is that my body didn't want to do what was being asked of it at that time, and I ended up with a section, and it was wonderful.

And so it pisses me off when people start trotting out all this natural is best stuff. Not for everyone it isn't, no.

I am still interested to know what peoples views are on people who have had one CS being offered the choice second time round. Given that the risk is the same as for first time birth, why is the choice given?

gabygirl · 22/05/2009 10:15

"I'm seriously having trouble understanding why so many people here are so negative about C-sections."

Congratulations Cote!

I remember reading about your experience with your dd and the worry you went through running up to this birth.

Do I remember rightly that you had a large baby first time? And was given a very large episiotomy?

And that this time around your obstetrician wanted you to have a highly managed bith and deliver in lithotomy position, with an elective episiotomy?

Well - if I'd been in your shoes I'd have wanted an elective section too, if the sort of vaginal birth you describe was the only other option.

I had a large episiotomy and a forceps birth with my first and was known to be carrying an 11lbs baby in my second.

I had a homebirth with my second with a very good midwife, and came out of the experience without needing any stitches and with a huge sense of joy and strength. Can you understand why I would feel so negative at the thought of a c-section for myself, having come through the birth so well?

gabygirl · 22/05/2009 10:19

"I agree: it is cost. As I said, if people were given the choice, they would probably choose CS. And this would cost the NHS more"

Yes - and more mothers would die in childbirth.

thedolly · 22/05/2009 10:22

A woman that had a totally normal and natural VB would never choose CS for subsequent births, would she?

BigBellasBeerBelly · 22/05/2009 10:22

But Gaby Cote was feeling negative about something that she had experienced.

If I read your post correctly, you feel negative about something that you haven't experienced.

Which doesn't make much sense.

Feel proud and pleased with your second birth by all means, but why feel negative about something you didn't do? A CS might have been a really positive experience too. You don't know.

(Apols if I have misunderstood and you have had a CS).