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.

For instance, see here.

And here.

The vitriol well, not trying to be cruel to women who have suffered these things. However, any women who has experienced this from a natural birth should perhaps point them out to other first timers, that it's not always all 'beautiful' and 'peachy' and things like that do happen later in life. if it wasn't for my mother and a few other friends, I would not have know this can happen - it really seems to be played down by a lot of natural birthers and midwives who seem to be on the fence since their experience has resulted in the problems I mentioned, and almost seem to resent the c/s-ers. I've had just as much grief from natural birthers as I have had from midwifes - my sister included - so i guess it's spilling over from that - nothing personal to anyone, just feel that there is way too much critisism dished out to people who choose surgery over natural... and as you pointed out - it doesn't need to be that way.... clearly it's easily given out but not easily taken the other way

trust me - i'm aware of all that - still choose the cs, and seriously, when it's all turned around and the pro c/s people purely comment on the negatives about a natural birth, it doesn't get received very well at all... Why? that's my vitriol

It shouldn't be "given out" at all. People should be free to choose the right birth for them. I have said before that I can understand that CS is a rational choice.

But, as I said already, birth is a massive undertaking, regardless of how it is achieved. And it will, most likely, effect the female body, regardless of how she does it, as the links I've provided prove.

Well, it is probably not received well, I should imagine, because a lot of people have been through a VB, and quite possibly have suffered the things you say. Thus, as you suggest, perhaps they feel resentful that there could've been another way (hindsight is 20/20, of course!). So, when pro-CSers "smugly" go on about avoiding damage down below (even if not true ) to an audience who may well have suffered that damage, well, it's like pointing out to a car crash victim that they ought not to have got into the car.

The equivalent, I suppose, would be someone like me, who had a complication-free birth happily announcing to someone who had complications following a CS that because I had the great wisdom to choose a natural homebirth, I avoided a scar and the risks associated with CS. That would, quite obviously, be a terrible thing to say to someone who has already suffered the consequences of her choice.

Thing is, that's just it, we're well informed of the results and risks of having a cs but we are never informed of the possible after effects of natural, and when its pointed out by a pro cs, it isn't received well. Someones got to inform a first timer, as the midwives aren't going to! But agreed, it shouldn't be critisised, attacked etc from either side, rather the individuals choice respected.

idon;t think it is simply the responsiblity of care givers to tell /inform women of the risks of VB or c.s.. women should inform themselves before they are in labour of pros and cons of all types of pain relief, of whether a VB wold be too high risk, the implications of a c.s etc etc..

it is not jsut up to doctors and MWs to tell women the risks/benefits as their own experiences will colour their advice.

gathering lots of info for yourself from all different sources is a good idea i think

and cote apologies, forgot to congratulate you on the safe arrival of miniCote.

pmk1 I think i can see where you're coming from. That the possible side effects of CS are always given in full but the possible after effects of natural birth are not.

Certainly cutting/tearing, loss of sexual function etc etc were never mentioned at our ante natal classes while the CS risks were laid out in full.

i suppose that is because without choice there is no point in telling people what they might be in for later? But then on the NHS you don't get CS for choice so surely the same logic should apply.

In theory it would be great if people reserched in depth before having babies. In practice they go to the ante-natal classes and that is that. And you can't blame them really.

i do think there is a bit of a conspiracy of silence surrounding the worse possible after-effects of natural birth. Women don't like to talk about those things (apart from on MN of course ).

Interesting. Yes, if your criticism is really one about information, then I agree with you.

I think Lulu is right, though.

I didn't go to any ante-natal classes (did go to pregnancy yoga, though). I knew about the risks of VB because I read some books.

Also, I was under no illusions that pushing something the size of a watermelon out of a hole the size of a lemon (to quote Rosanne Barr ) was never going to be a walk in the park.

Double negative there.

i wish i had thought about the possibility of a c.s and the issues about induction of labour before i was induced. and ended up with a c.s

i blithely ignored the bits about c.sections and presumed it would not happen to me. until it happened.

i thikn being mentally prepared would have been a bonus

If i had known then what i know now about induction it would be a different story here too. You do tend to just go along with things though. Hindsight is a wonderful thing.

I certainly didn't know about some of the nastier possible after effects of giving birth vaginally until after I had DD as was admitted to the "now you've had a baby we can discuss these things" club.

i read this post with great interest because i had 2 sections. and never had a VB or even experienced what labour is like. after my DS1 was born i felt cheated and felt not quite a mum because he was delivered by CS. (he was breeched and i had pre-eclampsia). with DS2 i had GD and was delivered at 38 weeks. my obgyn told me that i am welcome to try induction but she would not recommend it as i already had a section. and also i had high BP again.

i think i will always wonder what it would be like to push a watermelon out! i agree that no one ever talks about the bad things that can happen after a vaginal birth. my mum was very honest and told me that she was never the same down there after pushing out 4 babies!

Agree with BigBella and pmk about the risks of vaginal birth being underplayed, and they are very nasty risks indeed. Perhaps women have suffered them for millennia out of lack of choice means that women are somehow supposed to take those risks upon themselves, risks which are unjustifiably elevated in the cattlemarket manner in which hospital maternity units operate.

Not only are the risks of vaginal birth underplayed, but also the risk of a vaginal birth (particularly induced) resulting in em cs. However, in hindsight, I greatly prefer an em cs to an instrumental delivery.

It was a real eye-opener to come on mn and read eye-watering stories about vaginal births gone wrong with the psychological and physical permanent damage that entailed and chaotic labour wards. No midwife or obstetrician would have told me that.

I made my informed choice: elective. From a risk point of view, it is just a form of buying insurance.

"It was a real eye-opener to come on mn and read eye-watering stories about vaginal births gone wrong with the psychological and physical permanent damage that entailed and chaotic labour wards. No midwife or obstetrician would have told me that."

I second that and it's also why I am having an ELCS for my next DC when it comes along.

Hmmmm.

I do think it's important that women know that if they go into hospital to have their babies there's a really good chance that they'll end up with lots of damage to their lady parts. It's also important that they know that opting to give birth at home seems to hugely decrease the chance that they'll end up with their perineums in shreds.

When I had my first baby I knew that 25% of women in this country have a c-section.

I also knew that about a massive proportion of first time mums have ventouse or forceps.

I'd heard loads of birth 'horror stories' and lots of hilarious comments about 'pushing out watermelons'.

I knew some women ended up with pelvic floor damage after birth because - again - all the jokes about mums having to cross their legs when they cough.

I still didn't worry about how it would affect me, basically because I think that's the normal mindset of pregnant women. You know it, but you just block it out. And I'm glad I did. The damage from my first birth was pretty bad, but I still came away from it all feeling OK about things.
In contrast I figured that c-section must be about as risky as having a root canal, but probably less painful, as no one ever really talked about the pain of recovery from c-section.

What I didn't know about what how sh*t the care would be at my local hospital, basically because I did NHS antenatal classes and the midwife was hardly likely to say: "Oh, and by the way, you'll be left on your own for hours in labour and pressured into having pain relief you don't want, so as to give the midwife a bit of a break from your unreasonable demands for emotional support".

it is important not to lose sight of the fact that many , many women emerge totally unscathed, emotionally and physically from their birth experiences, be it vb or c.s

i found my VBAC to be totally incredible and the way i felt afterwards was such a sharp contrast to how i felt after my c.s

but again, that is my experience.

i had no intervention, i have an intact perineum and i can trampoline with confidence

We all seem to have calmed down a bit

It really it the case that both birth methods can be very positive and both can be very negative and damaging.

I suppose I get worked up when I see CS being demonised, when for the majority of women it is not done through choice but necessity. OK you could say that docs are too quick to step in and operate, but still most women don't feel that it's an active choice that they have made. I suppose i like to try and be positive about whatever method of delivery people end up with, and sympathetic if they have a bad experience.

All this is quite pertinent to me at the mo, as I'm 34 weeks and today went for a scan as my placenta is low lying. I've been told it's borderline and the baby is quite large, and they'll have a think in a couple of weeks. As I had a EMCS last time i can elect CS, or go for vbac. The odd thing is, as I mentioned on another thread earlier, I'm not really that fussed either way. I was kind of hoping the decision would be taken out of my hands.

Basically I want the baby out safe and with the least damage to me. But who can say which way that will be. Oh for a crystal ball...

Congratulations Cote.

I don't really get this right of passage stuff. I spent days in labour with ds1 after premature rupture of membranes, pushed for 2 hours and ended up with an emergency section.

I did not feel cheated i thanked god that i lived in the UK and we both survived and that i wasn't in a country where he'd have died and i'd have ended up with a fistula.

With ds2 i chose an elective because he had a big head and i'm small - afraid i disprove the argument that your body only grows a baby you can deliver naturally. Of course possibly my fault for being tiny and marrying a man who is 6ft 4 with a big head .

Currently pregnant with dc3 and will go elective again.

I recovered well from my c-sections, breastfed etc.

I totally accept though that a lovely straight-forward vaginal birth is the best outcome for everyone but for some of us thats not how it is.

And i do not feel any less of a woman/mother for having my baby delivered by c-section.

And Anna - seriously the scar is minimal and lots of vaginal deliveries leave scars too.

I'd like to think I am quite selfless to choose a elective in a hospital, whereby I take more of the risk on myself, than a home birth, where my unborn baby takes more of the risk because I want an intact perineum and a wonderful birth experience.

I am sure somebody will quote me statistics about the safety to baby of a homebirth - but sorry, unless I stay within spitting distance of a maternity hospital, the risk (however small) of a delayed transfer and a violent instrumental delivery or em cs is really not my (or dh's) cup of tea.

Bigbella, yes that's exactly one of my issue's, thank you, and Blueshoes, couldn't have said it better myself - exactly my thoughts.....

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?

There are risks for both with a c section too, but if you are going to have a c section I agree they are much better done in the hospital

I had a traumatic first VB, and asked for a cs with my next 2 babies. This was approved on medical grounds, but i loose count of the number of people (everyone in fact) who can't understand why i would opt for a section when i've delivered "naturally" before. This made me question my own judgement, but i must say both elcs have been much better experiences than my first. I bonded straightaway, my milk came in sooner, i had little pain, i wasn't incontinent etc etc.

However, I am not sure that it would work to allow every woman to choose a section if they wish - there is the cost element (I do feel bad about this but guess i pay my taxes), theatre/staffing availability, spaces/staffing on post-natal wards (although that being said i was in 2 nights with my last cs and 4 with my VB)... I still think that elcs should only be performed on medical grounds.

"I'd like to think I am quite selfless to choose a elective in a hospital, whereby I take more of the risk on myself, than a home birth, where my unborn baby takes more of the risk because I want an intact perineum and a wonderful birth experience."

A low blow, blueshoes, a low blow.

Women don't choose homebirths for the reasons you state. I didn't, at least.

I've avoided saying this, because I don't want to be inflammatory, but since you want to ratchet up the tension, I will too.

I chose a homebirth because I felt that, all things going well (and don't get me wrong, I understand that this was not in my control, but by removing myself from the hospital environment, I felt I was optimising my chances of things going well), I was doing the very best for my unborn child. Not for me. Au contraire, given that the only pain relief would be gas and air - which I didn't use, as evidently I am superwoman - you could argue that I was putting myself in a difficult position.

Given that my pregnancy was entirely without complications, and I was in good health, I decided it was best for my baby because:

my baby would:

• not be exposed to drugs, such as those in the epidural, or those involved with induction, or pethidine

• would be less likely to be manhandled out of my fanjo with forceps or ventouse

• would be born into her own home, not in a potentially dirty hospital

You know there are risks to a baby born by CS. You were, for instance, prepared to take the risk that the doctor might accidentally lacerate your child, in order to keep your fanjo pristine.

As I have said, over and over again: birth is dangerous, for both mother and child. We are all just trying to find our own way through that.