Do you think less women would opt for c-section if they still did the old vertical incision?

[SoupDragon]

Nothing judgemental here, just something that I wondered about after seeing mention of the old vertical incision method on another thread.

Obviously the "new" unobtrusive version is a vast improvement.

You're making quite a few assumptions here. "Opt for" c-section - yet most women have no choice. Most c-sections are emergencies, performed to save the baby's life.

Also, in the small minority there is an element of choice, women are usually considering the relative risks to the baby, the relative risks to themselves, how they will arrange childcare, how to cope with not lifting a toddler afterwards, etc. How to live with a scar on their stomachs afterwards comes way down the list of priorities, and I'm guessing whether it is vertical or horizontal wouldn't change very much.

I feel bloody lucky that they don't still do vertical incisions in most dire emergencies or it would been the choice of a) death for me and my baby or b) save me and the baby but wreck my stomach and womb.

I'm not sure there are that many c sections for frivilous reasons that you would need to put people off. Most people would rather not have a C section, there's nothing remotely glamorous about it.

Wouldn't have made a bit of difference to me as even though two of my three sections were elective, I still didn't have a choice in the matter.

I am glad it isn't still done vertically though.

I didn't "opt" for C-Sections and I don't know anyone in RL who did, either. Most of the time it's not a choice but a medical necessity. And while my scar is horizontal, it has left my stomach looking horrible, with a nasty little "overhang" so not a massive improvement on the vertical scar.

No, I'm making no assumptions whatsoever. Clearly I'm not talking about emergency c-sections.

It was a hypothetic question abuot the "too posh to push" and "honeymoon fresh" c-sections (and no, I@m not accusing anyone of having one).

I simply wondered whether it would change the decision making process for elective c-section where there is no pressing medical need for one.

Forget it.

Yes I would and thats if I can ever face doing it a 2nd time, pretty happy with one at the moment.

Here you go, Soupy!

I think it would be impossible to enforce tbh. I would imagine that most elective-without-any-medical-need c-sections are carried out privately (please correct me if I'm wrong), and I don't think that it would be something that would be accepted by anyone paying for the procedure. If you then had a situation where NHS doctors made vertical incisions to discourage it, but private doctors made the horizontal cut there would be uproar.

Personally, I'd like to see births becoming less medicalised with more midwife-led units as the way forward as the way to bring down the c-section rates - if that's what's deemed to be necessary.

there is nothing wrong with medical progress. It is a good thing they've found a better way to preform a CS, and we have to remember- all downsides it may have- is a life saving operation in many cases. So yes, I think changing the method is a great thing, and I seriously doubt it makes more women choose it over vaginal birth (women who do that for non-medical reasons have their own reasons which may or may not be valid, but it's their right- it's their bodies)

I don't know anyone who has chosen to have a c-section for reasons of vanity. Women who choose them for non-medical reasons are more likely to be scared about giving birth vaginally or have other psychological reasons so a scar wouldn't change that.

Anyway, I agree with shiri that it's a decision for each woman to make, they can do what they like for their bodies and babies.

It would make a difference 2nd time round! My first was an emergency CS but I am hoping to go for VBAC this time round - but if I had had a vertical incision last time, I would probably be pushed towards automatic ELCS this time (and for any future babies) as I think the risks of rupture are higher with an old-fashioned scar.

The only people I know of (on MN and elsewhere) who have "opted" for caesarians are the ones who have been severely traumatised either by sexual abuse or by previous labours, so hardly likely to make much difference. Though as MyName points out, it might well make a difference the other way round, making VBAC far less likely.

The vast majority of us have had sections to save our own lives or the baby's; we don't particularly yearn for a more obtrusive scar.
Agree with Shiri- better ways of operating have got to be just that...better.

No, I don't think it would make a difference. I had a c-section because ds was breech and I had no idea where the scar would be or what it would look like. I had more important things to think about.

At my antenatal class I remember a mother to be asking the midwife why so many women requested c-sections when the risks were higher. The midwife replied that more women are not requesting c-sections and that "too posh to push" is a media myth. She went on to say that the increase in c-sections was mainly due to births becoming more medicalised and the increasing use of epidurals.

But most 'elective' sections aren't really elective. They are women who have already had a section (usually an emergency) and don't fancy a VBAC, or women who would be putting themselves or their baby at some sort of risk by opting for a vaginal birth and so have 'chosen' elective section on balance. And maybe a tiny minority of women who have electives have some sort of psychological gear or phobia around giving birth.

'Too posh to push' exists only in the private healthcare system, and even then, it's mostly celebs who go for it.

So, no. I don't think the type of incision/scar would affect the section rate.

Should also say - women who get that cute little 'c-section smile' that you see on celebs in their bikinis are few and far between. Most women are left with a substantial scar/overhang, so it as not some sort of cosmetic option.

fear, not gear!

I do really wonder who is 'too posh to push' - I don't personally know anyone who had a c-section for that reason. I know we read about celebs that have - but how do we know perhaps their babies were breach.

Most people including myself had one (or 3 in my case) as a result of having had one emcs and then opting for electives as was decided I'd struggle to give birth vaginally - am very small and dh very big and have giant headed babies.

So I'd still have gone for c-sections - after 3 dc's my tummy is not my finest attribute

I guess I was too posh to push for both births?

My gut feeling right from the start was that any child inheriting DH's wide head would result in a nasty birth for me. As it turns out, DS1 was oblique, and still needed a ventouse in an elec CS to pull him out.

DS2 - was bleeding a lot in pregnancy yet scans couldn't detrect anything wrong. repeatedly told placenta was low anterior and fine, with final scan at 34 wqeeks. I was going for a 40/41 week elec but got it pulled back to 39 weeks. lo and behold, a low, ragged placenta and a v small baby. As the surgeon exclsaimed at his birth, 'how the hell was that missed?!"

I'm v v v glad I went for CSs and I'm glad the low, horizontal incicsion made my births v safe.

DS1 wasn't planned and I would havwe happily termionated if there wasn't a safe birth option that I was happy with.

I don't have an overhang; but then I keep myself reasonably fit (no gym or anything, just lots of walking and sit-uops every other day)

why do so many people get so 'heated' when c-section conversations are brought up?? Some people DO choose to have a c-section cos they just want one - theyre not all rich celebs either! I think its obvious Soups question wasnt aimed at emergencies otherwise that'd be a total contradiction of what she was asking (ie - emergency = no choice!) I think 'some' people who choose to have a c-section just because its more convenient or they dont want to go through labour etc SHOULD be able to choose that if they want to, and they branding of too posh to push is not on! IF they still did the 'old style' c-section would they still think it was a preferable option??? i think some people still would but not as many perhaps! I think its an interesting question quite honestly!!! If there are people that get so offended and bothered by topics like this then they shouldnt read or join in!

I really can't bear the word "elective." It implies sticking you hand up and saying "Ooh, me please!" Both my sections were planned, but there was no choice about the first, and only a snippet of choice in the second (in that after 40 weeks of insisting on VBAC I finally agreed to a section on medical advice).

In both cases the scar's shape, size and location was of no importance to me. I never bothered to ask what it might look like in advance and just found out by myself a few days after birth.

Yes, Soupy, I do think that for the teeny tiny minority of women who elect to have caesarians for non medical or non psychological reasons, then having a vertical scar instead of a horizontal scar would probably put them off.

But, since these represent only a handful of c/section cases, it would hardly make a dent on the figures.

I had a CS through choice!

First baby was an emergency CS and for the second baby they gave me the choice of VBAC or CS. After a lot of soul searching I went for CS.

Would I have made a different decision if the scar was up the tummy rather than across? Assuming no difference in healing times or complications or anything like that, but simply a different external scar, I would say that I would still have had a CS.

HTH

Old c-sections, with incision going down tummy - ALOT more complications during and after, and the recovery/pain after is shocking!