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.

No-one I know opted for a section other than for medical reasons, such as:

Placenta praevia
Cord twisted round baby's neck
Previous uterine rupture
Previously prolapsed cervix
Baby swallowing meconium

I suspect that the direction of the cut would have made a difference in none of thes cases.

I've never met anyone (apart from a few very very very wealthy types, and by that I mean Russian oligarch wealthy)who has opted for a section for anything other than medical reasons. Has anyone?

I think for the tiny minority who elect for c.s for a birth for purely 'social'reasons, a vertical incision may be off putting but as it is more dangerous, and increases the risk of rupture in subsequent births,. that if the woman was paying for private care anyway, or insisting on it via the NHS and was being given a c.s, then she would insist on the lower horizontal cut.

i think less women would opt for c.sections if they had one to one care, felt supported and listened to in the antenatal period and had proper support and debriefing following difficult and traumatic births

I thought the OP was coming at it from the POV that maybe women would be less likely to "opt" for CS if they had a more obvious and "disfiguring" scar.

Hence my comment about all things being equal in terms of recovery etc.

bossofme loads of women on here have elected CS for second and subsequent births when they had a CS for medical reasons first time.

when i was expecting my first baby i seriously considered a too posh to push cesarean as i was so scared of giving bith naturally. if the only option was a vertical scar it would definitly put me off.

i got over my fear but ended up having an emcs as ds got very stuck and forceps couldn't budge him.

so i am now agonising over whether to have a second cs. i probably will as i have a prolapse and don't want to make it worse and i also have a suspected herniated disc(have to wait until this baby is born for x-rays) and can't risk my back spasming in labour as i won't be able to move at all or push.

Imsonottelling - isn't that because the medical advice, rightly or wrongly, that they get given pushes them in that direction, rather than feeling they have a free choice per se? I'm not even pregnant with DC2 yet and have already been told by professionals such as HV that "for medical reasons" it would be better to have a CS second time around. Whereas when I look at the actual research, it suggests that the risk of rupture etc is very small, and it might be worth pushing for, well, pushing, IYSWIM. So what some people might term as choice might not feel like it to the women involved....

Probably a whole separate debate though!

They do still do the classic sections sometimes, I almost had one for ds because he was so small, had he been born any earlier I would have had to have one snd the prospect of it terrified me ! My consultant didn't paint a very good picture of it at all. I can't imagine anyone in their right mind would opt to have one !

I had a lower segment ceaserean in the end but I know a couple of people on here have had a classic one.

Uhhm would I choice between a vertical incision or death of me and child - I think I would have the vertical incesion

I have though got a wiggley horizontal line where they cut me open in a blardy hurry - which is fine by me.

bossofme with mine they presented the risks and benefits of both methods of delivery, although I understand that depending on who you see you might be pushed in one direction or another.

I do think that there are plenty of women who have made a straight choice, really I do. I have spoken to them on here on "vbac or cs" threads.

ImSoNotTelling - you sound like you had really good antenatal care.

Don't hang out much on the vbac or cs threads, but hope to in a couple of years

Actually, just looked at my scar properly for the first time in a while and its rather diagnonal rather than horizontal!

It's a really hard decision actually - it was for me and a friend who was in the samne position at the same time. We chose different options in the end and are both happy and healthy so all good in the end!

Good luck with things in a couple of years!

Thanks - will keep MN posted!

Why is the vertical cut a lot more dangerous? Just curious, my mum had one with her first child and went on to have 7 normal vaginal deliveries after that (this is 30-45 years ago now).

A mum at school recently had a vertical csection for delivery of twins.

It would only change my mind about having a cs if I was having an elective for reasons other than the safety of my baby and I.

Balloon- I found this on Wikipedia (always a fount of useful and reliable information):

"In the past, caesarean sections used a vertical incision which cut the uterine muscle fibres in an up and down direction (a classical caesarean). Modern caesareans typically involve a horizontal incision along the muscle fibres in the lower portion of the uterus (hence the term lower uterine segment caesarean section, LUSCS/LSCS). The uterus then better maintains its integrity and can tolerate the strong contractions of future childbirth."

I thought it was to do with less damage to the uterus but couldn't for the life of me think why.

thanks for the info duchesse - guess my mum was quite lucky in getting those VBACs then

Has anyone said 'fewer, not less' yet?

I had an elective on NHS and will have another. No overhang thing - and anyone with one after CS would have the same with natural - it's nothing to do with having a CS - rather to do with over eating and under exercising! Recovery is good if it's all to plan - was out of hospital after 24 hrs. Re the original question - not sure, but I think I still would. I'm glad there is such a variety of preferances, otherwise not enough room or staff for everyone to do the same ie: home births / water birth / CS etc

My friend had an emergency c section, then an elective one second time.

She showed her children the 2 scars so they could see where they came from.

I am not sure whether she would have done that if she had been a natural birther???!

why did gthey used to do them vertically then? Am I being thick!

I do know people who have had purely elective c-sections because that is the way they prefer to give birth. A friend has just had her latest babe in Oz, after flying home in order to see her fav doctor and stay in her favourite hospital (private obviously). All of the people I know who do have the electives go private, but I suspect this is a pretty unusual group who probably are too posh to push, and who cares anyway? It isn't my body.

I suppose for this very small (as in the overall population) group then yes there is the possibility that a bigger/more obvious scar would factor into their decision. But is there really any need to adjust for such a small group? Why would you do a surgery in a more painful/dangerous way than necessary?

Coincedence.

I was speaking to one of the mums I work with today.

She had her first baby in pakistan and had to have an emergency C section. She had a up and down one. I had never heard of it. Sounded horrible.

It caused a lot of problems later because it made it tricky if she had to have another one over here. As her babies have all been very overdue it was a worry.

I have a lot of friends who had their first babies very young. Its pretty common where I live. Most had theirs in their late teens.

A huge proportion of them had c sections. I have been amazed at how many. The common theme seems to be that most had potential problems rather emergencies or definate problems (IYSWIM) and had c sections sold to them. Most of them were well up for it because they thought it might be a lot easier than all that 'down below mucking about' (how any of them managed to get pg in the first place given their attitudes to anything remotely gynacological astounds me ), but really didnt know what to expect.

The majority dont feel good about it which is a real shame. Its not like they did anything wrong. They were following the advice they were given.

I wouldnt know how many of them really needed to have c sections and many of them probably did, I just feel they were not given enough info to really know what was going on. It seems like they were patronized a fair bit TBH.

I have never had any wish to have a vaginal birth and so had an elective section with my first and will have another with this one.

Not really sure that a different incision would have made ny difference to my choice - I am lucky my scar is small etc but I have seen pictures of absolutely awful scars prior to making my choice and was well aware I could end up with one like that.

Yes I feel the same Chynah. Never had any desire and never will. I was given all the info etc and the risks with CS are still quite low. After watching the news last night about Group Strep B It just adds to the positives for a CS.
I do think VB-ers are very brave though, it's just not for me

" rather to do with over eating and under exercising!"

A slightly contentious statement, this. I am extremely fit, enough that it has been suggested that my level of muscle tone and type of exercise I do (horse riding) may have contributed to the reasons for my em CS. I still have the horses, more of them than I had before my CS, and taking care of them keeps me very fit. I eat well, mainly eating fruit and veg I have grown myself, and eggs from my hens, and meat from my own poultry and my sister's pigs. I have a flat stomach (well, did, before becoming pregnant again,) but have a very defined ridge along it where the internal line of stitches pulled the muscle tight.

Once a part of your body has been disfigured by an opeing being made in it in a hurry, whether that be from an em CS, accident, or whatever, it is practically impossible to make the misshapen flesh and muscle lie as perfectly smoothly as it once did. To suggest that those of us who have overhangs have them mainly because we are greedy and lazy is as offensive to us as it would be offensive to you for me to suggest that you were too lazy or scared to give birth the way you were designed to in booking an elective section.

Pandora69,
Perhaps it is a contentious statement, but the emergency versus elective caesarian section is also a contentious issue which has stimulated considerable debate already.
If you refer to my original post, I was commenting on an elective caesarian, and whilst I agree that the manner in which the surgeon extracts the baby is with the utmost speed in an emergency caesarian, the wound closure can be taken at a more leisurely pace. If you have an apparent overhang or puckering around the scar, that may well be more as a result of your body's reaction in healing than any procedure and as already mentioned the amount of soft tissue trauma is considerbly greater in an emergency case.

I can infer from your comments that you were of course upset that your labour culminated in a failure to deliver naturally, and to add insult to injury, the resulting surgery left you with an ugly scar, for which I feel truly sorry for you.
I think what you are describing is scar tethering or scar contracture, (particularly if the scar feels fixed to the muscle underneath it) rather than the "overhang" remark which I was originally commenting on regarding over eating and under exercising, therefore, I think you may have taken my comments out of context.