NICE recommend all women should be able to have a cs

[LoveBeingAWitch]

Just seen tomorrow's front page of the Sunday times saying that NICE are saying cd has become such a safe op that every woman should be able to have one if that's what they want. Im quite surprised by this.

Women need to be able to make informed choices but I do see a real lack of information available to health professionals themselves. There seem to be a lot of assumptions about VB being natural and therefore automatically the best option. There seem to be assumptions that as VB is natural any subsequent problems are a natural consequence so are diminished or trivialised unless the woman makes a fuss.

Assumptions seem to abound that midwives are all angels and consultants are demonised as medicalising a natural process.

After taking NCT classes (which were great) I felt that my body could get me through a natural birth. I had a horrible long painful labour that ended in an EMCS after an attemp at ventouse and forceps failed. The bitch of a mw looking after me felt she knew better than me about the pain that I was expereincing (and this is after an epidural) and had me BEGGING for help. help that it turned out that I actually did need.

I've just had my second child by what was technically an EMCS but only because I went into labour a few days before my planned CS. It was absolutely fine, and I felt in control.

This time I did skin-to-skin immediately, and began bf ds in the recovery room. When I was not in a position to hold him when still in theatre, my DH did skin to skin. Having a section is not the "easy way out" by any means, but neither does it automatically affect your ability to be a mum afterwards either.

I'm two weeks post-section and I feel as ok as I would if I'd had a natural birth. I'm taking pain relief due to afterpains and a painful bf latch due to tongue tie. My wound is healing well. I'm limited in what I can do ie can't lift my toddler or drive, but I was fully aware of these limitations when I made my decision.

Out of all my friends who had vaginal births, I'm sorry to say that the majority of them had tears or epesiotomies that caused them far more pain and discomfort than I've had after both of my CS's.

I can't believe that women like herethere are made to go through VB's after such a truly horrendous first birth. I think it's barbaric. Every mw and doc I told my birth story to when they asked me why I wanted a CS this time, said "fine, I don't blame you".

Sadly one of the main reasons I wouldn't choose VBAC is that I didn't chooose the staff at my mat unit to get me through it. To carry on insisiting that women should attempt a "natural" birth, means that millions more needs to be put into all aspects of ante, neo and postnatal care to ensure that women are supported at all points of the journey.

I do not believe for a second that these guidelines are going to lead to women choosing a CS as a "lifestyle choice". It will just protect people like me for whom "natural" birth is a terrifying option after living through an experience where you genuinely felt like you may die. NO-ONE should ever have to go through that.

For those of you who feel these guideline are wrong, I challenge you to go through an horrific vaginal birth, and then agree to go through the experience again in the same place with the same staff.

And how can you justify saying people should be made to pay the financial difference should they choose the CS route. I would have paid £800, I can afford it, many can't. What kind of society do we live in where poorer people are made to relive a horrific experience just because they don't have the financial means to pay their way out of it?!

My horrific experience was a CS.........

I hope you have a choice next time iggly

I didn't

I too am glad that NICE have said this. I hope it takes away the stigma of having a section. I get told "oh you must have been too posh to push", "took the easy way out did you" and other such comforting things. There is a huge stigma attached to CS and huge pressure to deliver vaginally come what may. Hooray for the consultants at my hospital. DS1 was breech and couldn't be turned, DS2 after a hideous 19 hour labour with NO progress, not even a mm, baby was in serious distress that the lovely consultant decided that enough was enough and whisked me off for an EMCS.

I breastfed DS1 until he was 2 and DS2 is now nearly 11mo and still going great guns.

All women should have choice, it is her body and she should have the right to choose and not be judged by people with a lack of information and preconceived ideas with no basis in fact.

Benandholly, you actually copied and pasted a whole section of my post in which I was clearly criticising the NHS for failing women. You actually copied and posted it into your own post, and then proceeded to ignore it because you felt like being bitchy and sarcastic. How clever of you.

MrsJRT as a professional I encourage you to read the report.

I'd also again like to point out the two posts I put above regarding this being about providing a care pathway as much as allowing c-sections and my comments about costs, which you seem to have missed.

I have to say, my lack of faith in midwives in terms of their professionalism, head in sand mentality and tribalism over this issue really isn't being helped by what you are saying. You definitely are not helping my confidence with your comments.

In my case, part of my fear is about the fact that I have absoluetly no desire to deal with midwives who are not prepared to try and understand the issue or educate themselves about it. I am absolutely effing terrified of coming across bad attitudes from midwifes with the words maternal request on my notes. I know I'm not alone, and I know this has happened to other women.

IntergalacticHussy - maternal mortality is a bigger issue in the US than UK. FWIW, 35 women died in child birth in UK last year out of about 700,000 births. Thats 5 per 100,000 which is a good rate and up with the best.

Strangely in Italy which has one of the highest c-section rates in the world (including maternal right to one) they also have the lowest Maternal Mortality Rate. There is far more to mortality rates than purely the method of birth - its about demographics and level of health care.

OH AND ABOUT VBACS - new NICE report doesn't say much on the subject but does have a cost analysis and does say that its cost effective both ways and women should have the choice... Its not really the remit of the report though and its more about c-sections and this isn't new recommendation.

Iggly, sorry you had a bad experience regardless of how you delivered. Was it ELCS or EMCS?

Plenty of doctors see easy & complicated births during their training. Many of them would elect for a CS for themselves or their partner if they could because they know the risks of both options. It is about choice to decide what is right for you.
A gross generalisation I know but don't you think that if men had to carry & give birth elective CS would already be an option to all in the UK?
Good on NICE for keeping up with evolution. (& yes I know CS is not easy! My mother had 4 & would give anything to have been able to have a VB)

Iggly, bad experiences can happen either way and I am really sorry you had the experience you did. So choice is vital, so they don't say you HAVE to have a CS next time as you've had one before.

It works both ways, and women's experiences and feelings, along with medical need, should be the key reasons decisions are made.

You're right, bleedyghoul. After eulogising about how very well researched and prepared you were you went on to say:

"I'm always amazed whenever I meet a pregnant woman who is not planning to prepare in any way for the impending birth. It's like running a marathon without doing any training: madness, and potentially dangerous."

Does that help?

I don't really know what it would mean to choose a CS as a "lifestyle choice" - something about it being fashionable ??
But what is this fear we/ others have of women making choices ? ....
Doing what they feel is best ?
If a VB is generally the healthier option then probably more women will continue to choose this way of helping their babies into the world Unless they have some reason to make a different choice.
Sorry to hear from those who've had difficult births of whichever variety.

It was emergency CS.

Sir charles DH is a doctor and most doctors we know would not recommend CS unless medical grounds.

most female doctors i know opt CS

Clearly you had a traumatic experience iggly. But let's not rush to lump ELCS and EMCS in the same basket as they are vastly different.

Also, the views of medical professionals range widely. The fact remains that a planned section at the right time of gestation is very safe for both mother and baby. No mode of delivery is risk free. The key is informed choice.

I had 2 VBs - one bad with emergency vacuum delivery and pph, the second really good. Both times I was supported in the choices I made and kept informed of the risks and the benefits, which is really what it is all about.

I was terrified DD2 would be a CS (given how rough DD1 had been) because DH doesn't drive so we would have had no car transport for 6 weeks in an area with crap public transport. I didn't fancy the wound either, and worried about being able to BF post CS.

But I do think this is a good idea, because ultimately a woman who is anxious and stressed about having a VB is not going to have a good experience, and if the difference in cost is really that small then NICE are right to do this.

I also think that better care in labour would help - more midwives so that there is genuine continuity of care would be great and would probably bring the epidural rate down as well. However, trained midwives cost more than CS so it'll never happen.

Quietlyafraid, I will read the report, I admit I haven't and have been guilty of commenting blindly. To me as a midwife there is a vast difference between a woman requesting a section due to fear, previous bad experience, previous section and requesting one 'just because'. Yes we have to move with the times as a profession but it's understable I'd hope that there is genuine fear in midwifery circles that we are to become surplus to requirements, in that sense it isn't a judgement on women it's just a fear about 'what next for us' which is entirely natural. Personally I don't care how women give birth, professionally I hope they continue to have vaginal deliveries to keep me in a job I love.

So...nothing about the NHS then, b&h? How convenient.

Running a marathon without preparation is an extremely bad idea. Wouldn't you agree? And would you say it's smug for someone to say they'd prepared for a marathon and that their prep helped them deal with any problems they encountered?

You are being very silly, and I have now officially lost interest.

Amen to that, BlackSwan.

And not 'most female doctors' opt for CSs - not true.

And the thread developed as I would have expected - post posters extrapolating their own experience for the Nation.

Just because something is 'natural' (VB) and has been done for millenia, does not make it 'better'; equally just because something is 'high-tech/medicalised' (CS) does not make it 'worse' - the key is surely a thorough assessment of all circumstances, good communication, an understanding of the risks involved, and then, yes, a choice the woman should make.
Under the understanding that there are never any guarantees for a perfect outcome when it comes to making/carrying/having babies.
Not until the whole process happens in a lab - by which time I am hopefully dust .

I just don't get why anyone would want major surgery and the pain and risk of infection that go with it unless it was absolutely necessary.

startail It doesn't matter whether or not you get it. It's whether or not others are willing to risk it that's important. And finally NICE are acknowledging this.

I agree with posters about being let dow by the NHS. All the women I knew with babies had had CS, no mum or other family to talk through the reality of a VB. The NCT classes were bloody useless. The only thing I took from them was the memory of the teacher (who had one child by CS) demonstrating with a plastic doll and a knitted placenta and telling us that intervention was the work of the devil.

I wanted a homebirth (as I was so deluded) an ended up being transferred and a ventouse delivery after a very long labour and blood transfusion, the cause of which were unclear.

I'm 40+1. I did ask to see my notes and was met with surprise and the suggestion that I could see them after DC2 was born . I went through PALS and did get to sit down with a midwife as i wanted to be in a position to make informed choices about the next birth. Reading them, all I know it was as hard as I remembered.

I'm simply dreading going through it all again. I had a suspected low lying placenta and was hoping it was so I'd get a CS. How messed up is that?

If men were giving birth, there is no way they'd be pushing babies out, they would, as other posters have said, be taking advantage of medical science. I'd like to as well.

Startail - my friend had 3 babies. Each was 10lb plus. Giving birth to the third terrified her and ripped her to shreds.

She now needs major surgery to repair. She also has had to endure pain, humiliation and a wrecked sex life.

I think a section would have been preferable and HER CHOICE

I have had 1 EMCS and 2 ELCS. After the attempts to deliver DD1 vaginally - ending in EMCS - I would never have had another child if ELCS was not an option.
it is not pain-free and it carries risks, but when I read some of the threads on here about how damaged people are physically vaginally (tears, stitches, infections, etc), then I'm bloodyglad I had CSs.