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.

iggly

NICE spend an inordinate amount of time reviewing all research before coming to their conclusion. Cherry picking articles to support their stance is not allowed.

Bias is excluded

This is not about forcing woment to have sections. It is about correcting the situation whereby women are refused sections

"Oh I did not have a lot of explained as again the emergency CS was under GA. But...... knew all about it anyway. I am not stopping choice if they are willing to pay the difference NHS is broke and will get worse."

So now it's a purely economic decision? What utter tosh. OK, so epidural is more expensive than G+A. Should women having VB pay extra if they want epidural? The NHS is broke afterall...

Lenin grad you would not have been billed you tried VB we are talking an elective CS with no medicalised reason (some would argue a previous CS would be enough for you to say you want a second) there maybe similar reasons as well for the request (my DS was very large hence CS).

Look at the date of those articles as well!

2003 and 2001? that's old research

Hanhahahaha THAT WHO report.

Where to start with it?

oh yes... the one that actually MAKES up conclusions based on its own political agenda and not on the results it produced? OR perhaps the fact its about countries which don't have the same level of healthcare as the UK...

www.straightstatistics.org/article/funny-figures-who-caesareans

sigh There is so much Bad Science with that report words fail me. Its been utterly lampooned by a lot of academics.

I had ECS DD had stopped growing very small induced me did not work went to induce me again next morning but baby in distress tried to break waters for VB but then said needed EMCS as baby not strong enough for long labour

if I had known then what i know now would have wanted CS without attempted induction.once they knew baby had stopped growing instead of futile induction as it seemed obvoius to me was always going to end up with CS as long labour not an option and how many first labours are short?

I am not nor have ever been traumatised by this as understand it and glad DD is alive unfortunately in many places where "natural" child birth is the only option DD would not be alive, where medical intervention is not available or used maternal deaths in childbirth are higher and stillbirths commoner still

depsite EMCS I recovered very quickly from it with not that much pain control

I think if we believe that a women has a right to choose whether to go through with a pregnancy or not pro-choice; we also ought to believe in a right to choose delivery method not that someone else can veto her choices

I do not cherry pick articles I go to PubMed a well respected search engine typed in "maternal mortality and vaginal birth and elective caesarean section" and conducted the reseach limiting it to "review articles". I removed the WHO article due to the fact it was not developed countries. That was the only cherry picking I did.
Lenin grad yes it is life threatening more so if CS (non medically indicated CS vs VB).

Iggly - you have a viewpoint. You can make a choice. Go for it and enjoy that ability

Thank god NICE are going to give all women the same chance to choose and they are providing lots of good quality information to make that choice with

Elective c/s is a comparatively safe operation compared to planned vaginal births but only where large numbers of those women planning vaginal births are having substandard care and ending up with emergency c/s, which is the least safe option of all.

The massive difference in rates of intervention in childbirth at different hospitals serving similar populations are witness to the impact of poor care practices on birth outcomes.

IMO it's absolutely intolerable that NICE is recommending an increase in planned c/s within the context of an overstretched system where there are simply not enough midwives to guarantee safe one to one care for women planning vaginal births or those recovering from surgery.

If all women planning vaginal births had access to even a fraction of the care costs spent on a planned c/s, so that one to one care in labour, consultant input in the case of complications, and a decent birth environment was a given, we'd see a massive reduction in emergency c/s rates and instrumental rates. And if that happened it would be very hard to argue that planned c/s was the safer option.

Thanks BleedyGhoulzombiez.

I was exhausted at the end. The midwives were trying to get me to keep on pushing, I had nothing left to give. They were wary of the doctor who came in to see me and kept saying 'you can do this on your own', I knew i couldn't so when he asked do you want any help i said yes please. I was thankful to be listened to. i had a cut, a big one and was trussed up like a chicken and could not sit down for a week and had hire a blow up cushion. I remember trying to hide it from my nieces (in their twenties) saying to DP, don't let them see the cushion, they'll never want kids if they know what childbirth does to women down there.

NotnOtter - I know somebody who had 2 elective caesareans because she was told her babies were big. None of her babies were that big, just 8lb ish so not as big as my DD who was 9lb. But she happened to work at the hospital where she gave birth, she was given a choice.

When trying to to see how big my next one would be, I was told that scans were inconclusive. So even in childbirth, its who you know. .

Suffice to say, I'm thinking of asking for an epidural!!

Iggly vs NICE

Hmmmm

I have had 3 children, all by elective section, at my request, and at the time of booking them, without medical reason. Thank goodness more women will be able to make the choice I made.

Shagmund simply not enough midwives to guarantee safe one to one care for women planning vaginal births or those recovering from surgery

C/S takes 60 mins
Birth took me 29 hours

I was an inpatient same length of time for both

cereal, with your cushion story you have taken me back a few years! I used to take one EVERYWHERE I went...twas agony if I ever forgot.

The joke here is that I did an enormous amount of research prior to labour and opted for a home birth which went very well.

Same choice for my next birth but footling breech and failed ECV meant C/S.

I am still arguing for choice. I would opt for home birth again.

I believe that there is way too much pressure to have a natural birth at the expense of women's pelvic floor and anatomy. Has the long term cost of repairs been accounted for (let alone the long term trauma to women undergoing these repairs)

Shagmund. I still wouldn't chose a vb. Its not just about the 'safe' thing. Its about a range of reasons. I do not want to feel pressured into something for whatever reason. One to one care isn't going to be the solution for everyone. You do not understand the fear. I'm sorry, you just don't get it.

plus, i also don't buy into your economics argument. its not a massive difference, not to the extent that you are trying to make out.

quietlyafraid:
"You have conveniently chosen to ignore this as you are so utterly blinkered in your opinion that c-sections are completely evil as you had a bad experience."

I am not blinkered I look at the published literature and see that the outcome for the mum looks best with a VB vs CS for unmedicalised reason.

YOU are blinkered you have a phobia.

If I have a second pregnancy I will see how it goes and make a rational decision from my midwife antenatal appointments as to whether to have Csection or not.

Just a bit about NICE - they're there to make clinical recommendations in the context of the greatest good for the greatest number, essentially, and take great pains to establish whether treatments and interventions represent good value for NHS money - referred to as QALYs

www.nice.org.uk/newsroom/features/measuringeffectivenessandcosteffectivenesstheqaly.jsp

Whether or not various NHS Trusts, which are increasingly charged with their own financial responsibility and independence, can afford to implement the guidelines is quite another subject and nothing to do with NICE.

Issues around whether a maternity service is overstretched should be addressed to the current NHS managers in the individual trusts, and arguing that more ELCS will have a negative impact on other aspects of the service doesn't hold - no one knows that as a fact and it depends largely on how the service is managed, both in real life and on paper.

For example, if more ELCS meant less reconstructive urological surgery, which is more expensive than VB, then it's in the Trust's interest to implement the guidelines. It doesn't follow that the uplift will come directly out of the maternity budget.

"The proper comparison to have made would be between women who attempt a natural birth, and women who have an elective Caesarean."

Quoting from the comment on the WHO statistics you link to Quietly.

I think the proper comparison between outcomes for birth would compare low risk women planning vaginal births having optimal care, with low risk women having elective c/s.

Optimal care according to the NICE guidelines involves women having one to one care throughout labour, intermittent monitoring, access to consultant input if labour becomes complicated, and access to fetal blood sampling in the case of suspected fetal compromise.

At present large numbers of low risk women giving birth in the UK don't have consistent access to these services, which are proven to improve outcomes for both mothers and babies.

And I'd like to see the comparison look at more than just immediate health outcomes for women and babies, but also to look at longer term outcomes, including subsequent pregnancies and births.

"YOU are blinkered you have a phobia.

If I have a second pregnancy I will see how it goes and make a rational decision from my midwife antenatal appointments as to whether to have Csection or not."

How rude.

Interestingly, you'll be making a "rational" decision (which NICE now allows you to do! Huzzah!) but those who make a different decision are phobic?

Bagof Holly READ quietlyafraids posts.