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.

x-post there. Enough women survived to raise enough infants, hence the human race flourished.

But really, maternal mortality among human women is pretty high.

I CANNOT BELIEVE that women on here really think that if I'd just tried to walk about and bounce on a ball a bit more I'd have had a much better birth outcome. And Iggly, the human race only needs enough women and babies to survive childbirth to ensure the survival of the next generation. We can still be badly designed and do that. Humans are not designed for 100% survival rate - advances in medical science are enabling us as a race to reduce the risks and complications.

I've experience my trauma and I WILL NOT allow myself (NICE Guidelines or not) to suffer like that again. If I don't get my ELCS I'm packing a stanley knife and slitting my wrists.

Iggly you say that others are saying women are "crap" by pointing out that humans have it a bit touch and go with birth - a lot of payoffs for our large brains.

But in the same post you have said that women are lazy, fat, in the wrong jobs, spend all their time lolling around on sofas and have rubbish pelvic floors.

Righty-ho.

I'm astounded at some of the attitudes to women wanting a c/s.We're living 2011,c/ss are relatively safe. Women shouldn't have to go through horrendous pain and fear if they don't want to.Money is not an argument.

In no other hospital dep would people discuss and say sorry there isn't enough money for you not to have to experience agonising pain and fear.Put up with it.I'm staggered people actually think in this day and age it's ok. I'm also staggered that some people ion here whose only claim to fame is giving birth think they can lecture other women on how they choose to get through the most painful/frightening experience of their life.

As I said before perhaps a long term view when discussing money needs to be taken into account with the money spent on reconstructive surgery after v/b factored in.

Also an emergency c/s is a whole different ball game to an elective c/s.With an elective you're awake,can have skin to skin and start b/f straight away. Perhaps if women got what they wanted more there would be less emergency c/s and more quality c/s the like of which I enjoyed.

ffs human women - as opposed to monkey women I suppose

I'm trying to do too many things at the same time, sorry.

iggly I don't want to put words into your mouth, but it sounds like you're saying that if women only read enough and read the right people then they wouldn't be afraid of childbirth.

That's just not true. I did a huge amount of research whilst pregnant, from a wide variety of sources, and it did not assuage my concerns. If anything, it made things worse, because I read a great deal of clinically supported information on the risks of VB for someone with my issues, which I felt the literature on homebirth/natural birth did not adequately address.

It's not like I sat around wallowing in my fears for nine months -- I did everything I could to educate myself and try to reassure myself. Initially I thought a HB would take of most of my concerns but then I was denied when potential problems arose. So I moved on to preparing for a hospital birth. The state of maternity care in my borough terrified me. The NHS antenatal classes were useless. The MN Childbirth section gave me nightmares.

I am really interested in why women aren't afraid. But I don't think 'I was informed' is enough of a reason, because clearly it can go the other way. I think trust is a bigger factor -- whether you trust A) the people who will be taking care of you, and B) perhaps more existentially, whether you generally expect more positive outcomes in life.

Bottom line is, who are some of you to tell someone else how they are allowed to deliver their baby?

And who are you to say that it is more important for money and resources to be directed at your chosen method of childbirth than it is for money and resources to be directed at sick people who need drugs or operations.

People seem to be forgetting that having children is a choice in itself. You are not forced to become pregnant and you are not forced into having a VB if you don't want one. But if you want to have a child and you want to choose to have a more expensive method of childbirth than the one that is already provided free of charge, then pay for it yourself.

"However, they weighed this against the finding that women who had a CS described a significantly better birthing experience, both immediately postnatally and three months after birth."

Did the study control for quality of care, and one to one care in the vaginal birth arm of the trial?

I doubt it.

It's no fluke that when we're comparing outcomes for low risk women - those who have homebirths have the best outcomes of all in terms of breastfeeding and emotional and physical health after childbirth, even when you include in this arm the outcomes for the women who transfer before and during labour.

If you are truly wanting a clear picture of the risks and benefits of vaginal vs surgical birth for low risk mums, you need to look at the birth experiences of women whose care in labour optimises their chance of having a normal physiological birth.

If you are comparing planned surgical births with planned vaginal births taking place in settings which are obstructive to a normal physiological delivery, then you're going to get a distorted picture.

It wouldn't be acceptable to use as a comparison group women having surgery with dangerously inadequate staffing in theater, so why is it acceptable to include in research the outcomes for women giving birth on labour wards without one to one care or access to consultant input?

MrsHeffley, teh difference is that women choose to get pregnant. They do that knowing that the baby they have created needs to be extracted from their body somehow. They don't just wake up pregnant one day and then have the shock dropped on them they they have to go through labour.

But people do get cancer unexpectedly. As they do a whole host of other illnesses. They are not choices that people have made, Having children is.

Slave I presume you pay for your child's schooling and healthcare then?

Obese people and smokers choose to put themselves at risk of more illness.Should they not get treatment eithe? Gall stones can be caused by lifestyle let's cross off treatment for that.Dp cycles to work(lifestyle choice)maybe he should pay if he falls off.Perhaps people having more than one baby should pay too.......

I'm sure if one is to take your attitude there will be a pretty long list of treatment people should pay for themselves.

Slave - tenuous argument there

So you think that people like sexual abuse survivors (mentioned upthread as a group who quite often want a CS) shouldn't have any children?

That's a well thought out plan.

don't put words in my mouth. I don't think a bit of reading will make childbirth easier. I was responding to the point about looking at why some women are not scared and why some women are. For me that is what worked. I think we need research to see what will help other women. It could be about trust, control, the environment etc etc.

I don't present this as the wonderful cure for fear of childbirth. Different things work for different women.

And Sardine enough of the scaremongering with the whole "touch and go malarkey". We should take a bit of responsibility and look after ourselves. Where did I say that women are fat and lazy? Wide sweeping claim there there's nothing wrong with pointing out that there are things you can do to give you and baby the best chance during childbirth - that includes being fit and healthy.

No, I don't pay privately for schooling and heathcare, but I accept what is offered.

Same as I would if I got a smoking or drinking related illness, or if I got a sports injury.

It's not as if I'm being offered no healthcare whatsoever. Pregnant women are given healthcare. But if they want to upgrade to something that costs more when there is no medical need for them to do so, then why shouldn't they pay for it?

It's like me saying 'thanks for providing my child with an education, but actually, I have a few resons to think that private education will provide him a better outcome, so can the rest of you pay for that please? It's ok if that means that other people miss out on things they need, I don't mind'

MrsHeffley - there's a strong argument for all women to have access to whatever care they need to make birth bearable for them?

Elective c/s?

Access to a birth pool for all who want it, plus a midwife trained in waterbirth?

Homebirth with access to obstetric flying squads to optimise outcomes for women who run into difficulties while giving birth out of hospital?

One to one care from an experienced midwife?

Beautifully equipped birth rooms with a range of expensive equipment to optimise women's ability to mobilise in labour?

Midwives trained in hypnobirthing techniques (growing body of evidence showing hypnobirthing is linked to better outcomes)?

Doulas on the NHS (doula care is proven to reduce rates of emergency c/s and birth trauma)?

Access to a case-loading team for women who want to know their care giver before entrusting them to deliver their baby?

Yes to all of these things.

Plus better obstetric cover for all women, epidurals on demand for all, decent postnatal care, better support for breastfeeding.

Anything else?

Who's going to pay for it? And if we can only have one or some of these things, how do we choose which are the most important and cost effective?

I also think that if you told all women they had to have homebirths, the results for them would be less cheery.

At the moment women who want homebirths and have them have a generally positive experience.

The key is they were able to choose what they wanted. What they thought was best for them.

So allow people to choose CS.

Sexual abuse survivors have a good reason to want a cs. Therfore, they will get one.

That's not the same as all women being offered a cs in the same way they they would be offered a physio ball.

Nature clearly doesn't give a stuff about the individual. My grandmother carried five babies to term. All of them were delivered a good 72 hours + after her waters went, against current recommendations. Four of them lived. One didn't. Peter would have been 47 this year and my grandmother talks about him often, she sadly never got to see him. My grandfather had to bury him as at that time in Catholic Ireland, he was unable to be buried on consecrated ground.

I understand that some interventions are unnecessary, but 500 babies a year die in labour in this country, and criticisms of substandard care contributing to these deaths first outlined in the late 1990's largely haven't been addressed. This frightens me hugely, to be honest. I will cope with pain, I will manage a slow recovery again.. but my baby had a very low Apgar after the Kielland's delivery and it was terrifying to see him blue and unmoving. Thankfully, all was well for us and the doctors were clearly very skilled in using the brutal instruments of torture Kielland's forceps and we had a safe outcome.

I have been tremendously anxious since becoming pregnant this time. I suffered it a bit last time (there has been a lot of infant death in my family) but now I am more aware, realistically, of how unpredictable birth really can be.. and to be honest, I just want the safest option. So yes, natural vaginal birth for me if that is what nature allows but I have massive worries about induction and feel CS might be safer in this circumstance.

I would like to see quality solid research on what really is the safest option for mother and baby and to feel confident that the professionals relaying this research were doing so dispassionately and that recommendations were not resource-led.

Good lord, some people have very low pain thresholds, is it just tough for them?

No, they get offered pain relief.

LeninGrad I also think some women have more actual pain than others -- although it seems taboo to say so?

Babies and women both come in all shapes and sizes, it seems logical that some women will have more pain than others. It's not just a low pain threshold, it's having to deal with more actual pain.

Yet women have to beg for epidurals, I think because some think they're just not managing it well enough.

I absolutely could not cope with the pain or the lack of control and support in the system as it is and should not been forced to again.

Who would have forced you?

Are you being forced to concieve? Are you being forced to carry a child? Are people taking away your ability to earn money and pay for your own cs?

No, they are not. So why are you talking of being forced?