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.

I had a very traumatic labour, birth and postnatal period. I had a ventouse WITH episiotomy, which failed, and then had a caesarean under general anaesthetic. I went to sleep to the words 'don't worry about stitching her now, just do it later' in reference to my episiotomy.

I had a HB of 7 postnatally, a blood transfusion, and an excruciatingly painful wound haematoma, which wasn't released until day 5 when my staples were removed. As a result of this my wound split open. I then understood why I had spent the previous 4 days fainting with pain. I also developed a wound infection (surprise surprise).

I will not be planning an elective casearean next time. I will be planning a homebirth with midwives.

I was to blame for the cascade of intervention in my first birth. I did not read or understand how to cope in labour, I attended classes - but failed to truely educate myself to birth and how to avoid complications.

I should have taken myself home after an appointment in the assessment unit when I was over due, when it was decided I was in early labour. I should have questioned why I was sent to the antenatal ward.

I had an epidural at 3cm as recommended by a midwife because I was not coping with the pain. I should have said no. I was coping - but very vocally so. In retrospect, this is my coping mechanism for pain.

I should have remained mobile, and stayed at home as long as possible, in my own environment. I should have done many things differently. Yes, I could blame the midwives - but then they were only doing what they thought they should at the time - it was down to me to say no, or ask questions about what was being recommended and why.

Not all women who have a traumatic birth want to go on to have an elective c/s.

I wonder if enough work is done firstly to recognise where things have gone awry before, during and after a birth and secondly try to trace back and identify what the causes of problems were.

This would need to be done in a very open fashion with all the partcipants in such a study talking openly and honestly. There would need to be no pre-detrmining of outcomes to meet a particular agenda.

Only with good quality data can we start to see what are the triggers of problems and then start to plan to avoid them if possible.

Sadly, at the moment I cant see it happening partly because of cost but mostly because there is too much vested interest. All of the different professional groups seem to pull in different directions.

In the mean time women have to make the best of it for themselves with incomplete and sometimes inaccurate information.

Brilliant! I have read before that it's only £800 more.
It's about time women were allowed a choice.

Good. I had all vaginal deliveries but feel women should have a choice in how they give birth.

I had a cs. I don't think you should be able to demand one for the first birth, but yes for any subsequent ones most certainly. I do think that cs as an option should be taken seriously however not above a natural. Although you shouldn't be treated as weird/a cheat/snobby for airing why you might want one. Most births should be natural, that said its wise to be fully informed etc for a cs option.

Im more keen that planned inductions vs emergency inductions are reviewed. Struck me that this was just a bad way of organising eventual cs's. (How I ended up with one)

Will cheerfully add the disclaimer that I'm going for an ELCS for my first in six weeks...but..

I feel this is a humane decision and a long time coming. NICE's raison d'etre is to take a holistic view of the situation under consideration, financial, medical, risks, psychological, etc and then make recommendations based on the facts, so there are no vested interests at work.

I think it's important as an issue of choice, in that women should have the final say about what happens to their bodies- the same arguments around abortion really. It also works on the assumption that that women not only have the right, but the capability to decide, and too bloody right. Women are given these choices for all other medical procedures, and it's about time it applied to birth too.

I would be very surprised to see huge queues of women wanting a ELCS, and it will be interesting in five years' time to see what the effects have been.

I have mixed feelings.
On the one hand, an £800 difference is less than I would have thought.... but it still means there will be less money in the pot to go round for other aspects of medicine.

I have had a natural birth and a csection.
As someone said earlier, the pain in a csection is controlled so far easier to deal with IMO than natural birth.

Having said that, I wouldnt have missed my natural drug free birth for the world, and I think when a woman is well supported by a MIDWIFE - and I capitalise that intentionally, as midwives are the specialists in supporting a woman through labour, a doctor and anaesthetist have other roles and are quite unecessary in a straightforward birth. Also, if I were to have another baby, no way could I put my baby at any greater risk. Ultimately, if I was told by the experts, the safest way of delivering this baby,statistically, is natural vb then I'd definitely do that.

I really am not sure what to think, it feels a bit sad to think that our daughters and their daughters may all have csections, and major surgery will just be the norm in a generation or so, and it will be seen as really strange and 'out there' for women to deliver in the way they are designed to naturally. Another worry is that if Csection becomes the norm, then there will be a real loss of skills in midwifery, and women will be less likely to have access to experienced midwives who will say to them 'yes, of course you can achieve a natural birth'.

I think there are a lot of knock-ons to this.
But on the other hand, there are clearly a lot of women out there who dont wish to give birth naturally who want choice.

I meant to say, I think when a woman is well supported by a midwife, she can have a really good birth experience. Many women I know who aren't happy with their birth, and are subsequently drawn towards the idea of CS have had very medicalised births, lots of drugs and interventions.

I think that this is long overdue.
I had to ask for a CS on lifestyle choice. It was a lovely experience. Midwife was supportive.

2nd Section in Bristol was told that I wouldn't have got one under circumstances. I felt that this was wrong. I did have one because I'd had a first. But women should have whatever birth they chose.
I was ok about having to pay for some of my treatment, I couldn't afford the £10,000 london hospitals wanted nor did I want to go to London to have my babies but some cost would have been ok.

I don't see why more wealthy women should have a better service just because they can pay. But this has always been the way.

But just because NICE says so doesn't make it so. I think Bristol will still refuse but it puts them in a difficult position regading law if something goes wrong and one has been asked for.

"and it is just tragic that birth is no longer normal, but a problem to be fixed."

Of course birth is normal.

For some natural is good for others it causes horrendous outcomes physically and mentally. That kind of natural isn't good.

A modern and sensible approach to birth. Women should have the right to informed choice at every step of their reproductive lives.

When the NHS is so strapped for cash that dying people are not given life prolonging drugs, and the waiting list for "urgent" appointments can be two months or more, I don't understand why NICE are saying this.

They seem to have an odd sense of priorities. £800 x an awful lot of women will add up to a great deal of extra money to be found from an increasingly tight budget.

Brilliant news! I am all for informed choice whether women opt for VB or for ELCS. My ELCS was a wonderful experience and the benefits far outweighed the risks compared to other options, but the main thing is that everyone is informed and gets to chose for themselves.

Having had a CS it is something I wouldn't wish on another. I really hope that the women who choose elective CS are properly informed.

i had an EMCS with a lot of complications after,i had a wound breakdown and my abdomen burst,i was back on maternity ward for a week with the wound open,it was cleaned and packed everyday then i was taken into theatre and stiched back up again,it took me 8 months after the birth to be fully recoverd and thats just physically,i still take medication for PND

i dont think women have much support before or after the birth,well in my case i didnt

i thought antenatal classes were still when u went with your birth partner and learned breathing exersizes and positions

i always thought a CS seemed the easy option

i think its great that women will have an option,if i have another baby im not sure what i would opt for

I'm welcoming it and hoping it means I can have the cs I've been fighting for.

Most posters (and commentators on other websites/new programmes) seem to think that all vaginal births a) cost less b) result in a longer recovery c) are "natural".

I was induced, hyperstimulated, delivered by Keillands forceps.

DD is permanently scarred, I had some faecal incontinence, my episiotomy wound broke down and I was in horrendous pain for the first 2 months post-birth as a result. I benefitted from none of the post-natal care devoted to cs recovery, turfed out after 24 hours and 1 home midwife visit in the whole of my post-natal "recovery". It took over a year to be physically and mentally recovered enough to have sex with my husband and I have ongoing anxiety issues. I haven't yet decided whether to sue for the scar on DD's face. All things considered an elcs would have been a bargain to the NHS at £800.

My story is here. I'm currently 20 weeks pregnant and only sleeping properly 50% of the time due to the anxiety of how I will deliver this baby. So far my informed requests to a consultant for a cs have been refused. Would people rather I risk another birth like the one described and ensure permanent mental health damage?

Oops, should have said "result in a shorter recovery" of course!

That's an awful story herethere. I also had awful hospital 'care'. Some of the nastiest people I have ever met were the staff in the maternity ward. It's pointless to expand the medical procedures available without doing something about the vile bitches who work in hospitals. (and I know that's not all staff, but in my experience it really was 99% of the staff in the maternity ward).

A very good point BlackSwan.

With regards to recovery/outcomes from c sections these may well be different depending on whether it was a plannned cs or emcs.

My sister described her recovery from a emcs as a "Piece of piss" certainly far quicker than many of her NCB class friends who had difficult VBs. She was driving before many of them and one still has problems several years on.

Because the type of birth you will have cannot be predicted many women don't want to "trust to luck" that they will have an uneventful VB (especially in now dangerously unerstaffed maternity unitws) and probably feel that a planned cs is the safer option.

Excellent news.

I had a planned CS due to placenta previa. I would like a vaginal birth if I have another. I feel that women, once they have been fully informed of risks and benefits of vaginal and CS delivery, should be allowed to choose.

We are finally giving women the power to make decisions over their own bodies and not have to put up with things they don't want to. Hooray!

£800 is an awful lot of money when multpilied by the numbers of births per day (who might opt for a cs).

I think it's good news.

I had a regular straight-forward vaginal birth in hospital with DD and am opting for a planned homebirth with DS.

I think the right to choose should go both ways, if you are terrified about birth in advance you are more likely to need an emcs anyway. (as you will need more drugs to calm down, and more drugs = higher chance of intervention, more intervention = higher chance of emcs) A planned c-section is safer and cheaper than an emergency one.

As others have said giving women the right to choose whatever they decide can only be good!

I had my first by emergency c section due to severe PE. When I got pregnant the second time, due to previous situation, I wanted another c section, it was a nightmare, they wouldn't agree until the last time I saw the dr, he then reluctantly agreed to a planned c section if I agreed to a trial at vb first, which I did. Low and behold for a month before the planned c section, I had PE again, not as bad, they kept me going until the planned c section. When dd was born she had the cord several times around her neck and a true knot in her cord, if she had been born naturally she would possibly not have survived with a true knot in the cord.

I don't think I will have any more, if I did I would ask for another c section, after my experiences. It would be a weight off my mind to know it could be finalised early on, rather than having to fight for it.

As for c section for everyone, I think it is a shame that people with no complication to have themselves opened up, it is not a pleasant operation.

This was reported a while back and there were a few threads at the time. It came in the same week that some hospitals said they were going to cut back on CS to save money (how? CS are not handed out like smarties on the NHS at the mo). Anyway, that was another thread!

I think that this is a great idea. I really do believe that women are grown-ups and should be allowed to choose the method by which they give birth.

I also wonder what the genuine cost differential is between CS and VB - when you factor in post-natal problems and longer term problems I don't think they have any idea.

I worry about how this will affect the small minority of women who have medical conditions which would render a CS extremely risky, or life-threatening. These are women who are already denied most of the other choices available - they cannot have a homebirth or give birth in a MLU - so knowing there's another 'choice' they cannot have must feel fairly grim..