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.

Oops quietly didn't mean to sound so rude, but your bit about Germany made me lol and I really didn't understand the rest.

Gail, do you have a link?

I don't come onto childbirth threads very often but the topic has suddenly become quite close to home.

I am all for choice, but exactly how will this be funded? When I had my twins 7 weeks early both were breech , but as there were no theatres free I had a VB - which I was pleased about.

But if more women choose to have a CS because it fits in with their holiday plans (I completely understand about the need for ELCS for health/ mental reasons) how many emergencies will become a tragedy?

My consultant was all for setting up a theatre in the delivery suite "just in case". But we were lucky it worked out - unless there is a big investment in equipment/staff/theatres it will be a disaster.

Starlight My poor IT skills don't allow me to link , sorry. However, if you google The Lancet you can read about it there. A friend pays for access so I put quite a bit of info on the thread in Childbirth. Interestingly no-one has commented on it!

One of the things that stood out for me was that the catether method reduced the number of operative deliveries caused by foetal distress and the two signigicant maternal events both occured in women who had gel induction (one uterine perforation and one uterine rupture).

And for those interested in cost - guess which one was the more cost-effective option?!

"and women without 'clinical need' aren't treated with horror and contempt for choosing a c-section"

Comments like this give me a sense of deja vu - remind me of the 'formula feeding mums aren't evil ya know!' comments you get when you discuss breastfeeding. Comments usually made in the absence of ACTUAL personal criticism of a mothers choice not to breastfeed.

Other than a few chuckaway comments about 'too posh to push', I've never heard anyone in real life saying anything which suggested that they feel 'horror' or 'contempt' towards women who don't wish to have a vaginal birth.

It's almost like you want to feel persecuted or something.

Honestly quietly - people may not properly understand or support your wish for a c/s, but I don't think they think you're a BAD PERSON for wanting one......

"amazing any babies are born given how tightly the head fits and the angles that need to be achieved!"

Yes - quite. Especially given all the obstacles put in your way which make it even harder: like having someone come and shove their hand up your fanny every few hours (great for disrupting the normal hormonal cascade of labour); being made to lie down on your back, which makes the diameters of the pelvis even smaller; not to mention pushing your baby out uphill while being shouted at by strangers.

No wonder so many babies don't want to come out......

Whilst you're at it why don't we all get colostomy bags too, pushing poo out is such a drag, let's all take the easier, surgical option.

C-Sections are major surgery. There are risks involved in all surgery, and all medical interventions of childbirth. The NHS should not be paying for unnecessary surgery. If birth were "managed" differently women would have much more positive experiences of labour, and there would be fewer women thinking that a c-section is the simpler, easier, less painful choice. Perhaps we should spend those £800's on educating Dr's, ANte-natal class midwives and women who are afraid of childbirth to the point where they request non-clinically necessary c-sections. I think the money would be far better spent on some counselling and education, instead of slicing babies out of their mothers.

Well said GreenMonkies - just what I was trying to say further up the thread but failed miserably to do!

Greenmonkies (and anyone else who agrees) go ahead, direct me to some "education" that is going to remove the FACT that the last time I gave birth 1) It scarred DD for life 2) It caused me to be faecally incontinent 3) my episiotomy broke down and I had to sit on pee/poo next to a gaping open wound for 2 months 4) the pain of a back to back labour to full dilation of a baby in transverse arrest was so excruciating I wanted to kill myself (and attempted to knock myself out to end the pain). 5) I've had a breakdown and been under mental health care for the 1st time in my life. Every fibre of my being is telling me to have a cs to avoid ANY risk of being in that situation again.

I have explained my story to several HCPs, including one consultant and so far, at 20 weeks pg with baby 2, I have been REFUSED a cs. The NICE guidelines are for people like me.

Please direct me to the magic treatment that you say is out there. What/where is it? I'll even pay (it must be cheaper than the £12k I can't afford for a cs).

Do you ever get to the point where you can't even be arsed to answer? When you wish there was a button that would automatically post "READ THE THREAD, ALL OF IT."?

Greenmonkies, is it major surgery? Is it? Is it? IS IT? Thank fuck you pointed that out. Not a single soul in the gazillion previous pages knew that! What are these silly ELCS women thinking?!

^StarlightMcKenzie Mon 31-Oct-11 21:01:24

IMO any woman who requests a c/s should be given one, but there should be investment in all the things that would deter a woman from requesting one, such as confidence in quality VB care, experienced one woman/one midwife set ups, better antenatal education.

And this would work for epidural and other pain relief requests. To simply bully a woman into accepting a VB she has no faith in being able to achieve for some of the reasons stated above is barbaric.^

Great post starlight

Excellent example of thinking badly of people who want a cs Greenmonkies.

CS is terrible, major surgery or the easy option? which is it?

Childbirth for some is dire. CS would make them mentally and physically well. Comparing it to defaecating is ridiculous

Perfect example where help in the form of counselling is needed to help the person get over what is affecting them and then they should get a Csection on the NHS.

herethereandeverywhere
I had psychotherapy to deal with PTSS after my natural VB. It was really helpful. I was fortunate in having an enlightened GP who didn't just take the view that it's childbirth, natural, normal get over it.

I too went from a sane healthy person to a terrified traumatised wreck still having treatment 9 months after my pop face presenting delivery. (Hardly a surprise it went wrong eh)

I'm happy to chat if you need to. I do understand

BagofHolly lots of people have no idea of how painful it will be in recovery, how intrusive it will be internally, of the complications that can go on indefinitely, adhesions, prolapse, scarring. So yes, Sarcastic One, many people do not realise it is major surgery.

herethereandeverywhere, I have no idea what happened in your first birth, or why, so how can I possibly pass comment? I'm not talking about magic, or one-size-fits-all approaches, but the concept that any women who isn't too keen on the idea of a natural delivery should be able to request (and be granted) a c-section is wrong for many reasons.)

Quite right shagmundfreud, my overriding memory is being strapped to a bed being made to push and it felt uphill! I'd tried to get off and lie on a ball but ended back on it (not sure how, by that stage I was powerless ) and it was so unnatural. I am 40+2 now and have stressed to DP don't let them strap me to that bed.

And if a Dr comes in and offers help, don't let the midwife say no, cerealqueen is going to push this baby out when in fact, she is too knackered and has nothing left to give and wants the help offered. It is not indicative of a failure by me , or the midwife, but being made to feel like it is, is shit.

herethereandeverywhere - I don't think that anyone is saying that there's any magic treatment out there (well at least I'm not) but I do think that we as a nation should all make sure that ladies get the care and support that they are all entitled to (be that antenatal care, counselling whatever) before resorting to a major, invasive procedure.

And for what it's worth, my first birth was a horrific, traumatic event, that left me psychologically and physically scarred for several years. However, I educated myself, and as a result had my second baby at home, where the cascade of (unnecessary) intervention I'd suffered the first time around couldn't happen again. The response to a bad first vaginal delivery shouldn't always be to rush for the sunroof next time. Examine why the experience was bad, ask why it all went wrong, investigate, demand answers, and take what ever steps you need to so that it doesn't happen again.

Toothbrushthief I don't think badly of those who want sections, I think badly of a system that has made it seem like the better option. There are times where it is a life-saving clinical need, but to treat it as the same as a vaginal delivery is ridiculous.

Have you had a section Green monkies?

Because, Greenmonkies you said, "Perhaps we should spend those £800's on educating Dr's, ANte-natal class midwives and women who are afraid of childbirth to the point where they request non-clinically necessary c-sections. I think the money would be far better spent on some counselling and education, instead of slicing babies out of their mothers."

So I ask again, where do I turn to for this "education" which is going to reverse the desire to have my unborn child "sliced" out of me?

I would respectfully suggest that the only way my case (and others like it) can be satisfactorily resolved is to be granted a cs. A cs which is currently being refused (but which would more likely be granted under the new guidelines)

It is naive in the extreme to think that people can be educated out of a situation like mine.

I said earlier in this thread that my traumatic birth experience happened 20 yrs ago.

It would appear the same experiences are occuring.

I agee with the premise of improving VB .....but IT'S NOT HAPPENED. Why should we believe it is going to??

I do believe that a policy driven alternative will make professionals reconsider why women don't choose VB and work at correcting that

Greenmonkies hasn't been personally critical of someone for choosing a c/s.

Her point was about women being made so terrified of birth that they opt for surgery to avoid it. And see surgery as the 'easier' option. Which they do. As evidenced by the number of 'I had a glorious c/s - I scarcely knew I'd given birth' comments.

herethereandeverywhere I didn't say a case like yours (or all cases) could be "educated" away. There are some situations that call for a section, and they should get them. But not as a tick box at your booking appointment "how do you plan to feed your baby?" "how do you plan to deliver your baby?" and so on.

Toothbrushthief no, I clearly state I've had two vaginal deliveries, one traumatic one, in hospital, one a planned homebirth. I'm not sure how you think this undermines me?

Our section rates are rising, yet our infant and maternal mortality and injury rates are not falling. This alone should tell every one that it's not the safe, easy, cosy option it's seen as.

Where did I say no-one should have an elective? Where? I didn't! I said it's not something that should be made as a preference, and that more education was needed so that choices were fully informed, and not made based on fear and misinformation. Read the words I'm actually typing, not the ones you think I'm typing.

I'm going to bed.

I disagree Shagmund - her post implied that women choose the easier option because they cannot be bothered with VB. It's ignoring all the posts from women who have given their personal tales of trauma.

Not one of them has said frankly I can't be arsed...

Why do you think NICE are advocating it (out of interest)

Greenmonkies which part of the new guidelines advocates granting of cs as part of the booking in questionnaire? To be granted automatically on request? I think you should read the guidelines before you assume it will mean cs "on demand". It won't.