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.

Also things like fistula. You're alive, sure. But not exactly having a ball...

I don't think you need to worry HitTheRoadJack. The vast majority of women would still opt for vaginal birth, I am sure.

I should hope so.

And it's not because I don't "fancy" it. It's because I've weighed up the risk to both my physical and mental health and decided against it as a mature responsible adult. Pandering to some other person's idea of a 'real woman' is not at all on my list of things to consider.

Definitely think it's fair that women have a choice of whether to have a cs, particularly when one considers the fact that with a cs there is a certain level of care that is guaranteed and with natural birth the only thing that is guaranteed (in certain trusts anyway) is that they will do as little as possible for you, even if you have had a really shit time of it. The way women are treated in maternity units actually disgusts me - they treat women with so little dignity and respect it makes me really angry.

'wode up your fanny'

I don't think women would opt for c-section 'en masse' either.

For the record it isn't just about 'avoiding pain' that women want to elect. Its about a whole bunch of different fears and concerns that women have.

Some are rational. Some not so much. But then thats what a phobia is. Irrational and sometimes out of proportion from the real risks.

Fears include (but are not restricted to):
Fear of death
Fear of losing the baby
Fear of pain
Fear of injury (either to baby or to mother)
Fear of incontinence
Fear of a woman?s body 'not being the same' afterwards
Fear of it affecting sex
Fear of no longer being attractive to a partner
Fear of embarrassment and loss of dignity
Fear of not being listened to by medical staff
Fear of not being in control
Fear of flashbacks to a previous experience
Fear of being treated poorly by medical staff
Fear of vaginal birth
Fear of c-section
Fear of not bonding with their child
Fear of doctors

Its not as simple as saying women are trying to avoid the pain of labour.

If you have a woman who was sexually abuse as a child, then it starts to make more sense... Control and not feeling in a vulnerable position with legs up in the air etc etc.

Its a deeply complex and personal issue.

Not helped by the fact that when maternal requests are recorded, they don't record the fact that it was done for fear / mental health reasons (no standardised ways of recording electives was recommended by the select committee 4th report on health in 2003 but nothing has been done). This means when you've got all these people looking at the stats, and guess whats not showing up......? The words MENTAL HEALTH AND FEAR. it just gets assumed its lifestyle...

What about women who don't 'fancy' giving birth in hospital with access to medical equipment?

Do they have a valid reason?

Why is it different?

I think this is excellent news.

Like Bibbity - I don't think that suddenly loads of women are going to want c-sections who wouldn't have had them previously.

I've had 3 c-sections - 1 emergency and 2 planned and all were excellent but if I'd been able to have lovely natural births - well of course I would have done that.

Also was home in 24 hours after 3rd c-section and recovered very quickly after each one and bf succesfully etc.

And if you have a phobia I don't see what the problem is with having a section if it makes you feel better, takes away some anxiety.

I had a vaginal birth - just one. I'm healthy, it was normal and I'm still in pain 18 months later - and all the doctors can say (when I can see one, which takes months) is that constant pain is one of the things we can expect after giving birth vaginally. Nerve damage is 'normal', apparently. No one said that beforehand. Beforehand everyone said it was natural to give birth vaginally and it would all be fine. No one - not even once - mentioned the risks involved. For any other procedure in a hospital, they would go thru the risks in detail with you and leave you to make the choice.
I won't be having another child, even though we'd like one because the thought of looking after two children in constant pain - probably made worse by another birth - surrounded by doctors who don't have the time or money to do anything about it - is more than I can take. The doctors are not even sure why I'm still in pain and don't really seem that interested in finding out.
If you're about to give birth for the first time, have a cesarean. The alternative is like playing russian roulette with your health - and believe me, once you have to screw up all your courage just to walk to Sainsburys, you really realise how important your health is. And like I said, postnatally, the doctors might just give up on you.
Everyone I know who had a cesarean, bar one (who had a terrible time all through), had a shorter recovery time, so the extended recovery time thing is rubbish - plus people actually treat you like something a bit difficult has just happened and don't expect you to be doing everything.

Since we have the capability to peform CS it is onlyr ight that women have the choice. VCB hurts a lot and those who say things like "a nice natural birth" must have fanjos of steel.

I'm not sure how I feel about this. I had an elective section (big breech baby) with my first child 32 years ago, and I can't tell you how crushingly disappointed I was! I felt that I'd missed out on so much.

I had to push (no pun intended!) really hard to be allowed VBACs 26 and 23 years ago with the other two. So glad that I did, it was a much more satisfying experience.

Fantastic news.

I had 2 e/c both fan bloody tastic,pain free and I was up and about the same day(albeit slowly) even after my twins.With my singleton I was up and about before the v/bs on my ward.

There is absolutely no reason for pain with a c/s. I was off all strong painkillers on day 2 with both of mine.

it's good that the nice guidelines are being changed but better if nice guidelines were actually enforceable, on any area of health, not just maternity. 'national' health service my arse

anyhow, am v pro natural birth, but even more pro 'informed choice' and am pleased about this decision. have to say though, I had a horrendous c section - everything went very well and have a great scar, or lack of scar - but there was really crappy more or less non-existent pain relief so I hope they don't leave other people like I was left begging for pain relief. i would always take my own to hospital now for any operation, as strong as I could get it, cos the system once in there sucks big time

crummymummee I feel so sorry to read your story, and your username is so sad as well. If there are things you would like to talk about then a thread in health or mental health would be met with support and sympathy and maybe some practical advice if that is what you would like.

Also I have to say I know several women with problems down below still years later after a v/b, having reconstructive surgery.Nobody talks about this issue as it's a bit embarrassing but I'd love to know how much it all costs.Given the difference between v/b and c/s is only £800 I doubt cost can be an argument for v/b if you add in the costs of years of post birth ops/treatment after.

And I agree that there does seem to be an effect where problems that women have during pregnancy or after birth seem to be met with "it's normal, give it time, there's nothing to be done, soldier on" type responses.

MrsHeffley what about the women who have no problems "down below"? What about the women who have instruments left inside, or scar tissue issues?

I have issues with the 'trying to reduce c-sections' thing.

We should only be trying to reduce them if they are being done and women aren't happy about it. Trying to artifically reduce them actually puts lives at risks. Are women trying for longer than they should to deliver vaginally?

We have to acknowledge that babies are getting bigger, women older and more obese. I've been shocked reading about how training more obs to use kellands would reduce c-section rates. At what cost? I was reading a post on another forum from a woman who ended up with a colostomy bag after having a forceps delivery. Her heart breaking words that had she know the risks she would have opted for a c-section rather than go through what she was. C-sections have risks but vaginal births aren't without risks too... Something often missed.

A lot of the drive to reduce rates is still being fuelled by an old WHO report that recommended 10 - 15% rates internationally. WHO has since said there is no evidence to support an optimum number of c-sections and what really matter was that anyone who needed one, got one.

But you still have people like the Head of the NHS alliance quoting this... in a debate on electives and trust banning on national radio. (He's since been minced about it and apologised saying he wouldn't use the figure again).

Its being looked at in completely the wrong way if you want to talk about costs and risks.

If you want to look at c-sections we should really be looking at high rates of emergency c-sections and asking why thats happening - not looking at electives. Theres wide unexplained disparities across the country on this.

Emergency c-sections are the high risk thing and much more expensive than planned c-sections. Are there better ways that we can deal with this, perhaps we should be seeing if certain women, 6provided they are happy with it and not pressured^, should be offered a planned section? Afterall, I think the stats for over 35 year olds are 1 in 3 ends up with a section anyway?

It should be about what is in the best interests of the individual woman, not targets.

CHOICE IS PARAMOUNT THOUGH. It should be completely down to women to make call on this.

As a sidepoint, I support women who want to have homebirths. You can make a lot of the same arguments against homebirths as maternal requests. They have pressure group and political support though...

'instruments left inside'' "scar tissue issues".Not sure the former is exactly a regular occurrence and surely you can have scar tissue issues with a v/b (I have a friend who most certainly has).

Hittheroad, I can't decide whether you are being deliberately inflammatory or not. Because we could go along this ping pong route indefinately - what about the incontinence? or vaginal fistulas? I don't think anyone believes CS to be risk free, in fact women are probably more aware of the risks associated with CS than they are of the risks with VB. What we are saying is that the right to make an informed choice should be available to women.

"instruments left inside"

Yeah cause that happens so often...not!!

Hittheroad why are you so against women have an informed choice? I don't get it, not very sisterly of you I must say.