Does the NHS have an (unhealthy) obsession with vaginal birth?

[eastmidlandsmove]

There's a really upsetting news story about a premature baby who was in the breech position who died when a doctor insisted on vaginal delivery. The details are really quite distressing.

The case is clearly horrific and exceptional, but I was wondering if it maybe reflects NHS pushing women for vaginal birth. I used to think this was a great thing, but I keep hearing so many stories where women knew something was wrong and asked for a C section, and they were ignored.

I think that's one of the most disturbing things I've ever read.
Yes I do think the nhs appear to think a vaginal birth is best and it is in a lot of cases.
However they left me to continue labour towards a VB because I had a rare problem during labour. Had they intervened and not just left me in agonising pain then I might not have ended up in intensive care on life support. They knew early on in labour something wasn't right but chose to ignore in because they were extremely busy so it was more convenient if I delivered vaginally.

@Sausagema When is that data from? This case happened in 2014. It wouldn't surprise me if it dramatically increased the rates of CS at that hospital in the following years.

Poor mother, stupid doctor.
It’s not rocket science, even a non medically trained person would take all the indications at the time of labour/delivery that an ecs was needed ASAP.
I agree with previous posters that at the very least this doctor should be struck off.
My sympathies to the parents.

Expat this baby was breach because it was so early in the pregnancy. My last baby was showing as breach at 40/41 weeks and they offered to turn him but on the day they found that he had turned the right way all by himself. I had him at 42 weeks after being induced luckily it turned out fine and he arrived safely. It was scary at the time though.

Want2bSupermum

It depends. My local hospital (with an surgical obs team) delivers around 5000 babies a year of which they get less than five cases of delivery before 26 weeks. Depending on where you've worked as a consultant and your shifts, you may never experience that kind of situation for years in your career.

Of course, at a big regional teaching hospital, the situation is different.

I'm not making excuses at all. In fact, my argument would be that obs staff and midwives need a mechanism whereby the latest research and understanding of pre term issues is disseminated down to them.

What I do think is a problem in the NHS is the "not wanting to tread on other consultant's toes" attitude amongst senior medical professionals. My regional specialist consultant was very careful not to appear rude to my local consultant by suggesting a certain care plan or that he partially share my care with the local team. To me, considering I'd already lost two micro-premmies, this felt a bit like putting professional courtesy over the lives of babies (but I understood that was the culture, even though I reserved the right to roll my eyes about it).

formerly The incident happened at Dundee teaching hospital. Also, just in my small circle of friends I know of 6 mothers who have delivered babies at 23-30 weeks in the past ten years. If I know of 6 occurrences I would assume it's a lot more common than people let on. I went into preterm labour with my first and had preeclampsia. My obn here in the US wasn't panicking and managed to control it. I worked until I was 35 weeks when she signed me off. This doctor is wholly incompetent to think you can deliver a baby the way she did. I really think this case highlights the issue of the GMC being seen as a closed shop. It should never have taken 4 years for this to be heard. 12 months at most and that's if they are waiting on reports for a criminal prosecution.

This is shocking to hear. My first was breech and I had a scheduled c-section. I did a lot of research and all data shows c-section is the safest method of delivery for breech babies. I cannot imagine this mother's pain.

Article about whats happened in the US

broadly.vice.com/en_us/article/evqew7/obstetric-violence-doulas-abuse-giving-birth?utm_campaign=sharebutton

helena That is a deeply disturbing article but I bet it didn't take 4 years for that mother to win her case and i would hazard a guess the doctor doesn't have a license. A doctor from my obn group stopped delivering babies because she had a mother a 3 babies die in a 5 month period. Insurance wouldn't cover her and the state wouldn't let her perform obn services. She wasn't allowed to practice from the day after the last patient died while she was reviewed by the state.

I read that

I think baby was 25 weeks which is a slight relief as they might not have lived anyway
And mother was only 3cm

I can’t even imagine the PTSD for that poor mother . And father . This shouldn’t have happened

I have twins, twin 2 was breech and while in labour i was most certainly talked into trying a vaginal birth when if id been given the full facts i would have gone for a section. Everything turned out ok in the end but my twins very nearly died. Throughout my entire pregnancy in fact the doctors were adament that i should try vaginal birth even though i didn't want to and i made it clear as i could but NOBODY listened to me. They even wrote on my notes "vaginal birth if twin 1 is head down" mere moments after id said that if either one of them was breech i didn't want to attempt a vaginal birth.

I do think that the NHS are obsessed with VB, as evidenced by their "try this first" approach. I had my DC overseas where medical intervention happens much faster than in the UK. You would not be permitted VBAC in most other countries for example.

I don't think that it is a cost issue so much as an ingrained ideology that has been established, which is passed on to expectant mothers so they feel bad if they don't "achieve" VB. If more c-sections were booked for medical reasons, the cost would be less for a planned section and I suspect that the % would be about the same. Many EMCS are over issues that could have been identified in advance - eg hips too small.

As an aside when I was reading literature preparing for the birth of my PFB, DH and I came across a statistic that 95% of OBGYN would have CS for themselves or their partners: medically it is much safer.

motherhubbard - virtually everywhere else in the developed world, multiple births are delivered c-sect.

I had both my babies at the hospital involved and at no time was there any vaginal vs section agenda. I ended up with one of each and the care and support I received both times was exemplary. I think this story is a tragic accident. Perhaps when the legs were already delivered the doctor felt it was thr best way to progress for speed or whatever. Tragic yes but babies do sadly die in childbirth... we are so good now that we forget this. Also with such a prem baby the outcome may have been the same anyway. Still horrific but I've no doubt that the poor doctor is also traumatised.

In my experience I have found the contrary to be true, I had a failed induction in first pregnancy and ended up having a c-section. Last pregnancy I was planning vbac but the baby was measuring large for dates so consultant encouraged me to have a c-section.

What disgusts me the most about this terrible case is that the consultant is denying causing the baby's death. Why drag it out for this poor family any longer??

My vbac was my choice at the said hospital as well...i was actually booked in for a section by my consultant as she insisted I might want it. I didn't.

I don't know why csecs aren't the default for multiples to be honest. There's so much that can go wrong.

Whem my two were on nicu there were plenty of 25 weekers. Its certainly not a given that the baby wouldnt have made it.

Good God that article about the US is horrifying. And black women are 3/4 times more likely to die in childbirth??? How is this happening? It's barbaric.

I read this story, it is horrific.
However I don’t believe there is any reflection on the NHS view of vaginal birth. My son was born in incredibly similar circumstances, the bell was pressed for ECS but the doctor had to pull him out because of cord prolapse and breech. I think it’s terrible and if the cervix was only 3cm then that would be why, although I don’t think any of the baby would come out at 3cm.
It’s a painful, heartbreaking case but I’m not too quick to judge on it, I’m sure the doctor was probably doing the best in an highly unusual, stressful, fragile case with not really much to go by other than instinct and knowledge that the baby needed to come out early.
To the poster above somewhere (don’t know how to tag) saying that it’s a relief because they were 25 weeks and they may not have survived you should go do some research, what a disgusting comment.

Of the NHS is obsessed with vaginal birth they have a strange way of going about it given the c-section rate is something like 26%. There is also an increasing push to induce more and more women and failed inductions lead to more ceasareans.

If we want to improve maternity services there needs to be investment in more midwives and more one to one midwive care which is proven to improve outcomes and lead to less need for emergency caesareans.

kat If you notice in the article the doula is saying what they have seen. The patients themselves are not complaining. If the patients don't complain no one is going to know to investigate a doctor.

The higher mortality rate of infants is widely known and has been a huge focus item for years. The mortality rate is based on babies who die during the first year of life. What's interesting is that the mortality rate spikes in the 9-12 month range. It's actually low in the first 3 months, lower than the U.K.

They have introduced all sorts of programs to help improve outcomes. They have the WIC and headstart programs. WIC provides nutritional foods including lots of fresh fruit and veggies, whole grains and good quality proteins as well as formula, diapers and creams etc. The headstart program is early years education.