Traumatised women should not be forced to give birth vaginally against their will

[Ushy]

In the childbirth section, one of the biggest posts on the childbirth forum -nearly 800 replies - is about women who have had traumatic previous deliveries who are begging for a caesarean because they cannot face a vaginal birth again and are terrified.
This is just plain cruelty - can Mumsnet campaign for a bit more sympathy from maternity services? There is nothing wrong with promoting vaginal birth for most women but there has to be more understanding of the terror and desperation some women who have had traumatic births feel.

I think better support for vaginal deliveries is the answer - although how that will be achieved in this generation I do not know. I was terrified of a second vaginal delivery, but I was reassured by, a) the promise of one to one care, barring exceptional circumstances (luckily in my hospital that was possible), and b) the knowledge that I could get effective pain relief when required.

I am not diminishing the dreadful fear - I had PTSD following my first - but I for one was just as scared of having a C section because of having to cope with a baby and young child while recovering.

I think you are right that better pain relief and care would have been better to avoid trauma in the first place but once people have got a mega phobia you risk making them mentally ill by forcing them to do something they cannot face. The pregnancy just becomes a ticking timebomb or the woman has to go for termination. There was a researcher who looked at what happened to women forced to give birth vaginally against their will and their outcomes were far worse than offering a caesarean if she wanted it. I agree - if maternity services were better in the first place there would not be so many people traumatised but once its happened you can't make them endure 9 months of mental anguish.
It's barbaric!

I was meaning that the knowledge that better support would be available second time around helped me to cope with my fear. Although it would of course be vastly preferable to have received it to begin with.

My second birth was also a hundred times easier and I too would describe it as "healing".

I was 'granted' a c section after a near death first birth. It was very relaxing and trauma free, I had a c section for my third birth too. It wasn't a huge deal to get a c section either.

Different strokes for different folks.

All the support - promises of on one care and guaranteed pain relief in the world couldn't have convinced me to go for a VB after a traumatic birth.

It's all very well saying that that is "the answer" but last time I looked we were all different and whilst a better supported VB may have been what worked well for you, very many of us were very, very happy indeed with our c-sections, have no regrets and wouldn't change them for the world.

If anything, it would nice if people who aren't capable of walking a mile in our shoes just, you know, shut the fuck up occasionally and stopped trying to tell us what we 'need'

That was to gaelicsheep btw

Oh FGS.
Have you really nothing better to worry about?

What next?
A MUmsnet campaign to promote handwashing.

Ridiculous.

I had a horrific first birth In London and suffered terribly afterwards both physically and mentally. By the time I had DS2 we had moved to Devon where I was immediately offered a CS and great support throughout my pregnancy. I was quite surprised to read about mners who were being refused CSs and feel very lucky to not have had to fight for what turned out to be the best option for me. Luck people who had a better experience 2nd time round but the problem is you can't guarantee this and I was more concerned about the damage me having post natal depression again would do to my first ds.

I think I said "I think", did I not? Meaning, "in my opinion". Last time I looked this was a free country.

I think there is a bit of misunderstanding here. The question is should women BE FORCED to give birth vaginally if they are absolutely terrified. No-one is saying that women should not get all the support in the world to help them have a vaginal delivery - that's fine. The question is what should happen when they say I just can't face this. In the 21st century should women be FORCED into vaginal birth? I think it is appalling that this is happening especially because we know these people have worse psychological outcomes than women who were gven choice.

Absolutely support the campaign. If men had babies there would be a fundamental right to choose mode of delivery. I don't think a traumatic previous birth should be a prerequisite either. But C-section on demand would be expensive and in this 'age of austerity' I can never see this being agreed to.

Baysmum, what you said is what the research showed on this. From what I understand, of the women who were forced to have vaginal delivery, those who had it and there were no complications were over the moon but those that developed complications had a higher level of trauma and mental illness as a result. Those who chose caesarean and were granted it were all very satisfied. So there were more happy women and less mental illness in the choice group.

Total support from me.

There's an atrocious lack of understanding and sympathy around the subject of birth phobia. moondog's response shows this. People chose to believe it doesn't exist because either they haven't experienced it themselves, or simply because it is convenient for them to ignore its existence.

(You get the same attitude towards depression sometimes. 'People should just pull themselves together' etc. It doesn't work as an approach there, either.)

As regards the cost of a CS - the truth is that we don't know the full cost of a birth. The 'on the day' monetary costs are the only ones ever mentioned (so a CS is more expensive than a forceps delivery, for example - 'on the day').

The follow up costs of aftercare, physio, counselling etc are never taken into account. The emtional and psychological cost to a mother, baby and family where a birth leaves them so traumatised they suffer PND and bonding/relationship problems as a result is never accounted for. And at a time when over 70 percent of weekend admissions to my local A&E department are for alcohol related injuries - and these are people who get treated for free - I wonder why traumatised women requesting a CS are treated as a such burden on the NHS.

Of course there should be support/education/counselling for those wanting a better VB experience the second time round. But to offer them 'VB or nothing', whatever the likely consequences, is totally short sighted and inhumane.

PS Interesting article in the Guardian about birth phobia, PTSD, CS and attitudes towards them (and related issues) -

www.guardian.co.uk/lifeandstyle/2010/nov/20/elective-caesarean-tokophobia-childbirth-phobia

Barkfox, thanks that's an interesting article. This explains that some women opt for an ELCS due to 'fear' of childbirth. Not to go off on a tangent...but what about those of us who simply weighed up the pros and cons of vaginal birth/ELCS and decided ELCS was the right mode of delivery for them?

The tendency to characterise women (particularly pregnant women) as emotional and frightened is sexist. I felt empowered to say I didn't want to give birth vaginally and was prepared to pick up the cost of an ELCS - but it's a prohibitive cost. I'm all for choice for everybody.

The article also points out that it's unusual for pregnant women to routinely see a consultant. That's part of the problem in my view. Midwives provide a valuable service, but they aren't doctors or surgeons. Midwives can prove to be a barrier to women getting proper advice from a trained consultant on the availability of an ELCS and on the relative risks of ELCS. By this I mean that (depending on the midwife) unless a women is adamant that she wants to see a consultant she's unlikely to get to see one.

Yes I agree, they should have the option of a CS but I think they should first be helped to get over the first birth and look at the second more positively. I was very afraid (terrified in fact) of giving birth to my first and pleaded for a CS and wasn't even given the time of day to talk about it. Luckily it all went relatively well and I went on to have two more without the fear. I think in my case I shouldn't have had the option because I hadn't given birth before.

But does this actually happen?

Because everyone I've known who has requested a c-section because of previous trauma has had one.

OK its not confirmed until late in the pregnancy but thats standard practice, eg, I'd had 2 c-sections it was totally understood I'd have a 3rd but it wasn't put in the diary until I was 34 weeks.

I understand your concerns but don't think there really are many women who are forced to have or try to have a natural delivery who are vehemently opposed to it after a difficult first birth.

I had to be very assertive to get a c-section for my second delivery.

This surprised me as I had such an appalling experience the first time around - 3 days of contractions with inadequate pain relief (sodding TENS machine wasn't charged properly ) ending up in crash section, poor ds nearly died due to lack of oxygen and I was extremely exhausted.

Yet I was harangued and insulted by my consultant and his colleages at my 36 week appt who were not prepared to understand why I didn't even want to try a vaginal delivery.

I did not want to experince the pain, danger and uncertainty again and childbirth is never risk free.

Thankfully, I was allowed a planned section which was delightful, although the recovery was the downside.

I agree with Tracey but I think it also helps to know the system, if the first consultant says no then request another consultant and ask for one that is sympathetic to c-section requests. Personally when I had my first appointment at 16 weeks with the consultant they tried to fob me off with putting a date in the diary at 34 weeks but I sat my ground and requested they book a date there and then so I wouldn't worry about it for the next 24 weeks.

*waves to Tracey, everything went fine I have a gorgeous DD and will be back shopping soon I hope :)

I too had a traumatic first birth but a 'healing' second birth. In fact the second birth was just wonderful, possibly the best experience of my life.

If avaiable however I'd have opted for a CS the second time, std I was so scared the firts time I'd have probably even gone for it then if offered.

I think my fear and medical model is partly what hampered my first birth as I had an epidural far too early and then ended up entrtey with a medicalised situation in which I felt I had no control and I just suffered terrified whilst people 'did things' too me.

So it's tricky, I now the idea that we don't always know what is best for us is entirely inappropriare for adult women but I think the psychology of birth is complex and often our fear, or the fear of the fear, can cuase us too make choices which wouldn't necessarily be best.

Ultimately I suppose women should be given control to make the choice,and if it's 'not best' its their choice to do so.

BUT I think a diffreing atittide to birth and giving women control at the time of birth would be a better way to go.

Yeay Libra - I did chase you on another thread recently - congratulations!!

And yes I agree you do have to be very assertive. Despite me having had one c-section after very long labour etc etc they still tried to persuade me to try for a natural birth the second time. Luckily I had done my research and have Dr's in the family so knew what to say to get the outcome I wanted.

traceybath So what do have to say to get the outcome you want?

seriously, i'm due to see a second consultant soon (i'm 30 weeks) after seeing and being insulted by a consultant at 27 weeks.

I feel i'm being penalised for the fact that i didn't have a csection the first time. Its as if the hospital wants to ignore how traumatised i've been with the first birth because hey, i managed to get the baby out vaginally so i can do it again!