My Ob/Gyn admitted is is indeed true that most female Ob/Gyns opt for elective c setcion!

[cherrysodalover]

So having had a c section first time round(baby over 10 pounds- small pelvic opening) I assumed I would automatically get a c section.
Now I can have one if I want but am also being offered normal delivery as an option-we can scan to see how big baby is in the days pre due date- this can be 1 pound out though.
So I asked my female Ob/Gyn whether it is true that most Ob/Gyn's choose elective c sections and she admitted yes as do most urologists.
I asked her why she thought they did this knowing the slow recovery time and she said it is as they see what happens when things go wrong and so weigh up the disadvantages of a planned c section against this possible outcome which of course is far worse than the week of healing after major surgery- she also mentioned your pelvic muscles are less likely to be badly damaged by a c section.

I have to say it kind of shocked me- the women involved in helping people post birth who have problems choose surgery over natural.

It made me think maybe the midwives don't see this which is why so many are so anti c section- they may see women with pereneums damaged but they do not deal with them going back sometimes for many years trying to get the issues caused by this resolved?

And mmm yes it is making me sway towards having a second c section.
Anyway it really is food for thought isn't it?

Sorry quietly

Hope you don't mind me asking - have you considered hypnotherapy by a specialist practitioner?

I spoke to a head of midwifery at a large teaching hospital once who felt that this type of therapy can be very useful for women with extreme fear of birth - she'd seen some very good results with it.

"Going private might be an option, but realistically the logistics and costs of it, make it beyond my means".

A private section can be had for about £7K. Most couples where both partners were employment on an average wage wouldn't bat an eyelid about borrowing that much to spend on a car. Could you not run to this, if you were given time to organise it?

You shouldn't have to spend it and hopefully you'd find a helpful consultant - honestly most women who have PTSD or primary tokophobia are treated with kindness and compassion once the problem is acknowledged and she's been appropriately referred. You can always appeal to the head of midwifery or the supervisor of midwives at your local hospital to advocate for you.

Quietly - please don't feel like a failure. I agree with you - I'm sure there are a lot of women just like you out there. I know I was when I was pregnant for the first time. I was shit scared at the thought of labour. In the end, DS1 had to be born by an emergency section without me going into labour so any decisions were taken out of my hands. I have never felt like a failure about it, without that c section neither my son nor I may be alive today. On the odd occasion that anyone has made any comments to me about being too posh to push I've put them straight very quickly. I agree with you that mothers fears should be taken more seriously and hope you find something that helps you, whether that is a supportive consultant, hypnotherapy or something else.

The prospect of fighting to get it acknowledged is daunting enough. Try telling someone something like that when you literally can't speak. Just coming across one unsympathetic person in the process of 9 months... I really just need support. I just do not feel with all the pressures on the NHS right now, I'm going to get the level I need.

And then theres the social side of it. I have no idea how to begin to tell anyone I know, much less strangers. Its just this massive taboo. Don't tell anyone you might be considering having an elective c-section! Bad woman! Terrible person! Doesn't deserve to be a mother! You can tell yourself over and over again, this is total bull, but its still there at the back of your mind, making you question yourself.

Hence, the reason I find the obstetrician thing so very interesting as it really does break the cultural opinion and is very unpolitically correct. Good for them, if they think its best! I guess I find it reassuring in a way that professionals in the field are making ones similar to the one I would like. It does show that there really is a nonsense about the perception of the best way to have your baby. The evidence just isn't there. There is just too many flaws in the arguments put by either side, for one to be significantly better. Each has its pitfuls and risks. Clearly when there is such a split with midwifes and doctors, we shouldn't be putting so much energy into beating ourselves up over what we feel is best for us. Like I said originally, so much of this is based on cultural perceptions and beliefs, rather than anything else at all. And obviously the bits everyone is trying to avoid and fears is exactly the same. I just think so much more could be done to address so many issues it throws up though if people realised just how socially constructed this all was.

I'm 34 now. Time is slipping away fast. Money could be saved, but my hours have been cut to two days a week and I'm having no joy with finding a new job. But its logistics more than anything thats the real issue here. With seemingly no private maternity wards outside London area, I'm pretty screwed. That £7000 certainly wouldn't cover all of the costs - theres all the check up etc to consider. Not to mention the travel. And then the thought of being up here and there being a problem and not being able to get down there in time. And I don't have family down there to be able to help either. I think it really limits it as an option, so I just end up back at square one thinking that my only option is the russian roulette of the NHS.

Of course it doesn't help when my perfect doctor sister-in-law is currently pregnant. I'm refusing to go to any of my husband's family dos right now, as I can't handle it. I have cut off friends who have had children on facebook. I avoid pregnant women as I can't stand to be around them. But I know its just going to get worse.

So I'm sort of at the crossroads of making the decision that maybe I have to let this go and try and move on somehow in my life. Its making me feel irresponsible and unworthy of even considering the possibility of becoming a mother. All the time it just makes me feel a total failure. I know can't carry on tearing myself (and my husband) up with this. I'm angry that I feel like this though and I'm angry I feel put into this position and that others have options available to them that I simply just don't.

We shouldn't be having a debate about how shocking it is that female doctors have elective c-sections and everyone else is treated in a different way. It should just be acceptable for everyone if thats what they want and feel is best. Without question.

shagmundfreud and Quietly afraid- very eloquently put....and interesting points also from all.Apologies to anyone who feels I did not read their posts closely- this is a long thread..... but I am commenting on the attitude that I see in some of the posts that childbirth is this natural process that most women can go through with minimal intervention-it's a misnomer.23% is not an insignificant number and as I siad I do not have the stat for women who have such problems that lead them to wish they had had a c section.

Yes there will be more c sections than necessary in some circumstances and sadly circumstances when a c section would have save a baby's health or life and I think this is more what I am talking about.Depending on the maternity team and their attitudes a c section may be delayed because of this dogmatism that "You can do it- come on it is natural......"Indeed at some stages during labour this is a healthy attitude to take if all is in order but it stops being helpful and becomes dangerous at a certain point.

Whilst I do not have mortality rates to hand on either type of birth they are significantly lower than they have been in the past but my real point is that ihave detected a much more positive attitude to having a c section here in the US, should you need one and I think that is very healthy.My boss expressed her sorrow that I had had to have a c section and had not got to experience a natural birth-luckily I am secure enough in myself to have laughed when I received that e mail but many would have been affected by that kind of attitude that for some reason is more prevalent in the UK.

The attitude I encountered in the UK was so negative-from lay people and midwives and now having had the utterly positive experience in the states and to not have one of the 20 people I know report a negative birth story I am in pretty good position to compare-and I think something something is going awry in the UK, in the general attitude to birth and of course the influence of targets.I guess my Ob/Gyn just made me think when she revealed on request that indeed her profession tend to choose c section over vaginal birth.
I happen to think a vaginal birth is preferable if possible but that c section should be readily available when it is deemed necessary.
I am sorry you are having such a hard time quietly afraid but please don't let your fears prevent you having a child.It is the best thing in the world to be a mother. The fact is that an elective c is an option and I am sure you can have them if you push enough- it sounds like you have more than the average fear of giving birth and you have clearly researched it with intelligence.You have a 7 in 10 chance of having a vaginal delivery if you go for that- anyway my little guy is waking so have to go.
Thanks everyone for all the interesting points- I have learnt much from sharing the discussion from you all.

Well of course 23% isn't an insignificant number. What some of us are questioning is your assumption that it's a necessary number. That is a HUGE assumption. Here in Australia, it's more like 38% of births ending in sections, and the US is similar. Do you think that Australian and American women are more incapable of vaginal birth than English women? Or do you think that just possibly, some of those sections do not reflect a physical inability to give birth, but rather a combination of medical policies, psychological issues and hospital procedures which lead to an increase in sections?

Quietly, I find it inexpressibly sad that you're feeling unworthy of being a mother because your feelings around birth and medical intervention lead you to want an elective section. I hope you can get the birth you want. I wish more of us could get the birth we wanted, generally, instead of being treated like incubators where "healthy baby" is all that matters and our choices, our autonomy, our dignity become irrelevant.

I actually have the opposite desire from you, and am paying privately to have a home birth as they are not covered or even subsidised by the health care system OR my private health insurance where I am. And there's plenty of censorship to go along with it. So although our desires for our births are very different, I have enormous amounts of sympathy with you - it's so frustrating to feel like your options are being taken away, and then dismissed as if you're selfish and indulgent for even wanting options.

Quietlyafraid - having been working for a while on a 1-1 caseloading team, we actively target people who have mental health issues, along with other vulnerable women as defined by the CMACE report, and anyone who is having counselling or is under the care of a mental health professional will be allocated a 1-1 midwife on booking. If you are having counselling or are on meds for anxiety or depression and are in our catchment area, in our NHS trust, you would qualify for this service. Please don't take this the wrong way, but your extreme anxiety would probably have you in that category.

This means that you would probably only see the one midwife throughout your pregnancy and would build a very close relationship with them. You would have scans etc as normal but other than that the midwife and yourself will completely manage your care without having to see another health care professional if your pregnancy stays normal. If it doesn't, the midwife could come with you to any appointments that you need with doctors.

If you were in this scheme, your mental health state would allow you access to an elective c/section if that is what you need, and as a 1-1 midwife, we can choose a consultant for you who will be sympathetic to your needs. Or the midwives from the team would look after you in labour if you decided on that route.

Unfortunately you are not in our area and so I cant help you with this but I would have to assume that the same level of care would be available in most other hospitals - most of them have caseloading teams and most will target the same groups as my hospital.

Its just to let you know that it's far from a hopeless situation and I would really suggest speaking to the midwifery caseload manager in your local hospital on an informal basis to see exactly what support is available for you in your area, as it may alleviate a great deal of stress and worry over something that can be resolved fairly well in many circumstances. Good luck:)

I have been following this thread with ineterest but cannot post a lot as I have put huge amounts of mental energy into working out what is best for me (now 35 weeks pg with No2) and I can't argue my corner anymore as I have sorted my situation in my own head.

Just to say quietly please do not feel you cannot have a child due to your fears. If you cannot afford private care, then please look into getting a doula. A doula is in tune with you, will be your voice and advocate during antenatal appointments and labour, leaving you to stay silent. My doula is costing me £100 (she is a trainee) but even the most experienced ones are only a few hundred pounds.

Like you, I have severe white coat hypertension and I refuse to have my bp taken at hospital. I have a home monitor and am checking my bp with a clinically approved machine every other day (it's 100% normal). A cascade of intervention last time led to the Emergency delivery of DD by c-section, which affected bonding severely and whilst I did not get PND, it took me a long time to get over it.

I am so fearful of the litigation, policy driven, risk averse environment NHS that I have employed an independent midwife. I did try the NHS route and asked for a homebirth. They were supportive at first but then true colours were shown at 28 weeks when it became clear the rest of my pg was going to be battle after battle. I have actually been blatantly lied to by one registrar on the risks associated with VBAC. Luckily, I was aware this was a lie but did not have the courage to challenge it directly (I was alone at my appt- had my doula been with me she would have said something!).

Upshot, we managed to find a wonderful IM with experience in VBAC and Home VBAC and she is charging us £1,500 for ante natal, birth and post natal care. I am now hopeful I will get my homebirth and even if we do transfer in, she will be with me all the way and fight for what I want.
It is possible with the right support.

I am sad I have been forced down the private route and that DP is using his savings to pay for it but I simply cannot go through what I went through last time.

Btw, I find it interesting that whilst most of America has a c-section rate of 35% or more, the Farm in America (Ina May Gaskin's community) has a rate of less than 1%. the women labouring cannot be that different, so the difference must be the hospitals. In Brazil, the rates are around 80%.
My consultant was very happy to spell out the risks of a VBAC and homebirth but not once spelt out the risks of a 2nd c-section...

Quietly i hope you find resolution to your worries.

Tortoise that is the point exactly! I completely agree that it is not necessary. Same point is made by mrsarch's last paragraph. Best of luck to both of you with your pg's and births.

Mrs Arch - statistics are a very interesting topic. As you say the Farm has a c/s rate of 1 or 2% and that is fantastic, but these are not just women who turn up there to have their baby. One of our student m/w recently did her elective at the farm and she said that the majority of the women who birth there actually join the community and live there during pregnancy, so they have a very healthy diet, and they live and breathe pregnancy and childbirth for weeks before the birth, so that they are completely prepared mentally and physically, and they believe that they will birth normally. So it is a relatively select and very motivated group of women who birth there. Incredible achievement all the same.

I was looking at the our hospital birth centre stats the other day for 2010-2011 and our c/section rate was less than 4% of all women who started labouring there! And 2 of them were for undiagnosed breech. Overall our hospital c/s rate is over 30% though and that is the figure people tend to see.

However when you look closer at the stats, the birth centre does not take inductions, or anyone who does not have an uncomplicated pregnancy, so again it is selective and to come to birth centre, women have to be reasonably motivated and want to have a natural birth.

In delivery suite, you would be amazed at how many women simply relinquish control of their labour to the system, and when asked how they would like their labour to go and what their preferences are (mobile vs bed, analgesia options etc), they say 'I dont care - just do whatever to get baby out' and completely surrender their body and their birth to the mercy of whichever midwife or doctor they get. By default, many of these women end up on the bed, have an epidural and continuous ctg, labour stalls, start the synto drip and its downhill from there, rather than being mobile and taking charge of their labour.

cherrysodalover I'm glad you've found the debate interesting, and hope it helps you make a decision you are happy with. Good luck with it! I hope that my contribution has helped make just a few people be able to think and question things more. Even if I am on the extreme end of things and frankly, by my own admission, slightly nutty! I hope I have been balanced and honest about it, and not let my feelings cloud things too much. I do feel very strongly that is the message that needs to be put out there, and how the whole debate is being so driven by factors that aren't medical or scientific and what impact that has on all women. Thank you for starting it, its given me much to think about myself during the process - for the better...

MrsArchchancellorRidcully, your experience about what information your consultant told you shows the entire point. You aren't being given proper information; you are being led, perhaps unwittingly, by a biased point of view which isn't right. One that I've no doubt could be completely the opposite if you talked to, say a midwife at a birthing centre. Time and time again, I've seen the same remarks about how the obstetricians and midwives don't work as well as they could together. Last week there was this article in the Daily Mail. www.dailymail.co.uk/health/article-2044875/Is-obsession-natural-birth-putting-mothers-babies-danger.html Most of it I, personally disagree with as tabloid scaremongering (ironic huh?!), but I do think think there are some interesting bits in it. Not least the reference to training to create a better understanding between doctors and midwifes at Southmead hospital in Bristol (its near the bottom of the article). It lead to a significant reduction in baby deaths and injuries.

I really believe, that everyone has got to instead try and find out the best information that they can independently and go from there - and then make a decision based on their personal situation and not listen to other people. Easier said than done though.

We have to make the best decisions based on the facilities we have available to us and the levels of service and the standards they can provide. I think its just as awful knowing that women are having to fight battle after battle to get a homebirth. It seems being driven to pay for extra services privately is rapidly becoming actively encouraged and endorsed by a lot of women. Its scandalous that its come to that point. It doesn't exist anywhere else in the NHS.

The truth is, whilst that figure of 1% at the Farm does seem brilliant and the idea of preparing for birth in that way for some time seems the perfect way to do things, thats a reality that just doesn't exist anywhere else. Once again I think its important not to get too carried away with what it seems to show though. My cavet with that it is that people who go there are always going to be the most determined to have a natural birth in the first place. They probably don't represent a good cross section of women as only certain types will be attracted to it in the first place. As mintpurple points out with the stats for her birth centre and hospital, they will be distorted. People have a tendency not to look far beyond stats, and question them as they aren't taught to do this and only look at things at face value and not at the wider picture.

As for me. Just about hit rock bottom yesterday following a trip to the dentist. Suffice to say, 'didn't go well' would be something of an understatement. My reaction scared and shocked even me. I knew I was bad, but I've been in avoidance mode and hadn't realised how bad. After my 'performance' yesterday and what the dentist said, I do feel now that getting diagnosis of a phobia would be very easy but that doesn't really get me much further down the line. I just feel stupid and useless this morning. Even getting to the doctor to discuss phobias (never mind babies) without having a hysterical panic attack seems unlikely in the near future even though I need to.

Honestly, it feels like the final straw. I've told my husband and he's been ok with it, though I don't think he realises just how much I actually would like a child (I go into denial on that one) saying that 9 months of me being like that would end our marriage anyway. I need to focus on that, and start to think about an alternative idea of what the future could be instead and work on other aspects of my fears rather than think about children now. I think its going to take some time to come to terms with though.

Thank you to those of you who have tried to offer support and advice, I do appreciate it and hope it might help someone else who reads this thread, if not me. I know other people share my fears. Its just don't see any way forward with this anymore. I need to take control of my life as best I can and I think tackling things in small chunks rather than putting pressure of babies into the equation too. I'd rather make a definite positive decision that way than have it rattling around in my head for years and letting it take over.

Quietlyafraid- I really encourage you to get help with what does indeed sound like a phobia and I do so hope that it does not prevent you having a family.
I have to say I have many friends in their late 30s and early to mid 40 s who are having their first child- I went for a nuchal fold scan and the technician said I was one of the younger people he sees in a typical week at 38 so just to say you have got a few years to work stuff out before statistically it could become more difficult to start a family.
I wish you the best with it and hope that when the time comes, if you choose it, you get the birth that is right for the circumstances you find yourself in, which is what I am not convinced is always what happens for a lot of women via the NHS at this point in time from the many birth stories I have heard.

Only good wishes with tackling the challenge you find yourself facing- sometimes facing fears is the best way to overcome them.
I hated the thought of surgery involved in a c section- I was very relaxed about giving birth naturally strangely, but in the end the c section was so untraumatic and I got a healthy son at the end which was always my main hope and objective as it is for all expectant mothers.I have enough direct experience of the special needs caused in children from vaginal birth gone wrong, to really value the fact that i did not have to fight for a c section when it became apparent I was in whatever percentage of women it is that find the process of 'natural childbirth' to be as 'red in tooth and claw' as Blake would have us believe, about the rest of all those natural processes our world is characterised by.Whilst I do not compare childbirth to cancer or any congenital condition, there are many things that are indeed natural to the body, but we draw on the advances of medicine and technology to enable us to circumvent the problems that come in the wake of such natural phenomenon.