All women to be given right to caesarean

[Sandra2011]

The NHS plans to make the operation available to healthy women capable of giving birth naturally for the first time in its history.

Although a quarter of all births are already currently carried out by caesarean, women do not have the automatic right to ask for one if there is no medical reason for it. However there have been cases where women have persuaded doctors to perform it as a matter of preference, though this has always been an exception to the rule.

www.telegraph.co.uk/health/healthnews/8858147/All-women-to-be-given-right-to-caesarean.html

What's your opinion?

Ill informed in what way saoirse?

In lots of ways, what reasons an elcs will be undertaken, what labour is like, the fact you can't actually be told what labour is like, if you read through the whole thread you'll see lots of them.

Think if the nhs spend money on EC its not a bad thing if its helping someone who has genuine fears. I dont think that people see it as a easy option at all just some people are very anxious about giving birth while still knowing its not the easy option at all.

But those women already get it under the existing criteria. I just can't work out who these new guidelines will affect. Maybe it will be women who just think VB is a bit scary or because their preferred hospital is a bit far from home or because they don't want to go to 40 weeks... I just don't get it.

It seems to me that if you're reasons for having an elcs aren't strong enough to have one under the current rules, then it's probably not a very good reason. It's something I hate the idea of my taxes being spent on when their are far more needy people being refused treatment or having to wait months for necessary surgery.

Oeisha - I totally agree with Beebop: You need to prepare yourself for MUCH worse than what you have experienced so far with period pain. I think the health care professionals who told you that childbirth will be a walk in the park compared with very serious menstrual pain should be sacked! Unless you get an epidural at 4 to 5 cm dilation at the very latest, you have to prepare yourself psychologically for much worse than you have experienced so far. I was not prepared either with my first and I ended up "losing it" altogether because I could not cope with what was happening to my body, which I totally did not expect.

Good bloody lord. Honestly, I'm not an idiot.

When I say I've experienced a LOT of pain, I mean it. 4 doses of morphine (on top of the stuff they've given me, trying not to give me morphine as I was underweight) haven't touched the sides of some of the pain I've had, so please don't assume that I'm being unrealistic about pain levels. I ranked that pain at a 6/10 and was told next time, to rank 10/10 or 'as I feel' but MENTION that last time I felt this amount of pain that 4 shots of morphine later I still couldn't move without almost passing out.

I refuse to get myself worked up into a frenzy of expecting extreme agony and thus getting it because I'm stressed. I don't think that's going to do anyone any good, especially not me or my baby. If it hurts, it hurts and I'll deal with it. All I'm trying to get across is that IF you've had extreme pain before then childbirth is often less of a shock, and for some, less painful, or at least more managable that extremely bad period pains. For some women, childbirth is uncomfy but painless, so please, please don't assume it's going to hurt like hell, just prepare for what you want to do if it does.

Also, if you approach birth with a negative attitude then, well, is it surprising if it hurts and you feel out of control from the offset? No. If shit happens and control is taken away, then that's different, but to go in expecting agony and to feel terrible isn't wise!

We should be encouraging mums-to-be that everything will be fine, they will cope, they might find it very painful, yes, but there are things they can do to prepare and manage other than listening to horror stories of other women's shitty times! Prepare them for what might happen, yes, but don't insist that it's going to be hell and is something that's "happening to" them rather than something that they have a say in how to manage. That's why being informed, doing a decent birth plan, including what you want to happen if intervention is needed at various stages is important.

To get back to topic, if women ARE actually properly educated and informed about pregnancy and childbirth and given the time to plan, adjust and manage then it'd help a lot with reducing the fear of childbirth and help prevent ELCS when there's no medical need. It's a crying shame that women are not more confident in themselves and their bodies to at least try for a natural birth when there's absolutely no reason not to. Instead of plowing money into this, PCTs should be investing more in antenatal care.

Theres some statistic given to us by our NCT practitioner that in sweden where the culture of childbirth is very different that only 1 in 9 women end up having an epidural where in Uk it's only 1 in 9 that don't. Or soemthing like that-i can't remember the actual figures.

Yes childbirth is painful, yes it is overwhelming at times, yes it can go on for a flippin long time and the mother can be exhausted. But there are also some very painful experiences in life other than childbirth. Endometriosis pain is very severe in some cases and yes as a sufferer I would have happily had gas and air throughout some of my periods in the past when it's been bad. My c section pain post op with an infection was the worst pain I have ever experienced. Far far worse than any labour pain I had under strong syntocin after induction with my dd. C section is not an option to be taken lightly.

There is a huge culture surrounding the negative of childbirth in the uk that you must be aware of when making your decison. People here tend to relish giving gore stories, some of the pain olympics conversations I have heard seems almost geared up to frighten mums to be. If it were that difficult to give birth every single time then the human race would never have flourished.

Here is a perspective of someone who has had 2 EMCS after 2 failed VB's where despite being fully dilated the heads just couldn't come through the pelvis.
I am now terrified at the thought of having another CS. If it was possible for me to give birth naturally give I would choose that even labouring for 27 hours as I did with DD over a CS anyda

I have absolutely no idea why someone would opt for one without having tried a natural birth. It is very different in the cases of ladies who have suffered bad VB's, they shouldn't have to beg for them.

beatrice - what a ridiculous attitude to go into childbirth with. The human brain is immensely powerful and can in most instances influence the body to fit with its expectations. if you go in expecting pain then you will almost certainly experience it.

Surely it would be better to make ante-natal care more encompassing of things such as hypnotherapy/hypnobirthing so that women can feel empowered as they approach labour? I chose to save for a long time and pay out a rather large sum of money that we can ill afford so that I could have hypno because I wanted to enjoy my pregnancy and look forward to the birth and meeting my baby. I am happy to say that it was worth every penny so far, not only have I had a relaxed and calm pregnancy, but have learnt pain-control techniques that I've been able to put into use for other issues (like when I cut my foot open the other day).

Wouldn't it be nice if the healthcare system put mental wellbeing at the top of their list and promoted less drastic measures before suggesting that getting highly medicalised interventionist births is the only way to avoid pain and fear?

I agree with cakes, I'm also going the hypnobirthing route and I'm not naive enough to think that it will eliminate all pain. However, the techniques I've learned will help me manage it as best I can.

What I do know for sure is that going in with fear and expectation of an horrific experience will most likely get you what you expect.

Thanks for totaling misunderstanding the purpose of my post and treating me like an idiot. Will surely not post again on this forum!

There is a huge culture surrounding the negative of childbirth in the uk that you must be aware of when making your decison. People here tend to relish giving gore stories, some of the pain olympics conversations I have heard seems almost geared up to frighten mums to be. If it were that difficult to give birth every single time then the human race would never have flourished.

fishandlilacs This is SUCH an important point. People have been trying to scare the shit out of me regarding labour since the moment I peed in the damn stick. It's so wrong and I agree that it's become a culture in this country. Don't get me wrong, I'm not expecting to sail through VB- my pain threshold is pretty crap, I can't even cope with those speculums they use for internal examinations! But it goes back to the point that our bodies were designed to give birth a particular way (thats assuming that you don't require CS intervetion) and more should be done for women to understand and prepare for this.

Beatrice I'm wih you. All of this crap about VB hurting for a few hours only, OK if you say so. Incontinence, problems with stitching, piles like a bunch of grapes. I expect to.have a VB and would not see it as an easy option. However VB is not an easy option either in my experience.

I think that cost is a red herring. NICE have done the numbers, that's what they're there for. One baby brain damaged by a bad decision in a VB will cost the NHS a minimum of three million quid - that's an awful lot of ELCSs. The women on the ragged bits thread have had a lot of operations to attempt to repair their damage, none of it cheap. And a significant percentage of women who go for VB will end up with EMCS anyway, they've had all the expense of a CS (except that it might be in the middle of the night which costs you more in staffing, rather than normal working hours) and also the cost of many hours management in labour, and they'll have a much tougher recovery than someone who's gone straight to ELCS.

It may or may not be the right choice for any given woman, but it is not a selfish use of scarce resources.

beatrice I'm sorry you had such a rough time with birth and I certainly don't want to put you off being on the forums, but to assume the pain I've been through wasn't hiddeous and isn't going to prepare me seems a little unfair.
As I've said, I'm preparing for the worst, I know what I want to happen and am prepared to be in control and make decisions for me and my baby if things do go wrong. I still, will not, however assume it's going to be hellish and I will maintain as much control as possible. DH will be primed to know what I do and don't want, so if I am distressed, he knows my wishes and I can thus trust he will do what's best.

Plus, I wanted to reassure the worried Mums-to-be posting here that it isn't a painful nightmare for everyone. Remaining positive is important...

I wasn't directly getting at you, or others, but to assume that I'm being naieve to expect childbirth not to be hellish IS patronising and unfair. Yes, birth can have its issues before, during and after, and yes, share, but please be aware that just because it happened to you, it doesn't mean it will everyone.

Well I didn't even share what happened to me precisely because I did not want to scare anyone. Nor was I trying to patronise you or ridicule the pain that you experienced with your periods, after all how could I since I'm not you?
My point was simply that for me hearing things as they really were and perhaps expecting the worse would have been far better than go into hospital with the "it's all natural so it can't be that bad" attitude.
I, like everyone else, don't come to this forum to patronise or scare other girls! Rather those of us who have more experience come to this forum to help or advise the less experienced of us. That's why I'm hurt that i was misunderstood and that my post received such hostile reception.
All i was trying to say is that I do believe that VB should be approached with realistic expectations as far as how much you'll be able to control how you give birth and how you will react to the pain. It's not to say that a c-section is necessarily an easier option and I'm not even sure that it should be entirely up to women to decide which one to go for.
In any event, congratulations on your pregnancy and I do wish you best of luck with the birth.

Goodness what a lot of ignorance on this thread.

Firstly read the actual new NICE guidelines themselves. Not a précis, not a report about them, read what it ACTUALLY says.

Women requesting sections won't be booked in with the simplicity of booking any other appointment - there's a whole series of hoops to jump through before then, including finding a consultant who agrees.

There's also a spectacular lack of insight and empathy about the situations in which women who could physically attempt labour may want to avoid VB. What if your last labour was so so awful psychologically you just can't face the experience again? Perhaps you recovered well physically, but your baby died. Or you've had (in my case) a really tough time getting and staying pregnant that any avoidable risk to the baby is intolerable? Neither of these are technically cases of tokophobia, they would be sections at maternal request. Should they be refused?

In my case it was all all all about risk. An uncomplicated VB would have been statistically preferable but given the path I'd walked, the drugs I was on and how hard I'd fought just to stay pregnant never mind give birth, counselling to give me more confidence in my body simply wouldn't have cut it. My own personal body prefers not to be pregnant. It absolved itself of trust in that regard some years ago.
So I discussed this with my consultant, who agreed that ELCS was entirely appropriate and safest for baby as a simple VB wasn't likely.

Was that a "good enough" reason?

To have a serious discussion about the cons of each method it must include the potential complications of VB. Otherwise we end up with the age old 'CS = agony for 6 weeks' 'VB = skipping around the day after giving birth like nothing has happened' comparison. Interestingly no-one seems worried about frightening people who are forced into having c-sections. All interesting.

holly most people on here seem to be in agreement. In your case, most I think would agree that an ELCS was 'medically' needed and wouldn't have an issue with it! Just because people are using the word 'medical' it doesn't mean they've ruled out psychological reasons.

From reading the posts I think its sounds like people are considering psychological reasons as a medical reason. At least most are, a lot of us support you holly.

brett I was told by someone that I deserved to be punished for having a section, they were are arsehole obviously but some people thing women who have sections deserve to be scared.

Oeisha, that's my point- there was no medical need. It was my (highly informed) choice. I wasn't afraid of VB, or of pain - I had to have 644 (yes, 3 a day for first trim then 2 a day after that, done by me) injections whilst pregnant, but I was fit as a flea. I am ok with pain. It wasn't a medical reason. It was what I wanted. That's all.

As someone who has had my only 2 births by ELCS with no medical reason (NHS too) I would like to say that.

I had no pain.
I spent mimimal time in hospital and needed no aftercare thereafter.
I was back to"normal life" immediately with little exceptions and back out running and completely to 'normal' by 5 weeks.
I needed no extra help to care for my children afterwards either.
ELCS was the right (and well informed) choice for me and I would like to think that anyone else that came to the conclusion it would be their birth of choice would be able to have one.

holly But there was a medical need...you were a high-risk pregnancy...
"So I discussed this with my consultant, who agreed that ELCS was entirely appropriate and safest for baby as a simple VB wasn't likely."
...how was there no medical need there?

Because there are millions of women like me who MAY have been able to labour uneventfully, but for whom there are some factors that decrease that likelihood slightly. I wasn't at any particularly high risk of anything negative regarding the birth at the time of my ELCS being booked. It was at my request, not at medical recommendation. I could have just as easily argued I could have a VB.

"Add message | Report | Message posterOeisha Mon 31-Oct-11 21:21:51

copper I'm with you on the ELCS thing. Unless there's a medical need it shouldn't be offered (I also include psychological reason here). Just not wanting a VB seems like a petty reason to undergo serious surgery. If you just don't want a VB because it's inconvenient, how the hell will you cope with an actual baby?!"

Just seen this Oiesha. Words fail me.