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?

"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.

BagofHolly with respect, I disagree with, you I think you DO qualify for ELCS. There are medical factors surrounding your case that make a CS outweigh the risk of VB for you. I personally don't think it sounds like a simplistic choice. Best of luck with the rest of your pregnancy and birth

For me this isn't about which way is right or wrong to give birth as this is absolutely the mother's choice and there are clearly positives and negatives on both sides and it's nobody else's business...I can completely understand why somebody who has had a traumatic previous experience would opt for another way next time round. As far as I knew this was the case in the UK I.e. Women could request e.g. a c-section next time round having had a traumatic VB/EMCS, but maybe this is just for those that had EMCS first time round and not those who did have a traumatic VB. Also seems like there is inconsistency here I.e. Some people are granted their wish and others not - this is clearly not right.

I realize that NICE are not saying that every woman should automatically be given a c-section if requested, however a lot of women on these threads seem to think this should happen and that the numbers of c-sections would not increase...I strongly disagree with this and the fact that costs would not soar...people keep saying that VBs have additional costs post birth if something goes wrong I.e. Incontinence etc...but so do c-sections. Not all VBs are problem-free as is the case with c-sections...mothers and babies can also be negatively affected physically and mentally (and could have reason to sue) after c-sections.

In an ideal world every woman in the UK would be able to choose between HB/ELCS/VB in hospital but unless the NHS is completely reformed (and there is some element of payment like in many other countries) that won't and can't happen as the finances and resources just aren't available. The negative side to such reforms would of course be that those unable to afford additional costs would undoubtedly lose out..

I have never had a VB (had a planned CS abroad due to abnormally high BP) but I have close friends and families who have and some have had very bad experiences, but the majority have been fine. The same can be said about c-sections. It is easier said than done to say women need to have a positive attitude to giving birth and not be scared as in reality most people cannot control the way they feel...I have heard some very positive things about hypnotherapy but this isn't for everyone...

holly Honestly. I'm sorry you seem to be having a rough time with your pregnancy and birth choices, but you are obviously reading something into my posts (and others) that ISN'T there.
I wish you all the best with your babies, but please, please actually READ what people are saying. No one is criticising you for an ELCS as from what I can see you'd fit into the physical and psychological factors people would want to see, rather than "just not being bothered" people are concerned about. The fact you've seen a consultant for a complex pregnancy they aree whole-heartedly indicates this.
What I am disagreeing with is a woman's "right" to an ELCS just because it's inconvenient to have a VB (I'd simply worry about what the hell they think a baby's going to do to their lives)...ok, I know this isn't what the guidelines say, BUT this is what the discussion had moved to.

Oiesha don't patronise me. I'm not reading anything at all into your awfully judgemental posts. I'm also not "having a rough time with my pregnancy and birth choices" thankyou. The point I'm making is that under the previous guidelines I had to find a sympathetic consultant to sign off my cs. My situation fell OUTSIDE the guidelines - that's not opinion, that's fact. There was no medical or psychological reason that I should have had a CS. I could have laboured, and indeed most women with my history have VB. I just didn't want that. It was all over my notes "ELCS at maternal request." I had to have a meeting with the midwife consultant to fully explain the operation etc but I didn't change my mind.

I was lucky to have a pro-choice consultant and she said she understood why I felt the way I did and I could change my mind at any point.

As it happened, it was all academic anyway as the placenta turned out to be very low and so I would have ended up with a planned section anyway. I was aware of the potentially more difficult recovery and so transferred privately late in the pregnancy, and delivered at The Portland. It was a lovely, calm, pain free experience, as I'm sure it would have been at my local hospital. The aftercare I'm sure, is different which is why many people choose private care.

20 months later I had the same lovely consultant deliver my twins, again ELCS.

I really truly don't give a damn about other people's opinion of my birth choices. I do however take exception to ill-informed judgemental nonsense and feel obliged to put across WHY some women might want to make a different choice. Thank God NICE has recognised the need to protect their right to make it.

holly OK, whatever...

Eh? You've posted stuff which is wrong (women like me didn't qualify for cs) and untrue (I'm not pregnant and having a rough time with birth choices.) You say the thread has moved away from the NICE guidelines - when I read your posts it was never even there, just assertions based on ignorance and lack of empathy. One of the other examples I mentioned was (someone I know in fact) cases where the mother has recovered well from VB but the baby died. Should she have to labour again? YOU discount psychological factors as "petty." Is her shattering grief petty?

I notice this will be your first delivery. I hope it goes well for you and your child and I've no doubt that you'll have insights post birth that you lack currently. Good luck.

I'm confused now. I thought that oeisha said that women who had lost their baby but could otherwise be considered physically able of a VB should be allowed a section. I thought she said that was different from petty reasons not that that woman's grief was petty .

Minus273, would you mind cutting and pasting that? I can't see it. Perhaps I missed it in the many paragraphs she posted about what women should do, how they should be educated, what they should try etc, all with the confidence of the very silly.

I'm just confused as I didn't get that from her post. I'm sorry its just I'm thick and was trying to understand. I've been considering leaving MN and since I seem to be able to continually and unintentionally upset people I think it may be a good idea. I never set out to upset anyone and I'm really sorry.

minus No, you're totally right, please stay around, you opinions are just as important as anyone elses. I did NOT AT ANY POINT suggest that women who had experienced trauma throughout pregnancy and birth should be forced to have a VB/refused an ELCS (including grief...this IS something that will influence a next pregnancy). I have repeatedly said exactly the opposite. In fact no woman should be forced to have a VB as this is likely to cause trauma to Mum and baby. I have repeatedly said that physchological factors are included in the 'medical' reasonings (maybe this is the sticking point??) for a woman chosing an ELCS. I myself have suffered from serious depression and would NEVER discount a mental health issue impacting on pregnancy/birth. Holly has just taken umbridge through misreading what I actually said and isn't willing to actually read what I said and be grow-up about it, which she won't be, as she hasn't yet and I'm fed up with asking her to actually read what's been said rather than accusing me of things I have not said.

My only concern really, is that if someone "just can't be bothered"/"is too posh to push" then I believe these are petty reasons...after all, what are they having a child for?...and what are they expecting after the birth of their child, ELCS or VB?...and maybe the NHS isn't the appropriate source of funding for this. I'd expect medical professionals to seriously be questioning WHY a woman requests an ELCS and give all the support they could to a woman that says this, regardless of the outcome (VB/ELCS) as, if there is an underlying issues then that's very sad and almost unforgivable of the consultants not to have spotted it.

I am guilty of not realising Holly was talking past-tense and thinking she's pregnant now. And for that I apologise. I do not apologise for thinking Holly's experience of pregnancy was traumatising and that an ELCS was agreed to by a consultant because of this (especially note the last sentence here):

"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. "

I firmly support Holly and her consultant here. OK, it took her a while to find a consultant that understood how she felt, but she did, and good on her for pushing to find someone that listened. She's a shining example to Mums to be out there to push for support until you feel you've found someone that's properly listened to you.

So, no, I don't get quite why she's taken against me so violently, but she has and fair enough, she's entitled to do that if that's what she feels.

minus and everyone else, please carry on discussing around this topic.
I'm not responding to anything more Holly has to say to me as I firmly believe she's deliberatly misrepresenting what I've said and frankly, it's not worth my time if someone's going to be so irrational.

In your post "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." at 21:21:51 I read this that you are saying that ELCS shouldn't be offered without medical reason. And that you include psychological reasons in this judgement. Thankyou for clarifying - I think your wording is ambiguous. Notwithstanding that, it's still a spectacularly prescriptive stance to take, and you appear to contradict yourself - jn one post saying no woman should be forced into a VB they don't want, and yet in your last post you say "My only concern really, is that if someone "just can't be bothered"/"is too posh to push" then I believe these are petty reasons..."
Isn't it possible that these women are actually making an informed choice that's right for them? Women's choices and rights over their own bodies should be protected, even if they're different to yours.
As for " I'd expect medical professionals to seriously be questioning WHY a woman requests an ELCS and give all the support they could to a woman that says this, regardless of the outcome (VB/ELCS) as, if there is an underlying issues then that's very sad and almost unforgivable of the consultants not to have spotted it." that's exactly what the new guidelines do, you'll be pleased to hear.
FWIW I haven't 'taken against you' - at least you have an opinion, which in my book is piles better than failing to think about issues at all.

THe problem is that having guidelines as to what to do in cases of genuine phychological need is pretty worthless unless you train consultants in how to recognise and accept what constitutes a genuine psychological need. And unless you tell women that they have a right to keep pushing until they find a consultant who is willing to listen to their needs.

How easy is it going to be for a woman who does not happen to be unusually confident to keep insisting that she has genuine tokophobia in the face of a consultant who poo-poohs her fears? If noone has told her that you can ask to see a different consultant?

Personally, I would imagine the number of women who would willingly put themselves through major surgery for reasons of mere "poshness" and laziness must be pretty small: I'd be willing to bet that a fair few even of the ones that say they do are, in fact, terrified of giving birth and that is why they are choosing a section.

Those of us who are not terrified of giving birth tend not to consider a caesarian as an option- why would you consider having yourself cut open if the alternative did not appear a more frightening option? Would never have occurred to me.

You'd consider it because you prioritise the safety of your baby above all other factors. Makes sense to me especially if you don't intend to have any other children, so the increased risk to them from a CS-weakened womb doesn't factor. VB presents a tiny risk of death or brain injury to babies, but I wouldn't say that a woman who wishes to reduce that risk as low as physically possible is in need of psychiatric counselling.

And notoriously female ob/gyns tend to go for ELCS, I wouldn't say they're in need of psychological help, they're just focussed on certain specific risks - we all have different priorities.

BagOfHolly what you've misunderstood is the part Oeisha put in brackets. You read it as she includes phsychological reasons as petty, she actually meant she includes phsychological reasons as being medical reasons. It's just the structure of the sentence that has ended up with her comment being misinterpreted. HTH
And I think the vast majority of women on here would agree with your right to choose. You also said it was untrue that you had difficulty with your pregnancy but your OP suggests otherwise. Unless of course you were taking offence at it being considered difficult, when it's actually more than just difficult to go through mc's and bfn's. If that's the case then I understand but I think you're a little unfair to jump on Oeisha for saying that, she only meant to be understanding and supportive IMO.

Oeisha I think the way beatrice's post about pain of VB came across that you meant you'd just had very very painful periods and she felt you had been misinformed. Prior to her post you hadn't fully explained the pain you'd experienced, but I think after your explanantion it's understandable what you've said as most women wouldn't have been through such pain prior to labour. I know I have had awful periods and did feel a bit when I read one of your earlier posts, but after you explained I do understand. I also think she only felt that it's better for women to go into labour aware of the possibility of extreme pain rather than expecting it IYSWIM.