Elective C-Section (medical/non medical reasons)

[LittlePeaPod]

I understand this subject has been done before. I also know that ECS particularly as personal choice rather than as a medical need is an emotive subject and the debate about CS birth can be particularly contentious.

Considering 1 in 4 women in the UK experience a CS birth I have been disappointed to see how inadequate access to CS antenatal information is, so women can make a truly informed decision. Personally I think it's short-sighted to focus solely on VB and continually emphasise managing pain relief. The NHS is so focused on their target to reduce the 1 in 4 CS due to cost that they are neglecting their responsibilities to those women that choose or want a CS birth regardless of medical need.

I am currently 23+6 and I have chosen to opt for an ECS. There is no medical reason for a CS but this is a birth choice that I want. I understand that CS and VB both carry real but different risks but I believe these risks should be explained to women so we can make informed decisions about which birth risks we wish to take. Unfortunately this is not the case and the push for VB is so endemic in the NHS that women are not receiving the true facts on CS.

For those women like me that want an ECS birth. I just wanted you to know that due to the new NISA guidelines if you want/choose a CS the NHS now have to give you one. They will do everything they can to try and change your mind to the point of trying to scare you and make you feel guilty about your choice. But, regardless of medical need if you insist that a CS is the right choice for you the NHS have to honour your wishes and give you a CS. I am fortunate to have been able to privately pay for independent advice on VB and CS from three different very well respected professionals in the UK (two consultant obstetricians and one consultant in fetal medicine) and also received advice from a close family friend who is a consultant anaesthetist. I was shocked to hear how target driven VBs are in the NGS and how in fact this is what's driving the push for women been made to think they should have a VB and not the safety issue.

Ladies it is your choice how you have your babies and what you do with your body. If you want a CS you can have a CS regardless of medical need on the NHS. My DF and I have just spent a lot of money finding that out. I am 23+6 and the NHS have now confirmed I will be having an ECS and there is no medical or psychological need. I am having it because its my choice. I wanted to share this because prior to spending a fortune getting non biased information I was under the impression that I had to prove a VB was medically necessary, would psychologically affect me or that I had a fear of VB before a CS would be authorised by the NHS. Well that's not the case, its about personal choice. VB or CS you have a right to choose and the NHS have to honour your choice. It's just a shame and has royally pissed me the fuck off that if your choice is an ECS for non medical reasons the NHS are making it so difficult for you to opt for that choice in an informed way.

Can I just point out women are not "built" or "designed" to give birth. We are the products of evolutionary pressures, and there's an evolutionary trade off going on between easy birth and conflicting things that make birth more difficult - large head size to accommodate large brains, upright stance freeing us to use our hands...

As a result, a certain proportion of women pre-modern medicine die in childbirth, and even more are left with serious injuries. From an evolutionary point of view this doesn't matter! The level natural selection operates on is that the species as a whole should manage to breed more successfully than rival species seeking to occupy the same evolutionary niche.

Of course, humans being social animals can do a lot of things short of a Csection to try to minimise mortality/morbidity. Good nutrition in the preceding generation can rule out problems like rickets affecting the mother's pelvis. Studies of traditional cultures suggest that those where women's births are attended by relatives/ birth attendants have lower death rates, even in the absence of any medical training. Midwives skilled in helping with positioning, and with skills like turning the baby in utero up the odds still further. Historically, forceps were life-savers. And at the end of all the possible things that can be done to help a mother who is struggling, there are C sections, and thank heavens we have them.

Of course, there are iatrogenic causes of problems (e.g. unecessary episiotomies, labours that might have gone alright had the woman been able to move around, hospital-acquired infections). But anyone who bases their argument on "women are designed to give birth" is, frankly, talking out of their arse.

Personally I intended to have a VB, based on the issue of recovery time from major abdominal surgery. In the end I was advised to have a C section (and was lucky enough to have a very good recovery). But why shouldn't a woman, having weighed up the research literature, decide that actually given that she might be one of the unlucky women with a small pelvis or an awkwardly positioned baby, she would like an ELCS. Especially when, as I pointed out upthread, by the time you factor in repairs to prolapses, fistulas, etc, the total average cost of a VB isn't significantly different from that of a CS (NICE doesn't come up with these guidelines out of the goodness of its heart, or out of respect for women's right to choose their birth method; their brief from the government is to do the calculations on how to deliver the best value for money to the NHS).

And also, the fact that the NHS has to spend that much money repairing women's pelvic floors (and we're talking basic things like restoring foecal continence here, not designer vaginas) should at least make the nay sayers on this thread stop and think about whether it might just be possible (in fact plausible) that the concerns that make women on this thread opt for ELCSs out of choice alone are actually pretty reasonable concerns. "Damage downstairs" (tears, fistulas, prolapses, incontinence) is one of the great hidden women's issues that just gets brushed under the carpet by lots of people and dismissed in a cavalier and frankly unfeeling way. (And just as breathing exercises and staying upright won't help you if your baby happens to be transverse, there are levels of damage to the vagina/rectum/ perineum which no amount of pelvic floor exercises will help - though they are brilliant if you've had a relatively straightforward time of it).

You can get most of that damage from a cs too you know, and more besides.

Pickles. I think you need to revisit the whole conversation and it will explain where I was coming from and what my point was on the cost. There isn't any point in repeating myself and I didn't raise the tax issue. And as for the NHS looking after my medical needs in my older years. If you followed the thread you would already know that thankfully as it stands it may change I don't have to rely on the NHS. Sorry if that sounds rude but it does get a little tiring having to repeat or point out the obvious when its already been discussed.

LurcioLovesFrankie. Great post with a very different and interesting prospective. One which I had not really given much consideration to. Thank you for sharing.

I find out next week if I need to have a C Section. I was so dreading this prospect but this message board has filled me with a lot more confidence and hope. In fact I'm now not really worried at all, whatever the labour decision as long as I have a healthy baby at the end.

Thank you Littlepeapod for raising this issue and going through the pros and cons. Even when my private and well respected OBGYN went through the pros I was sceptical because I thought he was just scalpel happy! Having seen this and read other women's opinions my mind has been put at ease. Thank you x

Katebakes. Again, thank you. This is why I started this thread. Your and other comments lke this makes it all worth while. I hope there are others that are finding the thread helpful and/or making them think.

One of my best friends is also pregnant and has been totally maniacal about wanting a natural birth with no pain relief. She was then told she would have to have a C-Section due to placenta previa. For months she's been so upset, telling everyone that it's her idea of hell and can't think of anything worse and that she wishes she could have a VB with no pain relief.

Today she phoned me whilst as the hospital and said the following:

'So my baby has a huge head and if he's late I might be in hospital during Christmas and then what happens of it's really, really painful or I have a horrific labour?! Oh and I don't need a c- section anymore.'

'Oh great! You're happy about that aren't you?'

'I'm not sure anymore...I was getting used to the idea and now I have to give birth naturally and I'm scared.'

So we all change our minds...and I think we should all be more informed so that we an be open minded and do waist best for ourself and our baby.

I completely agree with you Pea that in my experience midwives would completely support my decision to opt for a home birth but not a section, although a home birth seems to involve a greater degree of potential risk to the baby. Likewise vaginal birth of a breech baby.

Butwilliseeyouagain agreed. It's strange. The other thing is the fact they try and keep women at home for as long as possible even if a home birth is not their choice. Again this whole issue of delaying pain relief when a woman requests it under the guise of "it's for the woman's good." Well we all know its because they don't want the labour to be delayed nothing to do with what's in the best interest of the woman or what she wants. My friend who is in hospital currently believes the MW is responsible for her horrific birth because she wouldn't listen when my friend was telling her something was wrong and she wanted to get checked in hospital. By the way my friend was due to give birth in a MW led unit in hospital but the MW kept telling her not to go in as she wasnt ready to This is a woman who was hugely pro VB and totally trusted her MW. The MW made her feel like she was a neurotic new mum to be. Surprise surprise something was wrong and the baby was in distress and nearly died and ended up in NICU and is currently in high dependancy. The baby is 4 weeks old and has to stay in hospital for another 4 weeks as far as we know. The MW is now under investigation by the NMC to see if she acted negligently. The hospital has also launched an investigation. Sorry for the rant..

"the fact they try and keep women at home for as long as possible even if a home birth is not their choice. Again this whole issue of delaying pain relief when a woman requests it under the guise of "it's for the woman's good." Well we all know its because they don't want the labour to be delayed nothing to do with what's in the best interest of the woman or what she wants."

"We all know"?? Who is we?! This is just extraordinary. This is one of the most outlandish and offensive generalisations I've seen for a long time. And from someone who hasn't experienced labour herself!

Fryer but I don't live in a vacume and I have family and close friends that have given birth. So yes i have seen what happens and heard what hapoens. Plus have you seen the consequences of a baby ending up on an ECMO machine as a request of this. Tell me have you sat in an NICU next to a baby attached to an ECMO machine not knowing if she will pull through or not? Or have you watched your sister nearly die because of the negligent care she got?

Not all midwives are negligent. And not all surgeons are gods.

My midwives in both pregnancies were utterly wonderful...

You cannot control all the risks. Where does it end? Not allowing your child to play on the climbing frame because s/he might fall? Home schooling because the flu might be going around at school?

Life is risky and being a parent is scary at times, but you have to deal with that fear or you'll always be controlled by it.

And at the risk of offending you, I think you need to spend more time thinking about the baby and life after the birth than about the birth itself. You seem to be dedicating a huge amount of time and energy to it, time and energy which could arguably be better spent focused on life once the baby is here.

Flowersinavase Agree with this not all midwives are negligent. And not all surgeons are gods. in the same way not all surgeons are scalpel happy and not all MW are competent. You can rest assured I am expending much more effort and I am as well prepared as I can knowingly be for our DDs. You can't control everything but you can educate yourself as much as possible and then learn from experience.

Now I get married today been up since 4am, very excited and will not respond to updates should any come till after.

Congratulations

Congratulations Littlepeapod have a lovely day x

Hope all goes well today Pea.

(that last one is Schloer by the way)

Thank you ladies. DH eeeeeekkkk and I had the most amazing day. All excited and been up since 4 again thinking about our perfect day

many many congrats! ! we are getting married in 18 months time...so cant wait...just over two weeks till our baby arrives via ELECS. ..can NOT wait..I will defo let you know how it all goes in two weeks..have every faith in the hospital and staff that all will go well

MunchkinJess thank you. . How exciting you get to meet your baby so soon. I am .. And congratulations on the upcoming wedding too . Please do update us post ECS. I really would like to know.

Congratulations littlepeapod! Glad to hear you had a lovely day! Munchkin, would love to know how it goes for you in two weeks, I'm booked in for 6 weeks time.

I promise to give a honest blow by blow account as I feel it's really important

Glad to hear you had a good day, can't wait to hear about everyone's elcs stories, I'm still sat on the fence undecided. Not due till 10th Jan so I need to make a definite decision soon.

I have read this thread from start to finish and I truly do not understand why people get so angry because someone else has made a different, informed, choice to them. Its incredibly self righteous to believe that only your opinion is right and that any one who chooses otherwise is wrong! I think every mother should have the choice to give birth in the way she chooses. I have had 3 c sections, (all for medical reasons not that that makes any difference) and no, I didn't enjoy any of them, they were certainly not a pleasant experience but who is to say having vbs would have been any different? Its similar to the bf/ff debate, its the superior attitude that baffles me. My eldest is almost 15 now and let me tell you the road is long :). How you choose to give birth and feed your child is a very, very small part of child rearing and (provided the birth etc is without complications) it has little to do with how they turn out, the care, love, stimulation and attention they receive is much more important and influential. My cs/ff children are healthy, happy and doing very well in school and i rarely even think of, or discuss, the way they were born.

Littlepeapod - CONGRATULATIONS and good luck (not that you'll need it) for today! I'm so excited for you.

I just wanted to add that littlepeapod is as conscientious and prepared about the health and welfare of her little bundle as any woman who had intricately resarched the best way to give birth naturally. This is why she's gone to so much trouble to find these things out.

I started this discussion knowing that I wanted a water birth etc. I had been advised that a c section may be necessary but the baby turned so was prepared for a VB. The more I read and the more bias free opinions I saw the less scared I was for c section. Now the OB, midwife and my GP have told me than an ELCS would be an option because he's a big baby and I'm tiny.

Littlepeapod has rightly brought this discussion to the table and in doing so has empowered women to make a choice. Yes it may be a different choice to yours and yes you may disagree with it but it is OUR choice. She has made me feel more confident and less scared. Believe me I'm pushy, a bit spoilt and know my own mind but in this instance this discussion has been invaluable.

Thank you :) x

Midwives talk about birth choices. My choice was to not have a midwife within 30 feet of me. No regrets.