"Too posh to push" ?

[jasper]

I know this is a clumsy phrase but at least we all know what it means.
Does anyone actually know of a woman ( themselves even) for whom this is/was the case?

I actually disagree 'we' should aim to have vaginal deliveries whenever possible. I think 'we' should have a choice in how 'we' give birth, because 'we' doesn't exist - only individual women. I completely support the idea that women should have choice in birth - pools, one-one-one midwifery, birthing suites with double beds etc etc, no matter what the cost to the NHS (funny how cost is only ever an issue when discussing sections). But I find the betlitting of women who have sections (they make 'excuses', they are 'too posh to push', they are lacking in self confidence , they don't 'bond with' - ie love - their babies as much etc etc etc) both offensive and genuinely hurtful. No wonder sections are associated with feeling a failure. I strongly suspect the constant condemnation of anyone who has a section is a huge part of this. Ye gods, you'd think that only women who have totally natural births were good mothers.

BTW, in what way is an episiotomy not an operation?

Pupuce, you said:

• To my knowledge there are no more baby or mums deaths in Holland then here - yet they have a much lower rate of intervention... I think it says a lot for our culture... that's all

And I believe it. And as for your conclusion, maybe it does say a lot about our culture. But why shouldn't a woman have the birth she wants if it's all the same to the baby? Truthfully, the reason I didn't want a c-section was because I was too scared. Because of that, I can completely understand the opposite-- being too scared of a vaginal delivery.

The whole reason for the post is that I happened upon the discussion, read Aloha's last post and wanted to agree with it fully as someone who gave birth vaginally (but with loads of drugs, because I know some people will want to know that and care about that fact). My view is: healthy baby + happy mommy = good birth.

Ok, I'm slow at posting. It's aloha's second to last post with which I was completely agreeing. And I agree with the last one, too.

Alhoa - I am completely with you on this subject - I have also never heard of CSs being available on request on the NHS (the example quoted below was for a second birth, following a CS where CSs are usually available again) - I asked for a CS - aged 42, not particularly fit, and yes, I admit absolutely terrified of labour, I was told 'a big healthy girl (!) like you will be able to give birth naturally' in the end I had to have an emergency CS, full GA etc etc as due to a physical abnormality my DS would not have been able to survive a vaginal delivery - nor would I. I too suffered absolutely no complications after the CS.

I also find it disconcerting that people can be so against CSs - to me how the baby gets out is a minor point about the whole issue of bringing up a child.

Gosh, thanks. I honestly support anyone who wants to have the birth of their choice (where this is safe for mother and child). I didn't have a choice, and have often felt truly baffled/hurt/angry about the way sections are regarded as the 'wrong' or even the 'bad' way to give birth. For some of us, they are the only way, for others it's the best way. But I tell you, having a condition where 'natural' birth = certain death, really takes the rose tinted glasses off the whole childbirth process. But babies are just as fantastic however they arrive. Well, back to work...

Aloha, I fail to see why you are being so snotty towards me. I only mentioned that I felt proud of my body to give birth and why souldn't I? I never said there was anything wrong with anyone having a c-section just that I never wanted one. Have you read anything about unassisted birth? You are being offensive to people that have choosen to give birth that way. You are defending your right to give birth how you want so why can't people give birth in a way that they feel is important to them. I have read some very moving accounts of women giving birth this way and I personally find it amazing that they have such strength of mind. I am not talking about myself - obviously my body didn't know how to start labour as I was induced!! I had amazing midwives and I was very pleased they were there. It sounds like your experience has coloured your opinions on how women give birth and you are being way too defensive.

I am not sure I want to get back into this heated debate as I don't expect it to lead to anything...

JJ it DOES make a difference for a baby to be born by caesarean or vaginally... Again please do not missunderstand me. I have nothing against a ceasarean if it is needed (danger to mother or baby).... and I know I shouldn't care if one gets one because they can't bear the idea of vaginal deliveries (out of fear, confidence, convenience,...)
But I can't help but think that birth is a physiological event... our bodies are designed to release oxytocin (hormone of love), endorphins (hormone of reward)... and neither are released when you have a (planned) ceasarean... these hormones play a role in bonding. On this topic I coud say loads more but I do not think Mumsnet is the place for it as it would generate a debate and some might missunderstand the arguments and it could all get very nasty!

In the animal kingdom (and I know we're humans) several species actually will not bond/raise their sectioned newborns.

I have also heard from an obstretrician at Kings College (I will try to find research evidence on this actually) that the impact for a baby's lungs and brain is different when born vaginally or by ceasareans.

Now several mums on this discussion thread have had a ceasarean by necessity.... I am sure you feel victimised (by some) but I am not sure that your aggresiveness (I am sure I am going to regret writing this!) helps you deal with what happened to you.
If YOU know your ceasarean was by necessity - HELL with the world! It doesn't matter.... does it?

......
OK SHOUT AT ME NOW!
.......

Not shouting pupuce, becasue your post is - as aways - reasoned and inoffensive. But why do physicians and a lot of others discount emotional necessity as a valid reason for a c-section. Nobody (reasonable) would try to argue that a mental illness was any less important or treatworthy (I know that's not a real word but I couldn't think of the right one) than a physical ilness, so why are emotional reasons for a c-section, such as being terrified of the labour process, not seen as legitimate excuses.

I think what you say Pupuce makes a lot of sense and I feel that we come to expect intervention that we have forgotten that our bodies are geared up to give birth.
As for your last statement I couldn't agree more.

Forest, do you not see that if natural birth = strong minded, you are implying that women who have c-sections aren't strong minded. It seems quite Ok to say this sort of thing about women who have sections, then when they actually protest, we get the whole patronising, dismissive, 'poor you, you must be really troubled by the birth' thing. Does it not occur to you that in fact, what is infuriating is other people's attitudes? Yes, I do think to hell with them (my dh always says, quite rightly IMO, 'it's none of their business', and wonder why some people feel they have the right to attack/undermine/criticise other people's birth experiences & choices (you will note that I specifically didn't). When did you last see a celebrity attacked for 'making excuses' about why she had a natural birth? And I have lost count of the slaggings off Patsy Kensit has had for having a section when she had pre-eclampsia, which can be fatal. But I also know that there are a lot of women out there who do feel ashamed and sad about the fact that they had sections, and I'm afraid that I think the negative and critical attitudes of others don't help. I understand your point Pupuce, and know you feel this strongly and it is part of your work. I'm sure it is absolutely invaluable when you work with women who share your viewpoint, but I simply don't agree with you. The best mother I know (not me!) had both her children by caesarian, purely because she was horrified by the thought of labour. Lovely, happy, passionately loved children both of them.
My problem with the word 'proud' is that If I wrote that I was 'proud' that my son was not disabled or autistic, that would be seen, quite rightly, as grossly offensive, because it implies that a/it was the result of some cleverness on my part and b/that it was somehow shameful to have a disabled child. You had your child one way, I did it another. I happen not to think yours is better. No worse, certainly (though it would have been a lot worse, physically, for me). But no better either. You clearly disagree. I don't know why that makes me the snotty one.

Pupuce : But I can't help but think that birth is a physiological event...

Ah, yes. And truthfully, I think women get much too wrapped up into it sometimes. Never knew there was a hormone of luuuurvvve (as my husband just said after reading over my shoulder). After carrying a child for nine months and then going on to care for them for who knows for how many years, it's going to matter how they got out and into the world? A few hours of drugs, albeit natural ones, matter?

Years and years of parenting will matter. Hours of whatever during birth, for the most part and definitely in general, will not.

Forest, your body may have been geared up for natural birth. Mine certainly wasn't. It's completely natural to die in childbirth, you know - confidence or no confidence.

Hey we shoud debate : is an episio an operation???
Well is getting your wisdom teeth out an operation??? I don't know - just asking...

Mears/Leese might be able to tell us... I DO know that an episio is done by a MW not a ceaserean... so I guess if it IS surgery it is considered minor.

An episio is a cut with cisors in the perineum and the length varies.... a ceasarean is a cut into 3(?) layers including an ogan - the uterus - and you have much more suturing. Blood loss will be higher, you need a stronger anaelgesia, you do go far deeper in a body and can damage other organs, you need strong pain killers afterwards,...

Aloha - I remember you saying that you would not go for a VBAC (is my memory correct)... is it because you know that what happened the first time will happen again? Just asking.
Thanks

And you've hit upon a sore point of mine here:
Pupuce: "I have also heard from an obstretrician at Kings College (I will try to find research evidence on this actually) that the impact for a baby's lungs and brain is different when born vaginally or by ceasareans."

One OB is an anecdote. One study is a data point. One review from a qualified journal is what you should start to believe. And the emphasis is on "start".

I agree JJ... this OB was quoting 2 research from the BMJ... hence I want to find them

I agree JJ... this OB was quoting 2 research from the BMJ... hence I want to find them

I understand the point you are making Forest about our bodies being "geared up to give birth" -but how many people posting here managed a completely natural, no intervention, no gas and air experience? Of my antenatal group just one out of six of us did - the rest of us experienced elective c sections, emergency c sections, ventouse, forceps whatever, you name it, we had it.

Going off on a tangent here, but a friend of mine gave birth recently and was told that the hospital no longer used forceps because of the risk to mother and child. I also know a healthcare professional, who is a leader in her related field, who has told me that neither she nor any of her colleagues would ever have a forceps delivery because of the above. With this in mind, I wonder why more women aren't offered c sections when it comes to this point. (And sorry if the person who posted about elsewhere about ventouse and forceps is reading this, I know you were seeking reassurance!)

Willow....just FYI - not for debate about how mighty I am - my second baby was 100% natural, in water... no gas and air either (can't stand the stuff).
Having said that 2nd births are usually far easier... first birth was drip and episio... after 6h30 2nd stage.

Actually if I put my doula hat on... out of the 13 births I have attended... only 1 had ventouse (no episio) and another one had forceps (and episio)... NONE had epidural, no caesarean*, no drip... loads of Gas and Air (which is not used in many countries by the way... women around Europe deliver without it!)

• I did help a mum with a scheduled ceaserean for placenta preavia.

No, Pupuce, I wouldn't go for a VBAC. And luckily I am sufficiently elderly that I don't think I'll have any problem getting another section if I went for No2. My personal and individual reasons? Well, I had an excellent experience with ds, and I would hope to repeat it. I also think it would be more relaxed as this time I would really know what to expect. Also, and this is NOT a criticism of anyone else, I really don't fancy the pain and what I personally perceive to be the possible indignity of labour - I don't mean the positions or the actual giving birth by that, but the effects of pain. I really don't want to be screaming and out of control in the way I witnessed in others in hospital. Before I was diagnosed and the section became an inevitability I was considering a asking for a mobile epidural at St Thomas's, but I'm afraid I just don't trust the NHS to provide effective pain relief in time to consider that route again. I've heard too many horror stories of shortages of anaesthetists or even of midwives telling women they weren't in pain or in labour, then telling them they are too far gone and can't have anything! If I had another child, my only problem with a section would be that I would be away from ds for three nights or so. But frankly, I plan a brief weekend away from him this summer while he stays with his beloved grandma, so that's not such a big deal. Also a first labour can easily last a couple of days and with a night or two in hospital I don't really see that it will be very different. I suppose I just have enormous confidence in my body that it can cope really well with a section and the recovery from it
So if that makes me too posh to push, so be it. I'm also 'too posh' to climb mountains, go white water rafting, scuba diving, parachuting or bunjee jumping. In short, not a big fan of danger, pain, or the unexpected, hormones or no hormones

Pupuce: I agree JJ... this OB was quoting 2 research from the BMJ... hence I want to find them

Excellent. Two data points. You can now draw a line but not a conclusion.

Actually, my only worry about my section last time (believe me, I had other worries such as some nasty bleeding which could have heralded a catastrophic haemmorrage) was that it had to be done a little early for safety reasons. In the end I was nearly 38 weeks, which was a whole week later than they wanted to do it (I insisted) and that was a huge sacrifice on my part because it meant a whole week more of NHS mince and potatoes, so I suppose I feel pretty proud of that!

Is an episiotomy an operation?

According to the dictionary, surgery (operation) is performed by a surgeon - midwives perform episiotomies therefore the answer could be no.

Surgery is also classified as an incision into the body, so the answer could be yes.

However, it is not actually classified as an operation, and as such an operation sheet (which is written for forceps /ventouse and C/S) is not completed.