Warning! Long post! OK, from what I have read and understood, the large scale study undertaken into c/s concluded that loss of specialist skills was almost certainly not the problem. It was more that no matter who is delivering them, breech babies do face a small but very significant risk in being born - and that mothers also faced possible health problems due to difficult and often instrumental deliveries, which often had a higher risk of causing long-term complications than elective c/s. The researchers did look at all kind of birth environments and deliveries and found the risk was always higher. When I got p/g I didn't actually go into it thinking I would have a c/s but it became clear very early on that I had no choice, if my ds or I were to survive at all. So, of course, I am thankful every single day for my c/s, which turned out, like most electives, to be straightforward, calm and, ultimately, wonderful and moving when I met my ds for the first time. I do sometimes (often!) wonder if we place too much emphasis on having a 'correct' birth experience (no pain relief, vaginal delivery, instant bonding etc) for ourselves which is a pressure in itself and makes some women feel like failures if they don't achieve all those things. My friend who recently had her first baby in three hours flat - no pain relief (due to speed not inclination!) - is the heroine of her NCT class. Lots of congratulations on doing it 'the best way', but as she says, 'It wasn't anything to do with me!'. Others who ended up having a c/s having planned for ecstatic hypno-birth (seriously) feel ashamed and as if they have had the 'wrong' kind of birth. I often read how we have 'stopped' looking forward to and enjoying birth. I have read a lot of literature from the 17th century onwards and I can't find any references to women (or men!) looking forward to a lovely birth experience. It was thought of as a scary ordeal (Eve's Curse etc) long before it was 'medicalised'. Mainly because women were terrified that at least one of them wouldn't survive. I do realise that improved hygiene made a difference, but the pain and complications from tearing and haemmoraghing weren't ever things women looked forward to. I wonder if anyone has any evidence to the contrary?
I am also interested in whether when looking at the costs of c/s v natural birth, how post-partum care is factored in here. Are restitching, incontinence care, and all the other things that mumsnetters mention factored into the cost? I honestly don't know if they are or not, but I suspect not.
I do have issues with the NCT's view of birth. I think the NCT is a very valuable and important organisation in so many ways, but the same friend who recently gave birth went to NCT antenatal classes were they were asked to role play different birth scenarios. The natural birth one was all about opening up like a flower, in the c/s one, the woman was asked to imagine lying helplessly on a table while the surgeon callously chats over her head about his golf games while carelessly slicing her open. I mean, talk about stereotypes! I didn't see any recognition in the literature that birth could be traumatic or that c/s could be a pleasant and very satisfying experience (quite the contrary - it's all about how the best you can hope for a sense of relief that you are alive!) and that is hard to read when you are facing a c/s for the birth of your child and have no choice. These things aren't 'just giving the facts' - a mantra I heard a lot from the NCT - they are very subjective and, IMO, slanted statements. As for recovery, my friend with the fast natural delivery (who feels great and would opt to do it again the same way, BTW) is only now, two weeks on, able to walk more than 100 yards without a lot of discomfort from stitches. I recovered just as fast - if not faster - from my very expertly done cs.
I won't pretend this isn't a cut and dried issue. But I think it does women no favours to imply (and this statement truly isn't directed at anyone on this site) that natural birth is always a lovely experience and that if it isn't, or you have another kind of delivery, that you have failed or had a second-class experience.
I'd never try to push a c/s on anyone. Quite a few of my p/g friends have asked me if I would recommend an elective c/s to them. I always say that I've never been in labour so I honesty can't pretend to know which is best for them and that there are pros and cons. I think the longer stay in hospital can be a big con - though I had already been in Kings for over a month so a few more days didn't make that much difference to me! And I know that not everyone recovers as fast or well as I did and warn that it isn't a totally pain-free option. But finally, I do think that how our babies arrive is of very little importance compared to what happens when they get here!