Why Choose Caesarean For Your First Baby?

[ballerini]

I am new to pregnancy and wondered for what the reasons would someone choose to have their first child by Caesarean section?
My friend mentioned it is more risky than a vaginal birth but I thought it was less risky because the cord would be less likely to get wrapped around the neck and it won't get stuck and stressed.

(@Blueskyrain not according to the stats I found online but I agree-of course it's too simplistic to quote costs left and right. Anyway, withdrawing from the lists now!!!)

I hear you CL, obviously a free at the point of use healthcare system has its limitations. However, I think it’s a very slippery slope we’re heading down when the full range of birth choices are only available to the wealthy. And being so scared of tearing/birth injuries that you opt for surgery is more likely to be tokophobia than vanity. For many a CS is a very positive birth experience and whilst the NHS can’t pay for everything, in my opinion no one should be denied this if they understand all the facts/risks and decide it’s ultimately the best option for them.

Just to add to a couple of the points you make. The 50% of OBs stat applies to the US where midwife led care isn’t really a thing so the OBs are presiding over low risk and high risk patients so they probably have the most objective view of all as they see all sorts of deliveries. I agree not overly relevant for comparison with the U.K. system but still interesting to know how they choose.

And in the U.K. private insurance doesn’t typically pay for childbirth, the exception being for expats who are working here but not entitled to the NHS. So if you opt to go private you usually have to pay out of pocket and it’s £15-20k on average for a c-section. So it’s really only an option to for the very well off.

I didn't even think you had a choice? With the trust I've been receiving antenatal care from it's just been that I'll be having a vaginal birth and that's that.

I just wanted to add - because I've seen it a lot on here - that it isn't true that your hospital 'has to' do something because it's NICE guidelines and therefore that all women can have a C-section on request. Guidelines are just that. My CCG won't do C-sections without either a physical reason or 'a proven psychiatric need' - they do say that they will then refer you to a hospital in another CCG if you want, but since that would mean a journey of at least 50 minutes to another hospital in any case AND they could also say no (a quick google suggests that the next-nearest has the same policy), for most women in my city that means that you can't have a C-section on request, whatever the NICE guidelines say.

@TroubledLitchen that was a UK stat, not a US one :)

But yes I hear you. Oh the whole things is so complicated. Choice over money and I agree-it shouldn't be something only the rich have access to100%.

I'm 41 weeks and really angry I have to wait for an induction for another whole week. But I'm kind of dragging my poor broken pelvis through the dirt grimly repeating 'it's hospital policy you have no choice in this' over and over trying to persuade myself this Is for a reason-e.g this baby will come naturally and it saves the NHS a bob or two not inducing me earlier. I'm probs not a very good person to be championing much right now 😂

CL is that a UK stat too?! Shocking, I expected (clearly incorrectly) that it wouldn’t be as high in the UK although makes sense as the doctors do see the more risky cases.

Your poor broken pelvis, I hope baby makes their appearance soon. I think induction is supposed to work more quickly if you’re overdue and obviously definitely preferable if baby comes on their own. I wish you the best of luck and hope all goes well for you.

I had a VB during the labour midwife could tell I was scared of the actual pushing out bit. She numbed my lady parts and did a small tear for me it helped me massively. Not sure if they would but I would ask for this again in my birth plan if I have another.
I have heard it's harder to bf after CS as it's harder to hold baby and milk doesn't come in as quick. Not sure if any MNs can confirm or correct me here?

@TroubledLitchen Thanks me too! Both the baby and I are really uncomfortable now!!!!!!

Did anyone read the article that the editor of Grazia did for The Times (I think) about her childbirth experience, it's worth a read

As a first time mum, I really wish I'd never read this post
My baby is due in just a few weeks and this has frightened the life out of me!!

I can tell you the reasons I chose one

• Afraid of the pain of labour. Afraid that I'll be in the "latent phase" of labour for days and denied pain relief during this time. Afraid that even when active labour begins I will be denied pain relief - will be told anaesthetist not available or something. OTOH I can be sure the cs will not begin until the anaesthetist is there.

• Want to avoid forceps and an emergency section.

• Want to avoid a bad tear causing incontinence that doesn't heal.

• Don't want to go overdue.

• Read so many horror stories on here about women in unbearable pain for days, then ripping in half basically, and now they are disabled with ptsd.

• I've been deathly afraid of birth my whole life, as Mum constantly repeats the story of my birth, after a long agonising labour I got stuck and had to be ripped out with forceps. The anaesthetist wasn't available so this happened with no pain relief at all. I weighed nearly 5kg at birth. I just can't risk being stuck screaming in the worst possible agony on a hospital bed, with a 5kg baby stuck halfway in and halfway out! I couldn't bear that, I wouldn't recover physically, or mentally knowing I could have avoided it.

I'm paying privately but I'm not in the UK so the cost is equivalent to around £3500. Luckily for me that's affordable, I'm more than happy to pay it.

Its not for everyone but those are my reasons.

I am a consultant surgeon and opted for an elective section with my first (and so far only) baby. I am neither stupid nor misinformed. The benefits to me were feeling more in control, safer for the baby, reduced chance of urinary incontinence and reduces the chance of faecal incontinence to almost zero. Reduces the chance of poor decision making in the middle of the night by junior doctors who feel uncomfortable treating a senior colleague.

Many of my colleagues have chosen the same but equally many have chosen to have a vaginal delivery.

The key is to research and understand the risks, giving birth is risky, some risks are more acceptable to individuals than others.

neednewshoes you can definitely breastfeed post section. It’s the removal of the placenta that gets things going for milk production. Providing all is well with you and baby you can usually have skin to skin in theatre and feed colostrum in recovery. A breastfeeding pillow can help with getting a comfy latch position. If you’ve had a bad time of it and a lot of bleeding sometimes that can cause a delay of a day or so in your milk coming in properly and it’s rare but baby can get also oral thrush from you due to antibiotics. But if you want to breastfeed then a CS definitely shouldn’t stop you from doing so.

Ah yes welshweasel that reminds me of another reason. I don't want to risk needing an emergency section at night, and being hacked open by a first year registrar.

I am also a medic and agree with PP that the order of preference is;

1. straightforward VB -no tears, home at 6 hours 2)planned c-section with calm, music etc 3)instrumental delivery
2. emergency c-section in labour
3. failed 3 followed by 4

So some people will Opt for 2) to avoid 3-5. For a first timer I believe the odds of getting 1) are around 50%.
Babies have less respiratory problems and are less likely to be readdmitted following a VB.

Stillwishihadabs, your chance of avoiding 2-5 is about 50%, in that you are right, but there is another option which you've omitted, which is very common:

Non instrumental vaginal birth with tears or epiostomy. Only about 10% of first time births will be (1) about 40% in this new category (which will include fourth degree tears etc), and 50% for 2-5

So it's a 10% chance of number one sadly, rather than 50%.

@TroubledLitchen thank you the friend who told me this must have been speaking from personal experience rather than general consensus.
Got to say having read this thread I think I want a CS if I have another Quite afew of my friends have had elective CS. I'm not sure with most of them if it was medical or they asked. I was never asked as I was classed as low risk it never even came up.
I did one of them parental classes and I do remember the midwife talking in favour of VB though she did say 1 in 5 become emergency CS.

@ForeverHopeful21 we'll be ok I promise :) FTM here too!! The NHS are well trained and wonderful and they will look after us. ❤️

I had an elective section . My doctor wanted to induce me early(37 weeks) when she explained how long the procedure could possibly take and end in a cs anyway I went for the section straight away. Up and about the next day drove 10 days later recovered beautifully. Also cleaned the house from top to bottom after 3 weeks no issues at all.

@OneForTheRoadThen I foolishly got rid of most of my detailed information after DD was born. However, this article contains several of the links www.newscientist.com/article/mg23130813-000-uk-doctors-may-starting-warning-women-of-childbirth-risks/amp/

I also found several more bits on the RCOG website.

Good luck

It's worth noting that 3rd and 4th degree tears affect a very small percentage of women. About 6% for a first birth and 2% for subsequent. So not overly high.

For those who are nervous about giving birth for the first time please don't be scared by this thread. People are always likely to share a bad story over a good one! My VB was totally ok. Quick induction, small episiotomy and discomfort for about a week. No issues with incontinence.

CL- the issue with not giving women the choice is that youd be taking away their bodily autonomy and making it all about costs which is unfair.

@Girlwiththearabstrap I gotcha and I agree. But playing devil's advocate, everyone gets that being under a Nationalised Health service one way or another. Cancer victims don't always get what they ask for or want treatment wise either which sucks big time too and arguably is more crucial for them than for a pregnant woman who could undergo a VB but has opted for a CS -also this is not related purely to gender but based on affordability and practicality. The system can only afford what it can afford. They have to draw lines somewhere and it sucks that it feels as if we women get the short straw more often.

Right last post I promise! Signing off. Some great articles here from people.

@DuggeeHugs thank you for that

Interesting reading, especially as I'm getting on a bit too.

@OneForTheRoadThen you're very welcome

I went into having DC1 extremely ill informed - I had no idea opinion and anecdote was the basis for much of what I'd been told. If I'd known the risks of an induction in my circumstances I would never have consented. Getting the facts before making a decision second time around made me feel much more in control.

I also feel that knowledge is power, even if it is scary. I felt more in control with my second birth because I researched more and knew my rights and my options, risks and benefits and alternatives.