Awful birth ‘options’ meeting

[Padronpeppersplease]

I’ve just had my 28 week birth options meeting with a midwife and wondering if anyone else has had a similarly pushy experience. She asked me about whether I intended to breast or bottle feed and also what I’m planning for the birth. I said I was 99% sure I wanted to exclusively bottle feed and then also that I was considering an elective c section. I’d heard previously that the NHS try and push both breastfeeding & natural births but I was not prepared for how pushy this midwife was! She said to me that bottle feeding was ‘way worse for baby’ and that ‘a c section was a million times harder on my body’ than a natural birth would be. According to her as my body is built for birth I don’t need to worry about the pain of natural labour and tears during labour aren’t anywhere near as bad as the potential complications of a c section, she also said that opting for a c section would limit the number of children I could have. Despite all this I’m still leaning towards a c section, I’m under no impression that it’s easy recovery & without risks but I honestly feel now like I’m doing something totally outlandish by opting for it.

I'm sorry you were made to feel that way. It sounds quite unprofessional. Yes they have a duty to make you aware of the risks and benefits of each option, but at the end of the day, it is your decision and maternal request is a perfectly valid reason for a c section. I had a birth options meeting for DD2 as she was a breech baby, and the consultant midwife I saw was lovely - really even handed, practical, kind and i left feeling really well supported. I would also say that many women who have had prolapses and fecal incontinence after childbirth would totally disagree with her assessment of the risks of natural labour and tears! Was she your usual midwife or a different one? It might be worth chatting through with your usual midwife (if you have a better relationship with her) as she might be able to reassure you.

They should listen to your wishes but I don't see anything wrong in strongly encouraging natural options.

Why would you want to opt for major abdominal surgery v’s vaginal?

She’s correct on both fronts and has a duty to make sure you are properly informed

Er maybe to avoid the increased risks associated with emergency sections and/or assisted vaginal births? As a first time mother the odds of having an unassisted vaginal birth are only about 50 per cent.

I have no skin in the game as I have 3 kids and didn't opt for an elective with any of them but I can totally see why people do. I'm 6 weeks post partum with my third, my only unassisted birth, and my 2nd degree tear wound still hasn't fully healed over yet for example.

You could ask to see a consultant midwife to discuss further OP if you feel necessary. However if the midwife will refer you as needed for an elective then I'd probably just let it be and ignore her comments tbh.

This. I ended up with a CS and formula-feeding, but neither would have been my first choice.

I would really do some research and keep an open mind to reconsider.

I had to have a C section at 37 weeks. I had to have steroid injections, and CS babies are statistically more likely to need NICU care as they don't get squeezed through the birth canal, meaning they can be born with a lot of mucus and fluid on their lungs. A vaginal birth really helps eliminate this. DD was born via C section, had fluid on her lungs and was treated for sepsis in NICU. I don't really have the option to do a vaginal birth but it would've helped her lungs in the process.

A c section is major abdominal surgery, with risks. The midwife is right your body is made to do this. It doesn't mean our bodies never fail, but I would never want to by choice try and recover from a C section ever again when dealing with a newborn or any subsequent children. It's not for the faint of heart.

I had an emergency c section first time and I was distraught - I had really wanted a vaginal birth. The recovery was hard.

i wanted a vaginal for second birth to be able to look after my toddler after birth and to drive etc. I had another emergency section. I was devastated as it does really raise the risk of more children. I felt 3-4 kids was now not as much as an option for me.

anyway, I would just say I wouldn’t CHOOSE a c section if i had the choice and I wish I could have had the possibility instead.

without a medical need it is outlandish in my opinion.

also if you can breastfeeed it is the more convenient option as you can do it anywhere with no prep, no cleaning. No getting up in the middle of the night. You could always try and see if you like it. You could always combi feed

I'm also another who ended up with nothing of these.

And none of them were my choice either, and wouldn't be my choice for any subsequent children if I could choose.

But the midwife needs to listen to the patient. I opted for bottle feeding from day one - DC’s are 100% healthy.

I’m sorry you felt so pressured, she doesn’t sound particularly factual, balanced or professional! I suppose it varies by trust but my birth choices meeting was with the obstetrics team at the hospital I’m giving birth at, not with the community midwife who simply made a note for the hospital to set up the meeting. My meeting was very balanced and I didn’t feel any pressure - have a follow up tomorrow so crossing my fingers that I have someone as reasonable again and it wasn’t just a fluke! Was your meeting with the community midwife? If so, can you ask to be referred to the hospital you’re giving birth at? You might find them more reasonable.

My community midwife team doesn’t seem to care if I live or die which is mostly disheartening but on the question birth choices kind of nice as they literally don’t care what I do and just refer to the consultant 😅

'But the midwife needs to listen to the patient. I opted for bottle feeding from day one - DC’s are 100% health'

@Parker231

That's great, but it still doesn't mean breastfeeding isn't the best choice.

It’s not the best choice if you don’t want to do it. Formula is amazing for babies and parents and the OP has already decided to bottle feeding and should be supported.

Formula is amazing for babies 🥴🥴🥴

it’s a good second best option you mean? It’s not amazing

Best choice for who? It's definitely best for the hospital stats as they are assessed on that sort of thing. In many cases it's best for baby, but most certainly not in all circumstances. And in many cases it's worse for the mother.

You can have your preferences. It is her duty to tell you the risks associated with choosing the more interventionist option. Ideally she would do that in a factual and balanced way but you can’t always get the most competent midwife unfortunately. That is a systemic problem resulting from poor training and high staff turnover.

The ‘your body is made for this’ comment is literally true and she probably says this to women who are choosing a section because they are afraid. If you listened to what she said and still wanted a section, no problem, just say so.

Sorry you experienced this OP. FWIW a planned section statistically has better outcomes for Mums AND babies than a natural birth.

I had a natural birth that went very wrong, followed by a planned section for my second. I totally understand why some countries just perform C-sections as a matter of course.

It sounds like she wasn't very professional in the way she spoke to you, however they have to make sure you are making an informed choice. By not discussing anything at all and just saying 'ok then' it doesn't assure them of this.

I work as an obstetric anaesthetic and recovery nurse and I've looked after women who when I've asked if they had any pain in their abdomen post surgery, they've asked 'why? Is it going to hurt?' They claim they were never told that it could be painful once the anaesthetic wears off.

Again with breastfeeding, a lot of people are unaware of the specific benefits that it does give baby over bottle feeding. They just have to make sure that they know you are aware of all the facts, and then you can decide either way. It sounds like you are informed and have made your decision and she could have spoken to you in a better manner.

@Luminousalumnus I bottle fed my baby, but as a whole, on a scientific level, breastfeeding is best. You can't argue with science. To an individual level it's not always best I know, I was on too many medications that aren't compatible at the time. But as a population level, breastfeeding is absolutely best and the midwife has a duty of care to inform people of that.

Actually there's evidence that babies born via pure elective section (maternal request, not due to any health issues with mum or baby which by their nature would increase the risk of complications) are less likely to be admitted to NICU than babies born via vaginal birth.

amp.theguardian.com/lifeandstyle/2022/feb/13/caesareans-or-vaginal-births-should-mothers-or-medics-have-the-final-say

The problem is that most places record planned sections under one category, regardless of reason. So you have planned sections for ill babies or mothers with health risks alongside maternal request sections, and obviously the outcomes of both have much different levels of risk. But when maternal request sections are actually recorded separately, there's evidence showing better outcomes than vaginal births.

'The data shocked the study’s head author, Darine El-Chaâr, a perinatal researcher at the Ottawa hospital. In the planned vaginal birth group, there was a higher percentage of negative outcomes compared with the MRC group, driven by serious vaginal tears and babies admitted to intensive care. “I myself am challenged by the data,” she says, underlining that she believes vaginal birth is natural. “I wanted it to be the other way around.”

Do you have any stats on that?

Breastfeeding is better for the mother’s long-term health (breast cancer risk for example). Whether it’s better in the short term is obviously highly dependent on how it goes. For me it was hugely difficult and at the same time one of the best things I have ever done. The feeling of being one with your baby is incomparable.

I also breastfed both my babies, exclusively, one until 2. But it’s not without its challenges and if you’re not 100% on board the chances of success are pretty slim. That being the case there’s really no point pushing it - I’m sure OP is perfectly capable of making her own mind up and it’s not like this is a decision she’s making under duress.

Really hacks me off that some midwives make such a fuss about a c section being “major abdominal surgery” when you’re asking for one, then when you’ve actually bloody had one you’re expected to pop home after 24 hours with nothing more than a few ibuprofen and crack on!

I bottle fed both of mine and had cesareans with both

She has no right to judge you, nor to make you feel guilty about a certain choice

And bear in mind too the vast majority of medical professionals go for cesareans!