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.

You’re not wrong about the initial commitment, but I have a family member who has done this for 11 months and it’s been pretty straightforward since the first few weeks. Getting breastfeeding going isn’t hassle free, either.

My relative didn’t want to breastfeed for her own reasons and didn’t even try. She wanted the baby to have breast milk though. It’s free, apart from anything else! She hired a hospital grade pump for the first couple of months.

Shall we just distribute a bunch "best mum ever" badges for individuals on here who had natural deliveries and breast fed so we can get on with addressing ACTUAL question the OP has asked - which is how far is it appropriate for a midwife to push against what appears to be a well informed choice?

@Maray1967 i had first vaginal and second C-section and was leaking for many many years after.
The only thing that stopped it was going back to horse riding 🤞
As @Floralsofa states we are not all the same.

@Miresquire

Ok. Then tell them that. I'm not going to argue with you over a claim I didn't make.

I think the date makes it clear that first time mothers are more likely to require an assisted delivery than those that have previously had babies. What people do with that information in regard to their own circumstances is up to them.

I couldn’t agree more. Having elective major abdominal surgery is “way worse for your body”. I had no choice but have real and lasting issues from it not to mention the risks involved. And oh yeah, your car insurance company may not insure you for six weeks following due to the risk of an accident and the weakness of that area. I’m actually glad she said this to you and tried to make you understand the risks.

C-section limiting the number of children may be true for some people. I have a friend who has had 2 and has been told a third would be risky due to the way her internal scars healed etc.

The pressure on breastfeeding means that when parents do opt or have to bottle feed their mental health is hammered by being a 'failure'. My children were bottle fed. They have thrived. Midwives should be more neutral and give facts and then help and advice without judgement.

Please please please choose what YOU want. This is your choice and you don’t need to be persuaded by anybody. It might seem like the most important thing at the moment but in 2.5 years you’ll have a toddler and won’t be thinking about it anymore. My little boy is 4 and he was bottle fed. He is wonderfully healthy, strong, robust, just wonderful and it seems like a million years ago. Just do you, this judgement from woman to woman is so crazy.

Please don’t listen to anyone pushing you either way. This is completely YOUR choice. They have to highlight the risks in a c section but that’s all, a consultant rang me, explained the risks and asked if I still wanted one and I did. I loved my birth experience, it was exactly what I wanted. Please continue to advocate for yourself.

Also I bottle fed and DD is perfect x

That stat means 1in 3 births are instrumental births. Then there are also sections. Section rate is something like 38%. I’m not overly good with stats but doesn’t that mean 62% of women will have a vaginal birth but of that 62% a third will have an instrumental….so about 40% of women will have a spontaneous vaginal birth???

in fact just looked at nhs digital stats, which for Jan 2023 actually has a lower instrumental rate. So 50% spontaneous vaginal births and 50% lscs or instrumental. But that’s all women, primips are more likely to have an instrumental so their overall chance of a spontaneous vaginal birth will be under 50%

Both me and my son have real and long lasting health issues from a vaginal birth. Childbirth is scary unpredictable and dangerous, it’s not true to say otherwise

No not really. It sounds like from your post you just didn’t like what she was saying and it wasn’t sanctimonious at all. And for reference, it is scientifically proven that breastfeeding is “better”.

Mental health of the mother. Yeah for me feeling like a baby was already shockingly difficult and relentless, I didn’t need to be sterilising 10+ bottles a day, washing 10+ bottles a day, mixing and preparing 10+ bottles a day etc. My mental health was made better by having exactly what my baby needed on tap. Was it hard? Yeah but that wasn’t a reason to not do it.

But 'way worse for your body' is totally subjective and isn't helpful for the OP.

Attempting a vaginal birth is no guarantee of having one, the risks are the higher if having an emergency one rather than an elective one, there's a reasonable chance of needing an assisted birth.
People have ended up with permanent stomas from attempting vaginal births and people can be back to normal activity and sex life within a few days of a section. They are different ends of a spectrum and the OP needs those risks quantifying- not broadband sweeping statements.

Totally agree you shouldn’t be pushed into a choice which isn’t right for you. Informed choice matters, stats matter. But this should be presented in a neutral manner. HCPs should not be using language like “worse choice”. Like you say OP a holistic approach should be considered and what is right for one woman is not right for another.

Have had 4 elective c-section.

Don’t feel I owe anyone an excuse as to why because have learned that the haters, think they know better my & childs medical situation better than consultants.

The recovery was fine. Not a big deal.

The UK aggression around c-section and breastfeeding is just wrong.

Not sure about the accuracy of your statements. I had an ELCS and had no trouble establishing breastfeeding and could feel my uterus shrinking with every feed for the first week. My baby also had all the expected reflexes (I had a book called Experimenting with Babies which covers pretty much every baby reflex and we were able to tick each off). Baby is hitting all their milestones on time.

OP I had no reason to go for a CS aside from protecting my mental health, having been majorly depressed through teens and early 20s I wanted to ensure I started motherhood in my best mental state - with a CS I eliminated a whole load of unknowns, knew what to expect and was able to start parenting without sleep deprivation. My midwife supported me in my decision (potentially due to my mum having PND after having me). I did ask my obstetrician beforehand if they'd have a c section in similar circumstances and they began by saying that it is absolutely my choice but that they personally would have a natural delivery, but they wouldn't have told me this had I not asked.

Mothers mental health can't be undervalued- do your research and then choose what you think will provide the best outcome for you and baby. There isn't sufficient harm in C sections or formula to the baby to justify railroading the mum into natural delivery and breastfeeding.

Sending you good wishes!

Just wanted to add OP this is for HCP but has good stats. RCOG have loads of good information leaflets:

https://www.rcog.org.uk/media/33cnfvs0/planned-caesarean-birth-consent-advice-no-14.pdf

Agreed - but the mw here made a huge generalisation which in my experience is not correct at all.

I’ve had one of each. No mw gets away with telling me that a cs is miles worse than a v birth. I had a second degree tear with DS1 which caused me some problems. My cs wound healed more quickly.

Because it's her choice? Also she may not want to risk 48 hours in agonising pain, a torn vagina/potentially anus, risk of urinary/faecal incontinence, the indignity of potentially soiling herself during labour. The fear of the lack of control. Potential use of forceps. Every labouring woman depicted in tv/film is screaming blue murder and appears to be in the worst pain of her life. She also may have a fear of childbirth. I don't understand why anybody would opt for a natural labour. Next question!

I second what pps are saying about, be informed but don´t let judgement make you feel guilty. You do what is right for you. I had an emergency c-section, so it wasn´t my choice, but recovered well. No issues. And my daughter was bottle fed, she is a fine, happy wise attractive chatterbox, and 6 years old.

It isn’t. It’s just bollocks propaganda to make women (as usual) feel guilty and inadequate.

There is absolutely no way even the most militant breastfeeding advocate could pick out a breast- or bottle-fed person from a lineup of 3/13/33 year olds, whatever they say, unless they were still physically attached to a nipple.

If I can choose whether I allow a “fetus” to live in my body, I can choose whether I allow the resulting baby to use my body as a milk dispenser. That’s all there is to it and anyone who disagrees is no different to the pro-lifers they so despise.

Yes you can have a c section with no clinical indictions. From the Birth Rights website: https://birthrights.org.uk/factsheets/right-to-a-c-section/

Do I have a right to a caesarean birth?

You can ask for a caesarean birth even if your doctor or midwife doesn’t think that you have a medical need for one. This is called a maternal request caesarean birth.
Your hospital must listen to your reasons for wanting a caesarean birth and have good reasons for saying no. The doctor must also offer you information to about the risks and benefits of a c-section or any other recommended treatment they may recommend instead. This information should be personalised to focus on what is important to you, in your circumstances.

What does national guidance say about my right to a caesarean birth?

National guidance from the National Institute for Health and Care Excellence (NICE) recommends that if you ask for a caesarean birth, the hospital should support this if they are satisfied you are making an informed choice.
The guidance says that the hospital should discuss with you why you want a caesarean birth and the risks and benefits of caesarean and vaginal birth.
If your request is due to anxiety about childbirth, the hospital should refer you to a healthcare professional who is an expert in perinatal mental health. You do not have to accept this offer of support.
The guidance says that if you still want a caesarean birth after you and the hospital have talked about it, and you have been offered support, the hospital should offer you a caesarean.
An individual obstetrician (doctor) can refuse to perform a caesarean. But they should refer you to another obstetrician who is willing to carry out the operation.
In March 2022, an important report was released about failings within English maternity care. It is called “The Ockenden Report” and it contains a list of essential actions that all English NHS Trusts should be carrying out. “Essential Action 7” of the Ockenden Report states:
“All Trusts must ensure women have ready access to accurate information to enable their informed choice of intended place of birth and mode of birth, including maternal choice for caesarean delivery.”
All NHS Trusts should be already taking this action now as well as following the NICE guidelines on caesarean birth.

The experience of breastfeeding varies widely. Being in pain every time you breastfeed so much that you realise you are trying to delay feeds, is not conducive to bonding. Neither is having a strong let down feeling that makes you feel sick and tearful. Neither is having been sexually abused throughout childhood and anyone touching your breasts brings that back.

Gosh there are some very pushy people on here 😅

Of course midwives need to inform you correctly, however they don't have to be pushy and be dismissive of your choices.

I chose to formula feed both mine from the beginning and was lucky to have supportive midwives both times, some of the comments on here blow my mind. How can breastfeeding be both best for mum and baby if the mum isn't inclined to do it in the first place? I'm not denying it's better for the baby but if it's at the detriment of the mums mental health and wants then surely it isn't 'best' in the long term? I never wanted to do it, the thought made me feel icky and that's totally okay, meant my partner could help way more too. It's pedalled that dads can bond in other ways such as nappy changes and cuddles but in reality they do normally want the mum way more as it becomes more of a biological bond which can be fairly restrictive.

OP - please keep at what you want to do, at the end of the day it's your baby and your choice. Please don't feel judged either!

My mum had me "naturally". I was turned the wrong way. My mum's own gynae was on leave. The stand-in tried and failed to turn me.

Mum's waters broke that night, a fortnight early. She was in labour 3 days. Her own gynae got back. She heard him saying "We'll get this sorted out now, m'dear..."

When she walk up, she'd had an episiotomy and forceps delivery, with all the ensuing complications. A nurse tried to insert a catheter and Mum felt a sharp pain. "Oops! Sorry! Wrong hole!"

Mum always wondered whether that had contributed to her subsequent "incompetent cervix" and miscarriages.

What I'm saying is that a vaginal birth can have different but equally severe complications to a c-section.