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.

Worryingly narrow minded of you.

You've no idea what experiences such a woman might have had, what support is available to her, what other demands there might be on her time.

This. This this this this this.

Honestly what is wrong with people, that we accept anything less than this for mothers and their babies.

Informed consent is a right.

They let their ideology get in the way.

Hi OP, I also chose to have a c-section and while some do have complications, mine was a breeze and I have zero regrets. I also chose to formula feed, and my daughter is happy and healthy. You know yourself best, choose what's best for you and your family.

You sound like a GP I would never want to meet. How judgemental of you as a health care ‘professional’. I chose to bottle feed my child, my friend breastfed. Both babies had terrible reflux and CMPA. My sons certainly wasn’t any worse just because he was bottle fed.

Also, it’s very rare for babies to suffer from lactose intolerance.

Except, they don't do this.

What they seem to do, is list all the horrors of c-section (which is based on emergency c-section research), scaring the woman senseless, whilst keeping fairly mute on all the dangers and risks of vaginal birth.

It's simply incorrect to say that an elective c-section is much worse. At least in a c-section, the hospital date will be planned and they have to have a certain amount of people present. Contrast that with women giving natural birth who feel like they've been just left to it as the few midwives on the ground rush around between patients.

Then all the women pressured to have natural birth, only to a have a horrific one, which might end up in an emergency c-section anyway (which would be riskier). The women who'll end up with permanent faecal incontinence and painful vagina for years & years due to botched up stitching.

There are benefits to the baby from vaginal birth, but I'm not sure if the risks are worth it is the mother has concerns.

However, please do some reading up on breast milk @Padronpeppersplease I have asthma, eczema and allergies, and sometimes I wonder if my life would have been easier and better if I'd been breastfed, which I wasn't.

The OP mentions having had breast surgery. It might be impossible for her, it might be that she knows trying and potentially being unsuccessful would be detrimental to her mental health. Which would in turn be detrimental to her baby's wellbeing.

What's judgemental about what she ( the GP) said?

It is totally and completely your choice and your midwife should have only made you aware of risks - not tried to persuade you either way.

You crack on with what you want based on YOUR priorities, thoughts and feelings. Do not be dissuaded by your midwives or commenters here claiming vaginal births / breastfeeding is optimal. Both of these things come with disadvantages and risks too - it’s YOUR choice which risks you care most about!

I say this as someone who opted for a vaginal birth and predominantly (though exclusively) breast fed until my baby was 2.

My elective section was much worse than my emergency section

post op complications
5 days in high dependency unit
12 days in hospital
wound infections
3 months of severe pain
6 months to recover

the horrors can and do happen either way both elective and emergency sections

it’s simply incorrect to say otherwise

It can be the best choice, if the mother doesn't want to breastfeed. That's the point.

When I gave birth elective c section wasn’t really an option. My births were totally different, 1st was quite traumatic and I would have chosen a c section over it any day, I had a bad tear, took months to recover and ended up with a pretty bad infection from a particularly retained placenta, I was stitched up badly and sex afterwards was painful. 2nd birth I had an epidural and it was pretty relaxed and painless, recovery was quicker but still painful, I was stitched up again but this time it was done correctly. There were people on my ward after both births that seemed to be walking around a day after c section where as I was still struggling. I didn’t breast feed either of mine due to inverted nipples, I wasn’t offered any advice in solutions.

I do think woman should be able to chose how they birth their children but I guess if everyone opted for a c section it would be pretty tricky for maternity to cope (lack of surgeons, lack of beds for recovery).

This. They say natural birth also ''kick starts'' a baby's immune system in. a way that caesarians don't.

Maybe this is why ''Allergies'' now are so common?

https://www.bbc.co.uk/news/health-49740735

Obviously moot, but I suspect not. Especially as we're getting older, fatter and less likely to be a multip. If everyone had an ELCS, that would mean no complex instrumentals or EMCS. None of the sort of VB that costs more and needs more resources than ELCS. It would also be easier to plan in order to use resources most effectively.

I encourage all women attending this sort of meeting to ask what percentage of first time mums planning a vaginal birth at the hospital they're going to have a birth that doesn't involve an emergency caesarean, forceps or ventouse.

And then proceed with the conversation having acknowledged that about half of all planned vaginal births for first time mums and with emergency surgery or instrumental birth.

Re: feeding decisions - nobody should pressure women, but most people going into having a first baby have no understanding of how breastfeeding shapes the day to day experience of caring for a baby - probably because the only thing people bang on about in relation to this issue is health benefits for babies, rather than pointing out that breastfeeding is often an amazing parenting tool for mums. I understand midwive's frustration over this, but it's still not ok to talk about it in a way that makes someone feel crap.

Other mammals , foals, lambs, puppies, kittens, calves it's well known that their own species' milk is perfect for them, and that if the mother dies, or rejects her offspring, ''milk replacement'' is considered a serious second best, and almost anything is done to find a substitute mother for the youngster, as it's physically and psychologically better for the animal to feed naturally, as it's meant to be fed.

Only in humans is artificial formula considered ''acceptable''.

My mother had to bottle feed because she had a serious {fatal} illness.

But if a mother is healthy, Breast is definitely best.

I think it should be possible to have these conversations without shaming or blaming one side or the other.

There are lots of ‘optimal’ things women can do when pregnant, giving birth and feeding their baby.

It’s based on the science of the day so changes over time.

It’s also okay to make different choices based on personal needs and situations. And also personal wants.

For example - it’s optimal not to drink alcohol while pregnant and breastfeeding. But it’s also usually fine to have the odd drink occasionally after the first trimester and to manage the odd drink around feeding times when breastfeeding.

It’s optimal to have one consistent primary caregiver for infants but most families can’t afford a SAHP so the next best option of nurseries is perfectly good solution.

It’s okay to say the optimal choice for the health of the baby - and mostly for the mother too - is a vaginal birth and breastfeeding. But that the next best options are good enough too.

It will be interesting to see if ongoing research into the effects of different delivery and feeding methods have on the rise in autoimmune disorders and asthma and allergies can produce a medication or treatment for C-section babies to help match the advantaged of the birth canal delivery.

I was planning on C-section and breastfeeding. Ended up with forceps delivery and gave up breastfeeding 3 months in. Some things just don't go to plan.

I hope your attitude is better in front of your patients who can make their own decisions as to whether to use formula or not. Breast is not best if that isn’t what the mother wants to do.

It's totally YOUR choice but a very emotive subject.
I had an emergency c section, wanted a vaginal.
EBF for 6 months...wanted to stop but was pressured into carrying on and 5 years later I have crippling back pain from the fact I was hunched over to breastfeed for so long because my c section took so long to heal (cut my bladder, damaged my bowel).
I don't most people's experience birth is what they want or expect.
DH refuses point blank to ever have another child after all the damage to me.
A mothers mental health also matters..but we are indoctrinated into believing that the mums don't matter.

Also the reason why health professionals are often pushing vaginal birth and breastfeeding is because they are aware of the wider medical research into worldwide C section rates and scientific guidance.

For women in third world or poorer counties not enough C sections are available - the WHO has a current formula that suggests if a countries C section rate is below 10% then women and babies are dying unnecessarily from complications. But the medical benefits to maternal health caps at about 20%.

https://www.google.com/amp/s/amp.theguardian.com/lifeandstyle/2019/jun/20/is-breast-really-best-i-looked-at-all-the-data-to-find-out

The benefits of breastfeeding are probably quite overblown. This article gives quite a good lay summary of why that is. And there are definitely some costs (eg. mandatory sleep disturbance if exclusive).

Any medic that aggressively pushes breastfeeding, rather than simply relaying the costs and benefits associated with it, is failing in their duty of informed consent. I say this as someone who themselves nursed for four years in total - and yes, I can think of several reasons why someone would choose a different path to me. It's not that hard really.

I had an awful first birth - if I could go back again I’d have absolutely chosen a CS over that shitshow. I was UNLUCKY. It’s all so personal and nobody knows how it’s going to go for them so it’s pretty important to do your own research and then make your choices (and know your rights!). The one thing I will say - I actually found breastfeeding easy. Of course, you’re never allowed to say that as people who struggle can’t bear to hear it. But it’s not always unbearably tough and it certainly seemed easier to me than the faff with bottles and sterilising. But I was LUCKY. Again - so personal.

my friend, a female obstetrician, had a forceps delivery like me and like me said she wishes she had asked for a c-section at the time the forceps came out.

Don’t forget a huge reason for pushing VB is the NHS simply couldn’t afford for every woman who wants a CS simply as a preference to have one. At one time they targets for emergency C sections to encourage staff to keep the numbers down - it was later removed as they realised it should be down to necessity and not figures. But the costs of a section is enormous vs a vaginal delivery.