Page 14 | Awful birth ‘options’ meeting

wordler · 04/12/2024 18:02

Eltrut · 04/12/2024 17:44

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.

That article is five years old and there has been a lot more research done recently - also including studies which have accounted for differences in socioeconomic groups.

The benefits are even greater for those in lower economic backgrounds. More should be done to help women breastfeed though - it’s not helpful to say ‘breast is best’ and then not support the women who have to go back to work straight away and make them feel bad for not being able to supply breast milk.

https://sc.edu/uofsc/posts/2024/03/breastfeeding-benefits-for-mothers-and-babies.php

www.chla.org/blog/research-and-breakthroughs/new-research-traces-breastfeeding-benefits-10-years-childhood#:~:text=The%20analysis%20confirmed%20that%20breastfeeding,families%20of%20lower%20socioeconomic%20status.

Breastfeeding benefits mothers as much as babies, but public health messaging often only tells half of the story

Public health and nursing researchers Tisha Felder and Joynelle Jackson write for The Conversation about the benefits of breastfeeding.

https://sc.edu/uofsc/posts/2024/03/breastfeeding-benefits-for-mothers-and-babies.php

SunQueen24 · 04/12/2024 18:03

I loved breastfeeding and am a huge advocate. But I imagine there are little to no benefits of a woman attempting to BF when they don’t want to.

wordler · 04/12/2024 18:06

There’s research that shows that the benefits are the same for those who supplement with formula alongside some breastfeeding. So you don’t have to exclusively breastfeed to get most of the benefits.

That’s why they encourage you to at least try even if you end up using formula.

user2848502016 · 04/12/2024 18:08

The midwife might have worded it in a slightly insensitive way but she's right though, they have to at least try and talk you through all the options, it's literally her job

SunQueen24 · 04/12/2024 18:09

wordler · 04/12/2024 18:06

There’s research that shows that the benefits are the same for those who supplement with formula alongside some breastfeeding. So you don’t have to exclusively breastfeed to get most of the benefits.

That’s why they encourage you to at least try even if you end up using formula.

I meant more on balance when you take into account the mother’s mental and emotional well being.

Honeycrisp · 04/12/2024 18:11

SunQueen24 · 04/12/2024 18:02

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.

Not exactly.

Rather, it's a consequence of the short term way we look at funding in the NHS. In fact, NICE took the view that the cost differences between attempted VB and ELCS were minimal. And our birthing population has only got older and fatter since then.

However, a lot of the costs of attempted VB come later on, and others relate to legal costs. Of course there's a substantial incentive to kick the can down the road.

SunQueen24 · 04/12/2024 18:11

Scirocco · 04/12/2024 16:57

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.

Show quote history

Breast Reduction can be a contradiction for BF but just here to say I have implants and had zero issues feeding - which is typical.

wordler · 04/12/2024 18:12

SunQueen24 · 04/12/2024 18:09

I meant more on balance when you take into account the mother’s mental and emotional well being.

Show quote history

I agree with that - no one should be shamed into these choices.

And there’s not nearly enough support for the women who would really benefit from being able to breastfeed rather than buy expensive formula.

Honeycrisp · 04/12/2024 18:12

user2848502016 · 04/12/2024 18:08

The midwife might have worded it in a slightly insensitive way but she's right though, they have to at least try and talk you through all the options, it's literally her job

No she isn't. She's given terrible advice here. It's literally her job, as per the legal test in Montgomery v Lanarkshire, to appraise the OP of the risks and benefits of her options. Telling her that a CS will be a million times harder on her body than a VB isn't doing that, nor is telling her she doesn't need to worry about pain relief.

SunQueen24 · 04/12/2024 18:12

Floralsofa · 04/12/2024 14:20

Powerlifter here and 3x vaginal birth, don't leak, not even deadlifting 170kg. Anecdata is not data.

Show quote history

They don’t collect data for urinary incontinence, only fecal incontinence.

Eltrut · 04/12/2024 18:23

wordler · 04/12/2024 18:02

That article is five years old and there has been a lot more research done recently - also including studies which have accounted for differences in socioeconomic groups.

The benefits are even greater for those in lower economic backgrounds. More should be done to help women breastfeed though - it’s not helpful to say ‘breast is best’ and then not support the women who have to go back to work straight away and make them feel bad for not being able to supply breast milk.

https://sc.edu/uofsc/posts/2024/03/breastfeeding-benefits-for-mothers-and-babies.php

www.chla.org/blog/research-and-breakthroughs/new-research-traces-breastfeeding-benefits-10-years-childhood#:~:text=The%20analysis%20confirmed%20that%20breastfeeding,families%20of%20lower%20socioeconomic%20status.

Show quote history

Only had a skim but I don't see any references to subsequent RCTs or sibling studies in the links you've shared? Which is what you'd need to contradict the point I was making.

(Controlling for socioeconomic status is basically impossible, so observational studies of breastfeeding are pretty much guaranteed to be biased. Doesn't matter how big the sample.)

Such studies may exist (I haven't reviewed the literature since it was relevant to me) but I can't find them e.g. on Google scholar. If you know of any then feel free to share.

SunQueen24 · 04/12/2024 18:24

Westofeasttoday · 04/12/2024 15:56

I’m really sorry to hear that. You are right childbirth is unpredictable and dangerous. But a c section adds on the recovery of major abdominal surgery to that mix.

Show quote history

Purely anecdotal but the recovery from my ELCS was an absolute breeze and I do wonder if people over egg the recovery aspect. The recovery from my complicated VB with 3rd degree tear and episiotomy was far, far worse and less predictable. Plus I have life long issues now as a consequence. I will say my ELCS didn’t worsen those issues.

SMLSML · 04/12/2024 18:24

Silvan · 04/12/2024 13:00

I disagree, having done both. Obviously something like bonding is quite hard to measure in a research study, but to me it seems likely that breastfeeding feeding is better for bonding because there is a physiological relationship between mother and baby, which you don’t get with bottle feeding. There is obviously also the fact that the mother is doing all the feeds which is better for bonding.

I completely agree that no one should put pressure on anyone to breastfeed if they don’t want to, but I think we should be able to own the downsides of our choices as well as the upsides. You can acknowledge that breastfeeding is ‘better’ in some respects and still decide it’s not better for you in your specific circumstances.

Show quote history

Wow 😅 this is the kind of thing that winds me up, please could you define what you mean by 'bonding' in this respect? All breastfed babies I've seen only end up wanting to be constantly on their mums and the dads don't get a look in...

As a formula mum it's pretty hurtful to hear my 'bond' isn't the same. I'd argue it's as good if not better as my babies have always seen me as their safe space but also have a lovely relationship with their dad too which is handy when you're parenting as a team ☺️

yipyipyop · 04/12/2024 18:27

I had an elective c section and bottle fed from birth. I didn't get any comments like that. I'm 8 weeks post my second c section and recovery has been so easy. I'm 40, high bp and a bit overweight and have had no issues with recovery.

FluffMagnet · 04/12/2024 18:28

user2848502016 · 04/12/2024 18:08

The midwife might have worded it in a slightly insensitive way but she's right though, they have to at least try and talk you through all the options, it's literally her job

Indeed their job is to talk through the options, i.e. give the pros and cons of each in neutral language. Did that happen here? No. I've heard heard a midwife discuss the cons of a VB, not the pros of a CS (to which I do always think, God help any woman who has been scared into having a VB, and then finds herself wheeled off for an EMCS.)

WhiteLily1 · 04/12/2024 18:31

Padronpeppersplease · 04/12/2024 12:09

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.

Asssuming you are low risk pregnancy the she’s not wrong.
It’s your choice of course, but she’s absolutely correct that a natural birth is statistically better for your body and for the baby.
Breast feeding is absolutely better for the baby.
There are reasons to opt for C-section and bottle feeding of course and it’s your decision but you shouldn’t have your head in the sand about the benefits of both natural options for your baby.

WhiteLily1 · 04/12/2024 18:35

SMLSML · 04/12/2024 18:24

Wow 😅 this is the kind of thing that winds me up, please could you define what you mean by 'bonding' in this respect? All breastfed babies I've seen only end up wanting to be constantly on their mums and the dads don't get a look in...

As a formula mum it's pretty hurtful to hear my 'bond' isn't the same. I'd argue it's as good if not better as my babies have always seen me as their safe space but also have a lovely relationship with their dad too which is handy when you're parenting as a team ☺️

Show quote history

You’ve got it all wrong though and back to front 🙈
If bottle feeding suits you well that’s great and there are sp pros, but they are mainly pros for the mums not the baby.

Honeycrisp · 04/12/2024 18:36

FluffMagnet · 04/12/2024 18:28

Indeed their job is to talk through the options, i.e. give the pros and cons of each in neutral language. Did that happen here? No. I've heard heard a midwife discuss the cons of a VB, not the pros of a CS (to which I do always think, God help any woman who has been scared into having a VB, and then finds herself wheeled off for an EMCS.)

Show quote history

Exactly. The thread seems to have had a parade of posters who, because they think attempted VB would be optimal for OP, have answered based on that and nothing else.

It would've been perfectly reasonable for the midwife to say ensure you're aware of the risks as well as the benefits of ELCS, consider all options including those you might not have thought of, mull over whether this is most conducive to the family size you want. That is not what OP has described.

ThatRareUmberJoker · 04/12/2024 18:37

MumblesParty · 04/12/2024 16:42

As a GP, every week I see at least 2 babies who are struggling with formula - reflux, lactose intolerance, constipation, diarrhoea, vomiting, colic etc. We have to try a succession of expensive complicated formulas , different bottles and so on. And it can take weeks to find a formula that suits. It blows my mind that people without medical contraindications don’t even try to breast feed, given that breast milk is the perfect food for the baby, and it’s free.
OP your midwife would be negligent not to promote breast feeding. It doesn’t work for everyone but I can’t imagine not at least trying it.

If you're a GP then I'm Einstein I call bullshit

Westofeasttoday · 04/12/2024 18:42

SunQueen24 · 04/12/2024 18:24

Purely anecdotal but the recovery from my ELCS was an absolute breeze and I do wonder if people over egg the recovery aspect. The recovery from my complicated VB with 3rd degree tear and episiotomy was far, far worse and less predictable. Plus I have life long issues now as a consequence. I will say my ELCS didn’t worsen those issues.

Show quote history

So I think maybe when things go wrong they can really go wrong either way. Sounds like your was awful and hopefully not normal. My besties planned c wasn’t normal and she almost died (not dramatising or exaggerating) but again not normal.

ThatRareUmberJoker · 04/12/2024 18:43

Honeycrisp · 04/12/2024 18:12

No she isn't. She's given terrible advice here. It's literally her job, as per the legal test in Montgomery v Lanarkshire, to appraise the OP of the risks and benefits of her options. Telling her that a CS will be a million times harder on her body than a VB isn't doing that, nor is telling her she doesn't need to worry about pain relief.

Show quote history

Healthcare professionals wonder why they get struck off. They try to play God.

Westofeasttoday · 04/12/2024 18:49

ThatRareUmberJoker · 04/12/2024 18:37

If you're a GP then I'm Einstein I call bullshit

Show quote history

Why don’t you believe it? Because you don’t want to. Purely an antidote but I agree with the GP.

There were eight in my NCT class. So not huge number but a small random group. Three breastfed. Two natural births and one emerg c. Some issues but progressed fine.

Of the remaining five - four were natural and one emergency c. All five had issues with bottle feeding. Two had a babies who kept throwing up the formula and had to try loads and ended up on a dairy free formula, one wouldn’t take the bottle and many many teats and bottles were tried until one worked, one had reflux from gulping air and teat not working and the final baby spit out the heat every time and had to be syringed at the beginning.

Sure anecdotal but I hear all kinds from those who struggled with bottle feeding too. Both are hard and have issues.

Parker231 · 04/12/2024 19:10

Westofeasttoday · 04/12/2024 18:49

Why don’t you believe it? Because you don’t want to. Purely an antidote but I agree with the GP.

There were eight in my NCT class. So not huge number but a small random group. Three breastfed. Two natural births and one emerg c. Some issues but progressed fine.

Of the remaining five - four were natural and one emergency c. All five had issues with bottle feeding. Two had a babies who kept throwing up the formula and had to try loads and ended up on a dairy free formula, one wouldn’t take the bottle and many many teats and bottles were tried until one worked, one had reflux from gulping air and teat not working and the final baby spit out the heat every time and had to be syringed at the beginning.

Sure anecdotal but I hear all kinds from those who struggled with bottle feeding too. Both are hard and have issues.

Show quote history

Again anecdotal but I don’t know of anyone who has had difficulty in formula feeding. Easier than ever now with perfect prep machines, microwave steriliser etc

Bikefantour · 04/12/2024 19:15

Padronpeppersplease · 04/12/2024 12:09

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.

This is scaremongering. Both planned vaginal delivery (which may end up with instruments or emergency caesarean) and planned caesarean are reasonable options. One is controlled, the other one is not. For first time mums, the risk of a severe tear is around 6%, which means it's common. The main risk of a planned caesarean is an infection, and it can be serious.
Formula feeding is also perfectly reasonable. Planning to exclusively breastfeed is not on the other hand as problems with supply, latching or pain are extremely common. The riskier days are the first few ones as colostrum might not come or there might not be anywhere near enough what your baby needs. Under feeding is a common amd dangerous problem. Supplement. Or formula feed from the start and avoid all these issues. The benefits of breastfeeding have been completely overblown, particularly the bonding. Breastfeed if you enjoy it, otherwise baby won't care how she's fed as long as she's fed.
All the best OP!

SunQueen24 · 04/12/2024 19:16

Issue being if someone had trouble breastfeeding their GP would be no help whatsoever. It’s very difficult to access services. Take tongue tie - my 2nd DS’ tongue tie was missed in hospital - there was a 3 week wait. My nipples were shredded, my little one was suffering with the intake of air when feeding and getting distressed. Luckily he was no.2 so I had enough knowledge of breastfeeding to get by until we saw a private tongue tie nurse. I can’t remember the cost but I bet it was prohibitive to many.