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.

Those saying that you can’t tell whether an adult has been bottle or breast fed may not have read the many studies that suggest bottle fed babies are more likely to be obese later in life.

In my experience her opinion is correct but she expressed it wrongly. It’s important she lets you know all the options with both pros and cons and no pressure.

Perhaps the OP had already researched the issues like many of did whilst pregnant so didn’t need anything further from the midwife?

Thank you for posting this. I have long tried to find this information.

In isolation, she is right. And they have to tell you so they don't get sued. Genuinely people can be so stupid and will claim they 'never knew' breast milk was (again, in isolation) better because of all the advertising by formula providers etc. I'm sure I remember something about someone suing Nutella for not making it clear enough it isn't healthy.

But as I said, right in isolation. In real life there's lots of other factors.

I had an EMCS. Was my recovery harder than an uncomplicated vaginally birth? Yes. But I've also known friends have a much harder recovery from complicated vaginally births, and much more complicated c section recoveries.

Some people have 3 or 4 c sections no issues. Others have issues with the scar after a single section. Either implanting in it or being thin and risking rupture.

Some (myself included) breastfeed and it works well. Others struggle, especially mentally. And 100000% it's fucking hard work even if you're really committed to it. If you aren't wanting to do it there is no point making yourself miserable with it. The hormones do enough of that for you! As long as baby is fed it will be fine.

She doesn't have to. If you actually read my post I said I'd always suggest someone give it a go unless they have strong reasons not to, for the simple and utterly selfish reason that once established it can be a damned sight easier and more convenient than FF, especially when travelling

Note the word "suggest".

I had all the same non evidenced hectoring when I was pregnant. Not one antenatal hospital midwife mentioned the practical advantages which may benefit the mother. Not one hospital midwife was able to offer any real practical help in establishing feeding. One of them suggested I was putting my baby at risk if I FF which fortunately made me just laugh out loud but I'm sure it enabled them to tick their box saying "BF promoted".
If the NHS was serious about promoting breastfeeding it needs to hector less and provide more real support and practical advice.

I've done both as I didin't have the luxury of modern prolonged maternity leaves - I had to transition them when returning to work. I did find BF a lot more convenient than FF simply because there is no kit or formula to worry about.

You ignored the part of my post which said mothers choosing FF should not be harangued and that most establish FF successfully.

I do accept it, of course, why would you lie. It just feels a high proportion from women I know and reading on here and all over the internet.

Issues such as prolapse and incontinence can come from pregnancy rather than birth. Vaginal birth can cause pelvic floor damage but a c-section won’t necessarily protect a woman from experiencing it.

Absolutely her body her choice . It doesn’t go out the window when it comes to breastfeeding but it isn’t wrong for medical professionals to give her advice on what is scientifically proven to be better for the mother and baby. Yeah, you can argue how much better etc. but generally overall it is better. That isn’t opinion or feeling it’s a scientific fact.

@Padronpeppersplease try not to be too disheartened by the judgemental comments from your midwife and on here. Some women (for various reasons beyond their control) can’t breast feed, doesn’t make them any inferior to someone who exclusively breast feeds. Your midwife should be giving you facts, statistics and information regarding vaginal and elective sections. That way you can make your own informed decision. They shouldn’t be giving their personal opinion or be pushy in anyway. If I was you I would try and change your midwife as this really isn’t professional and has clearly impacted you. It’s hard enough behind pregnant without being judged. For what it’s worth, I don’t think you are alone in this and I personally have had similar conversations with people, albeit NOT my antenatal care team. People will judge you and give you their own opinions but ultimately it’s your body and no one else can make that decision. Go with your gut instinct, good luck xx

I was more talking about the various comments on here.

Of course a medical professional should give advice. There are ways of going about it though and coming across as pushy isn't the way to go about it, if anything it will turn someone further away from attempting to breastfeed.

I had the same experience with my first, they were super against a c section as if it would be the worst thing i would ever choose to do - turns out i had a HORRIFIC ‘natural’ birth, 36 hours later ended up in theatre with a forceps delivery and an episiotomy, which was not stitched correctly, burst open and my recovery was 2 months and absolutely god awful it made me seriously depressed. I’m pregnant now and in my booking appointment made it very clear i was having a c section and no questions are to be asked. This is your body and your birth and you can do exactly how you see and feel fits.
My friend has had a section for all 4 of her births so not sure what she’s talking about there.
Yes the recovery can be very hard after a section, however it can be just as awful and difficult from a vaginal birth. You do what you want and remember your in control not them!

This is completely ridiculous 😂😂😂 it’s 2024 i can’t believe there are still people making others feel like something ‘could’ be wrong with their child/adult from being bottle fed!!! Insane.

Well to counteract this my whole family has been bottle fed and not a single one of us is obese or anywhere near. In fact one of my best friends has breastfed her child since birth (now 18m) and is very seriously ‘overweight’ for a child of his age, has affected his walking ability too - wonder what the evidence of this is.

Formula is linked to an increased risk in obesity. This is well known. It's not blame or insanity, it's based on numerous scientific studies.

Not all formula fed babies will be obese, your anecdote does not negate the stats.

It really isn’t. There are many scientific studies (by reputable organisations and top medical journals and hospitals) that all say that breastfed babies have a lower chance of obesity. This doesn’t apply anecdotally to you or your friend. This is over a number of people on average. If you want a long list of the studies I can provide them but a quick google will tell you the same. In fact, I will show you where it lists this as an advantage from the NHS (without of course all of the numbers which aren’t hard to google). Here are some pics from the NHS, WHO, UNICEF and a study summarised in the Guardian who all say the same.

Bottle feeding isn’t wrong. However it is wrong to deny the science behind breastfeeding and call it ridiculous.

I had two, no intervention, natural births (second one at home) and I want the same for my third, currently OTW. I also breastfed both, exclusively for 6 months and then till they weaned naturally (around 2+). My reasons were very simple and very selfish: laziness and vanity.

I have been old enough with my first already (mid 30s) to want to make my life as easy as possible. I was and still am too lazy to fix bottles and carry them around when up and about. Boobs are, on the other hand in front of my chest and I have carried them around since I was born. I also assumed that trying to get maximum sleep and just doing everything my body was made for doing as an adult female would save my sanity. And it did - we co-slept, night feeds were minimum hassle. I had a lot of support to get the breastfeeding going because it’s a skill and someone needs to show you how to do this. I’m not in the UK and had excellent support from the midwives and HVs but I also demanded it and would not get fobbed off.

Same with c-section. I would obviously have one for medical reasons but would never consider a major operation just because. I have always had a flat belly, when I was younger it was without any effort, and with considerable maintenance (regular exercise) since I turned 40. I like it, I didn’t want to give myself a scar and a c-section overhang without a medical reason.

I had straightforward pregnancies, wasn’t overweight or obese, stayed very active and my deliveries were straightforward and I recovered quickly. If I were overweight, had sleep apnea, gestational diabetes, high blood pressure or any other pregnancy complication I would of course go for an elective c-section.

I also agree with PP who said that it’s the pregnancy that puts a lot of strain on the pelvic floor. I am 46 now and pregnant with DC3 and I have to actively work on keeping my pelvic floor healthy, which I have also been doing before getting pregnant because the muscles are affected by age-related sarcopenia as any other muscle. It has always been important for me to stay in shape while pregnant because I was already considered a geriatric mother with my first child and now I am considered an ancient anomaly by all health professionals with my spontaneous pregnancy at 46.

I think you have your reasons OP and it’s fine, I just wanted to give you my reasons for wanting completely different outcomes. I think very often women are “it’s fine as long as the baby is out and healthy” and forget their wellbeing in the process.

Interestingly the Probit research, which is the nearest we're getting to an RCT, didn't find that breastfeeding was protective against obesity.

Which makes sense, as the reason humans become obese so easily is because it's an evolutionary advantage. Most human beings who have lived did so in times when starvation was a very real and ever present risk. It seems counterintuitive for us to have evolved a feeding method that makes a beneficial trait such as ability to keep weight on less likely.

When picking apart the data you've got to remember the huge confounding factors that obese mothers are less likely to be able to breastfeed ( large breasts, inhibited prolactin response). So children born into obese families are more likely to be formula fed So it could be that those children are already epigenetically predisposed to being obese, and that the lifestyle choices in the family make them more likely to be obese.

One of the postulated mechanisms is that you can't overfeed a breast fed baby in the way you can a bottle fed baby, so it could be that bottle fed babies are behind fed beyond saiety, leading to appetite dysregulation.
This is why formula being taboo is actually a huge negative, as parents who are bottle feeding need to be taught paced feeding, which may negate this risk.

You've also got to remember that 64% of the population is overweight or obese- your child has a very high chance of being overweight is obese regardless of how you feed them!

If you are a normal weight and have a healthy diet as a family that is far more protective against future obesity than breastfeeding.

Ooooohh they won't like that. They don't like feeling like they could be challenged.

I've asked why is it that GPs still consider and handle HRT like it's radioactive material (when it's a top-up to existing hormones in adult women), but hand out hormonal contraceptives that are not only mostly synthetic, but so high in dose that they stop ovulation altogether, a much more severe effect. They prescribe those to developing girls too, and the pill seems to be their answer to a variety of different ailments (everything from migraines to acne) in a way that HRT isn't considered. The pill can also have side effects.

I'm still waiting for an answer because the 3-4 GPs & consultants I've asked so far didn't have one.

Ooooohh they won't like that. They don't like feeling like they could be challenged.

Too often true.

OP if you are still reading - you need to see a hospital consultant - so you need to work out how to do that in your area may be as easy as requesting one.

They may still want to talk though all the options but hopefully should be more willing to listen - and look up the NICE guidelines just in case they are not.

We had one argue with us about the age of our children as he misread the notes and added 10 years on - DH had to get a photo of recent birthday out to make him stop as basis was it was 12 years since I last gave birth so should have a c-section the maths would have meant I was 16 with first rather than 28.

Yes it's true, but feels good when you do it.. I refuse to just be a cost cutting statistic, I'm a person who has to live in my body for the rest of my life. I'll never see those people again and they'll forget about me soon after. Women need to know they can decide for themselves.

Absolutely!

I am a midwife and I think her approach was not professional. It's your body and your baby and you have the right to decide what feels best for your. The midwife's responsibility should have been to give you a balanced and informed view on both choices. They all carry risks and they all have benefits/disadvantages. However I must say that pursuing a vaginal birth when you are not keen for it it's a bad idea as you need to feel in control, relaxed and let the oxytocin flow. That can be achieved through preparation classes, hypnobirthing, etc, but only if it's important for you.
I myself had a planned csection and will have another one with my second baby. I have seen too many bad outcomes working in labour ward and it scared me. I also saw some wonderful natural births and if you are low risk and you can use a birth centre then the outcomes seem to be much better in my experience - when you start interfering in birth the chances of things going wrong increase. I actually think home birth is one of the safest choices followed by planned csection. In my experience, two big things to consider is the recovery (yes it hurts for a while) and the fact that the risks really increase after 2-3 sections (so would be unwise to choose it if you want a big family).

In terms of feeding. Again whatever works for you. Breastfeeding has a lot more benefits both for mums and babies compared to formula feeding, but if that's what you want to do luckily we have clean water in this country and your babies can still be safe and thrive as health is not only decided by feeding mode. I breastfed my first til two years and it was the best thing ever, but I was sure I wanted too and I worked hard for it to work. The support is awful so many times you need to pay for specialist support. I am way too lazy to be washing and cleaning bottles and making them up etc. However it all fell on me, I wished at times DP could feed DD too.
Please do your own research, listen to other points of view but at the end nobody can force you to do anything and you have to be comfortable with your decision that's the most important thing. And no, it's not weird at all to have maternal request csection and bottle fed babies, I see it every day.