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.

A midwife needs to ensure you are aware of the risks and benefits of your decisions. Vaginal birth and breastfeeding are the physiological norm and there are risks to electing not to choose either of these from the get-go i.e. not due to specific medical indications.

You may also get a more balanced view with a consultant, if you get referred for a discussion about elective. Mine spoke to me about the risks of c sections but said she would also give me the risks of vaginal birth and that she wanted women to be able to weigh those up and choose what is the right path for them. She didn't offer an opinion on what was 'best', just kind of teased out what my priorities around birth were, which were a safe, controlled environment, knowledge of how things would unfold, being well rested instead of physically and mentally exhausted and traumatised, etc. And once you kind of drill down into priorities, you might find it's more obvious what the right fit for you is.

You don’t need a medical reason to decide to use formula.

It’s not that I don’t think breast milk is better than formula milk if the two were hypothetically presented side by side in ready made bottles - but I feel like too often the assessment of which is ‘best’ ignores the mental health of the mother and by extension what is on balance best for the baby as obviously if a woman is really struggling with breastfeeding and getting stressed that’s not a good outcome for her baby either. I don’t even know if I can breastfeed due to breast reduction surgery and although I’m open to trying at least for first few days I just didn’t appreciate the very sanctimonious presentation of the ‘facts’, nor did I appreciate being asked when I said I thought it seemed much more intensive what else I would be doing with my time (she said ‘Netflix exists and you can just sit on the sofa’) - didn’t realise that giving birth meant all other obligations in my life went out the window!

My sister and two close friends all had c sections and have all said the recovery was no way near as hard as they expected. My sister also has 4 children, the last 3 of whom were born via elective c section so the comment about c sections limiting the number of children I could have didn’t really seem accurate either, I know it’s a risk but it was c much presented as a likelihood. I pointed this out and I just thought she was very sniffy with me.

Ultimately I don’t think I’m being selfish or disregarding my baby’s health outcomes by opting for these things. Thanks everyone for your opinions :)

The PP who I asked to provide the stats to back up their statement said “a first time mother is quite unlikely to have an absolutely no intervention birth in hospital”.

1 in 3 assisted births to first time mothers does not, to me, scream “quite unlikely to have no intervention”. It says to me that is more likely that I would have an unassisted delivery.

Stats matter. Words matter.

Well it's 1 in 3 need assistance vaginally and 1 in 3 need an emergency section.

You don't know that you can't breastfeed

You don't know that it would adversely affect your mental health

You are making assumptions

What utter bullshit! It's all down to money. A c section costs the NHS more.

I had a 'natural' vaginal birth with DC1 and tore completely through my pelvic floor into my sphincter muscle and into my uterus. With two paracetamol. Literally felt like in half! I required surgery after delivery was admitted to ICU after a massive PPH. Was utterly shit recovery. Aftercare was extremely crap thanks to Covid.

DC2 was a planned section due to the above. Was an absolute breeze!!! Recovery was fantastic. I was in the park day 3 with dc2 in the pram and DC1 on the swings! Recovery much much easier.

Push. If you want a section. That's your choice. Demand it and dig your heels in.

Good luck

Honestly I hate the breast Vs bottle feeding debate but stuff like this just pisses me right off, yes it's absolutely fucking amazing that there is a safe alternative to breastmilk, as for thousands of years babies just died instead as their desperate mothers tried spooning animal milk into them

How amazing we have an alternative with the exact same nutritional content and no statistically significant health risks for the individual baby!

@Zimunya

I don't have the full references sat next to me on my sofa but yes the squeezing out through the birth canal is thought to be beneficial as are the bacteria that the baby is exposed to, the evidence is growing as I said and scientists are trying to work out the whole correlation vs causation problem. I've read it in medical journals, you'll find references in newspapers too.

If a baby needs to be delivered by c section for medical reasons there's no question it's better, what is being questioned is whether it's in a baby's or mother's best interest to offer an elective caesarean on demand.

It's not the report I read but a summary from NIH on safety

www.ncbi.nlm.nih.gov/books/NBK559197/

They split the statistics, assisted means vaginally with ventouse and/or forceps. The other 1 in 3 have to have an EMCS.

•		The chance of you needing an assisted vaginal birth if you are a first time mum is between 1 in 2 and 1 in 3 in the UK (1 in 8 including women who have given birth before).
•		The chance of you needing an emergency caesarean birth is 1 in 3 if you are a first time mum in the UK (1 in 5 including women who have given birth before).

Well that's a great idea if you want to be deliberately misinformed enough to put your child's health, safety and development at risk at every stage. Forget safe sleep advice, car seat safety, research into educational outcomes and just do whatever you feel like.

I don’t know whether I could have breast fed, I never tried as I wanted to use formula.

I had an emergency c-section and if I'd had a second it would have been an elective all day long. People go on about it being hard on your body but honestly it was a total doozy.

When there is a problem then it's great there are solutions

That doesn't mean the solutions are as good
It doesn't mean the solutions are risk free

Also check the stats re steroids as above. My baby was delivered at 36+5 and wasn't given steroids. There has been significant change in the NICE guidelines.

Would also look at the birth stats for your hospital. To get and informed decision

I think that’s a very balanced come back OP.

in essence it was a birth choices meeting and she had to do her job and talk about all the options as she can’t just assume you’ve done all your research so she has to treat all women with a degree of doubt and give an educational meeting. She’s just doing her job and talking through outcomes and options.

i had a birth choice meeting for VBAC and they had to tell me about elective c sections as part of the conversation.

I have another birth choices soon and I know they will have to touch on VBAC again and elective section and emergency section to cover all bases

I must admit I've never understood people opting for a c-section, I've know some who had to have a section and, three years or so later when pregnant with their second, were determined to do it naturally this time.

For the majority of women, vaginal birth is straightforward, they are likely to have a few perineal stitches but no other problems and everything 'down there' gets back to normal fairly quickly..

However, each to their own.

Regarding breast or bottle, it is a good idea to let your baby feed at the breast for a little while, even a few days, because colostrum contains lots of good things and it's nice to do that too. You can change to a bottle, some people have to for various reasons, I did but at least I tried and am glad I did.

I wish you good luck, op.

That sounds like my experience and it was absolutely ghastly. And you're definitely right - the main reason the NHS advocates for 'natural' births is financial. In the US, where insurers have to pay out if things go wrong, a far higher proportion of births are by planned C-sec as it's lower risk.

Mother putting "I want" Before baby seems quite off to me.

How far would you take that?

I think you are right. Of course bottle fed babies have great bonds with their mothers and fathers. I was bottle fed myself, I loved my mother to bits - I can remember as a little child.

However, there is no denying that breastfeeding and bottle feeding are not "equivalent" - in fact they are quite different. A breastfeeding baby has part of the mother's body in his or her mouth. The breastfeeding produces all sorts of powerful hormonal and emotional effects on the mother. Cuddling up with a baby and giving him/her a bottle is not quite the same thing as the baby sucking on your actual breast, where you can feel the hormonal hit in your brain etc, you feel the let down of the milk, etc

And an older baby biting/pulling at the teat of a bottle is not quite the same thing as an older baby biting/pulling your nipple!

With breastfeeding there is a physiological relational dynamic which is not there in bottle feeding.

That does not mean that bottle fed babies don't have a lovely bond with their mother of course.

Personally I was glad I was able to BF (realise this is luck to some extent!) and to be helped by the hormones etc to manage the night wakings etc.

This is scientifically wrong

So? My two vaginal births (both with second degree tears) were also total doozies. Anecdotes aren’t especially helpful.

I had a mammogram a couple of years ago and the leaflet did a good run down of costs and benefits, false negatives, false positives etc. I felt it was still misleading as it implied mammograms may be "uncomfortable" whereas a quite common experience is "really bloody painful"...

I have yet to come across such an NHS leaflet for cervical smears, still less pregnancy, childbirth and feeding, but it could be done.

@mumsnet, maybe a campaign?!

Wrong, it is not the exact same nutritional content and you are factually inaccurate. Literally just google it it’s very easy information to get.