But your statement of 'often done necessarily' is something very different from a discussion about mothers and babies dying in the UK because of unnecessary c-sections. That is certainly rare and nothing to do with what I think might be a meaningless stat of '1 in 3'. Of course tackle the unnecessary deaths of mothers and babies, but understand it and its incidence first. And hold somebody accountable for poor decisions if they were made. But don't assume that a cs being unnecessary- whatever that means -is reason to apportion blame. Because women and babies die from necessary CSs too. Of course they must, that's how risk and statistics work (though if there's culpability it MUST be pursued of course) but to point the finger based on statistics but not acknowledge the individual cases as just that is foolhardy at best. I suppose what I mean is don't make CS your scapegoat for this. Women dying unnecessarily in labour. Babies dying unnecessarily in childbirth. Those are your things to attack. CS might be a part of that. Obstetric decisions are definitely a part of that but bandying about stats and using them to defend a position when they don't hold up to scrutiny does NOT help the real issues.
And I think there are several issues. What you might define as 'unnecessary' might not be accurate. Not absolutely imperative at that time, perhaps not the only way of a baby being born if you take the examples of elcs or mother's refusing consent for instrumental deliveries but that does not make them unnecessary. If you follow a model of CSs only being allowed for women who have absolute need according to a list (as seems to be happening in Derby) then you take away a woman's choice and you dismiss some very real aspects of giving birth like fear and previous trauma. I understand darlene that you are trying to support and champion the cause of good birth for women but attacking consultants who make the decisions using a statistic that means nothing isn't helping. And it's stats like this that allow places like Derby to make these arbitrary lists. Thank God I don't live there because you'd be sacrificing my mental health for a measure I don't even pretend to understand.
My consultant was talking about forceps and how demonised they are. He says in some situations they're a very useful tool if used properly. But he says there will always be one case where they cause harm, perhaps desperately awful harm but that of course this is the case when everything has a risk attached. But when it happens the reaction is always 'why on earth didn't they just do a cs, they're so much safer for the baby'. But you do a cs based on evidence and intuition and people tell you that you operate unnecessarily. He does his utmost every day to make decisions about the best outcome for a mother and child using all the information available to him but will be roundly criticised whatever decision he makes.
If I opt for a vbac next time, it has been suggested that an hour of inactive and an hour of active pushing is the maximum that I should be 'allowed'. My choice of course but the consultant thinks that after 2hrs of being fully dilated, given my history that from that point I should be moved to theatre (if I haven't given birth) and a decision made about how to proceed. Possibly to cs. Now that's probably not 'necessary' according to the WHO but I know that my consultant bases his suggestions on 20 years of deliverying babies, minimising the risk of rupture and a good educated guess on how long a 2nd stage might be before he considers it a repeat of last time. And he also acknowledges my mental health. 8hrs fully dilated last time gave me crippling ptsd. Telling me what he WILL do next time (if I consent to it) gives me back some control. If somebody tells me that any of this is unnecessary then you might just break me. Because I feel fragile enough as it is and hidden in the '1 in 3 cs are unnecessary' stats is a frightening message of 'you should do better/try harder' or just simply 'you've failed'.