Caesarean vs vaginal birth nowadays

[Bikergran]

I just heard on the radio that this year in the UK, caesarean births have outnumbered vaginal births. Can I ask why you had a caesarean, if this was an option before labour commenced, or was it an emergency, and did you regret it? Or did you want a caesarean and were refused?

For full transparency, I am well beyond childbearing age now, had 3 children vaginally, one with forceps, another very traumatic psychologically. My DIL had an emergency caesarean after being in strong labour over 24 hours. My mother had 2 classic caesareans (where they cut you vertically from breastbone to pubis) in 1941 and 1953, the first one being performed by her family GP as the consultant couldn't get through due to wartime restrictions.

I was just surprised by the statistic, why do you think there has been such a massive rise in numbers?

In terms of why the rise, I think it's a mixture of a change in the birthing population (older, heavier, fewer multips) and the pendulum swinging the other way against VB being a goal in itself. Meaning there are births that are now EMCS that might've been forceps a decade ago. The instrumental rates are relatively stable, but that has to be measured against the change in the birthing population.

I chose elcs x 2 as maternal choice and have no regrets and loved them.

i did this for various reasons but maternal care at my local hospital was a key factor.

I had zero confidence in them. @YouChair sums it up perfectly.
i also was concerned about post birth injury being ignored/ not properly treated and being forced into medical interventions before the team conceded/consented to an emcs.

I believe I was right in my choices based on my fucking diabolical post partum care and excellent results via elcs.

I googled this and it’s slightly inaccurate.45% of births are indeed by section, but you may have misinterpreted what they mean by spontaneous vaginal birth and assisted (using forceps or other) which combined outnumber sections.
I had two sections, both medically advised as I was over 40, had type 1 diabetes and babies were large - in fact my son born just shy of 37 weeks was 10lbs 4oz! Not entirely due to the diabetes, as I am almost 6ft tall and I weighed over 8lbs at birth in 1962, which was large then.
I do know a number of women who had sections, but none were planned unless medically advised. There was certainly a bit of a stigma about having seditions back in the early 2000s when I had mine, my DH’s ex actually saying I didn’t have a ‘real birth’! And my mother was upset when I told her they had strongly advised a section. Maybe that has changed?

I’ve read that when women used to spend time in a hands and knees position such as when they used to scrub the floor, it helped encourage the baby to move into an optimal position for birth so less likely to need a caesarean.

I tried that, as I was breech. It didn’t work.

i have a friend and her baby kept turning around right up until birth. Her baby was only 5lbs so obviously had room to keep turning around!

My first 3 births were vaginal deliveries and all had complications. My 4th dc was delivered by a planned c section.

Yes I regret my c section, the aftercare was awful and my complications ignored. I'm awaiting a procedure to fix the damage 6 months later. The care on the ward was really bad. I have had 2 vaginal births 2 c sections- the 'mode' of delivery isn't the issue it's a failing maternity system. One of my children passed away due to negligence - it made me scared of birth again and I carry lifelong trauma from my pregnancies

I had an induction in 1999 after being overdue 10 days. I laboured for 12 hours and got to 7 cm dilated but my DS heart rate kept dropping so it was decided to perform a c section. The cord was round his neck and he weighed 9lb 12oz so I was quite thankful for the c section.

Had a VBAC with my second DS and found that a much better birth even though it was a ventouse birth.

I've had one vaginal birth followed by 2 elcs. The elcs were insisted upon by my gynae as I had a gynae operation between DC1 and DC2, which resulted in an increased risk of uterine abruption. So for me it wasn't a choice, it was medically necessary. However I did find the elcs more convenient and straightforward, and I preferrer it to a vaginal birth, but I would never have requested an elcs without any medical reason.

I've been quite fortunate and pregnancy and childbirth have been quite easy for me. I didn't find the vaginal birth painful as I opted early for an epidural, which was completely effective, and I didn't tear or need stitches. Recovery was very quick and easy. Recovery from the elcs took longer but I had plenty of support so it didn't interfere with caring for my dcs, and there are no lasting effects.

Baby 1 was breech, I was offered an attempt to turn her and trial of labour by the consultant and head midwife, who then said they'd had done one since their training. And they were both in their late 50s. So I took the section and never regretted it. Baby 2 was another section as was overdue and policy was no induction for VBAC.
Both were calm, smooth recoveries and none of the issues friends and relatives had with complex natural births.

I think poor maternal healthcare (and female healthcare in general) probably plays a large part.

I had an ELCS for my first, albeit on medical grounds it was just recorded as “elective”. I have EDS which means my risk for uterine rupture is far higher as is my risk of severe tears. Yes I’m having a second section.

I think the key contributing factors are:

• a push in recent years for earlier interventions (e.g. for small or large babies, awkward positions, overdue babies etc.) to try to reduce stillbirth rates. These often involve inductions (which in many cases end in emergency sections) or straight sections; and,

• fears amongst pregnant women of poor maternity care. Women with bad past experiences may opt for a c-section to remove some of the uncertainty, and FTMs hearing of others' horror stories may too. Pretty much everyone now knows someone who's had a baby by c-section which normalises it somewhat.

No judgement re earlier interventions; it's a tricky balance to strike. Both of my babies were identified as needing to come early. The first came via EMCS after a failed induction (poorly managed placental abruption) and the second via a lower priority EMCS which was a lovely experience. No chance was I rolling the dice with another induction after the first, as I was in the same hospital which was still seemingly facing the same issues as with my first.

My sister had 3 kids, said she wishes she had a cs, has her vagina as never been the same since the first.

My other sister had 2 kids first was normal birth second was cs.
She also said the same her below never really went back to how it was, looks the same but not the same, child birth changes it.

I had a planned cs one and done.

I had a C Section due to a placenta issue, but honestly, midwives started planting the seed of having a C-Section from my booking scan at 8 weeks. And continued to bring it up numerous times throughout my pregnancy. I really didn’t want one but they did feel pushy about it.

Add into the mix that the county I live in have closed the midwife led birth unit and suspended home births for 6 months (which will no doubt be indefinitely) women are being pushed towards medicalised births in delivery suites.

I am convinced that my local hospitals’ ideal scenario would be a date booked in the diary for a a planned section at the 12 week scan. Makes sense to them, staffing planned, no rush of spontaneous labours appearing at the door and bed spaces taken up for less than 24 hours as they kick you out as soon as they can with bare minimum aftercare.

Our maternity system is failing, but I just can’t see how it’s going to improve it’s all quite sad.

I had one because the baby switched to breech during active labour. She was sort of wedged in my pelvis because of how she'd flipped. I resisted having a C-section but the medical professionals all agreed that it would be safer for me and the baby so I signed the form.

2 elective sections after 1st baby was found to be breach at about 38 weeks. Both really positive experiences.

I didn’t want any short or long term negative effects like incontinence, prolapse, looseness, soreness, stitched wrongly etc
I’ve heard SO many awful stories from women all through my life. It saved my sanity not having to worry about the chaos and pain of vaginal birth, interventions etc

my sections were fantastic, pain after but healed well and no longterm effects.

Induced with my first at 41 weeks as my blood pressure was creeping up and maybe reduced movements. I was close to 10cm (consultant tried to physically stretch me open the last half cm with her fingers 😭) but baby wasn't coping with the hormone drip at max and he wouldn't come out with forceps so sent for emergency C-section.

Second I really hoped to go into labour naturally but they'd been scaring me throughout pregnancy that my baby was on the small side (bounced between 3rd and 10th centile). So agreed to balloon induction at 39 weeks. Failed again, balloon insertion was horrific even with gas and air, I started contracting almost immediately and baby started kicking so much they took it out a couple of hours later as they were worried she would exhaust herself. Tried breaking my waters twice but cervix not open enough. They offered to re-try to balloon once baby had calmed down but at that point I could not handle one more person sticking their fingers up my cervix so I said I'd take the C-section (still an emergency since they'd started the induction process, but much more relaxed.)

I do carry some disappointment but I have 2 strong beautiful children so cannot drive myself mad thinking about how things might have gone if I'd pushed back on any of the decisions.

EMC due to failed induction, the care I received was so poor they didn’t notice I was going into anaphylactic shock following an allergic reaction to something they had given me, midwife just thought I had a “low pain threshold and was being dramatic”.
Hugely traumatic for all of us, DC and I both nearly died - needless to say I only have 1 child!

Obesity?
Later first birth age?
Women better educated about downsides of induction and instrumental ventouse or forceps births?
Less paternalism / misogyny in respecting women’s choices?
NICE review identifying that csections cost neutral compared to natural births when include costs postnatal complications for natural births?
Publication and knowledge of failures in maternity care in UK - safer to opt for surgical doctor care?
Suspect is a mix of the above.

I was born by c section in 1988 after an induction at 40+10 and my head got stuck on mum's pelvis. She went on the have 2 vbacs with my brothers. So the induction turned section thing isn't new. I have had 2 home water births. Both out of guidelines because of my BMI. I'm assuming since I picked home birth from the start sections weren't offer to me. Both my sil had induction turned section in the last 8 years. One had 2 induction/sections the other had 1 induction/section and 1 elective for her second.

i had an cat 1 emergency c section as my waters broke 5 weeks early and ds heart rate was dipping and they wanted him out.
i was due to make my birth plan with my midwife a few days after this so i didn’t actually know what I wanted to do.
I don’t regret it because in a way i liked that the choice was taken from me because I was worried about it all, and obviously it got ds here safely.
it definitely isn’t an easy way out though, recovery is brutal

I think it’s an extraordinary statistic. Between us, my sisters and I have 13 children. The first 12 were vaginal. The last was a planned caesarean, which was recommended because he was breach.

The news item I saw said that many births were now high risk because they were to older mothers and/or overweight mothers and caesareans were more likely to be recommended for higher risk births (which makes sense).

I was overweight and 36/38 when I gave birth and both were straightforward with no intervention. I do have good childbearing hips though (childbirth is the only time I have been grateful for them)!