Childbirth rights- are you pro-choice?

[Feminist5]

I am sure majority of the ladies who post on the women's rights forum are pro-choice, and support a woman's right to terminate a pregnancy.

My question is more about the woman's rights when she chooses to continue with the pregnancy. Should she have full control over how she gives birth?

I'm not talking about outrageous requests like demanding that a doctor perform IVF and get you pregnant with sextuplets or that a doctor perform an appendectomy or chop off a limb during pregnancy just because the woman wants it.

However, childbirth is a slightly different situation because the baby will come out somehow and I feel liken the woman should have a voice in how and where that happens. It is also quite common for doctors to be biased towards fetal rights and override what the woman feels more comfortable with.

So I am therefore referring to a woman's right to choose how she should give birth, as I happen to think this is a feminist issue.

Do you think women should be able to choose the following (as long as they are fully informed about the pros and cons)?

A home birth?

An elective cesarean?

An epidural?

An elective induction?

Or do you think that a doctor should be able to force a woman to give birth in a way that she doesn't feel comfortable?

Despite the NICE guidelines saying that it is ultimately the woman's choice if she wants an elective cesarean or a home birth, women are still having to fight for these unconventional choices.

Just as it can be disempowering to be forced to stay pregnant against your will, it can also be disempowering to give birth in a way that you don't want

Totally disagree with that. Unless the procedure would involve the doctor breaking the Hippocratic oath, it is irrelevant what their preference or view is. What a load of paternalistic rubbish.

Sorry, was that in reference to my post? I don't think it matters what a doctor's preference is either to be honest. Unfortunately our healthcare system will always tip the balance of power more towards a doctor than the patient. The next best option is to have the right to a second opinion or a waiver. I am not saying denial of preferred treatment should ever be an option.

I think that women should be given the facts (risks etc) and then allowed to choose (within reason).

I also think that there should be much more information and support around post birth difficulties inc trauma, mental health, continence issues, sexual function probs and all of the myriad of things I have read about on here. At the moment there seems to be a culture of women thinking they have to "put up" with stuff which they wouldn't normally, because it is related to giving birth.

Viva, it seems that planned c-sections are considered safer than VBACs.

www.bbc.co.uk/news/health-17353803

(I know this is a derail but I'm sharing the link because the topic was discussed earlier on in the thread)

Peaceandhope, the Drs I work with definitly tell women that vbacs are safer. The research in that link just looks at the risk of uterine rupture which are obviously going to be higher in vbacs, therefore stillbirths also higher. But if you look at the actual figures its a v small risk.

Drs also generally consider other risks of sections, so higher risk of pph, higher risk of dvt, higher risk of sepsis. Sepsis and dvt are the two highest direct causes of maternal death in the last two CMACH reports so not to be treated lightly.

Then there's the risk to future pregnancies, higher chance of scar rupture, higher chance of placenta accreta or previa.

I was told when I was deciding between vbac / elcs for child no. 2 that vbac carried slightly higher risk for the child and elcs carried slightly higher risk for me. So meh really.

What gets on my nerves is that possible post birth recovery difficulties with cs are told in detail yet similar risks for vb are ime not mentioned at all. I know so many women who have been utterly unprepared for the long term damage wreaked on their bodies by vb and I also know lots of women who held back from getting help as vb is "natural" and so the after-effects are as well so don't make a fuss type thing.

Viva, ELCS doesn't have a higher risk of PPH :) In fact a planned c-section has a much lower risk of PPH than a vaginal birth. (This is what the latest research by NICE indicates). The impact on future pregnancies will not be applicable to every woman, because not every woman goes on to have more than 2 children. It's misleading to say that the risk of stillbirth is a 'small' risk and nothing to worry about. When it does occur the consequences are devastating. The risk of DVT and embolism is equally small with an ELCS, yet we are happy to scare women with that. There has to be a balanced debate for women to be able to make empowered choices.

I would be very reluctant to trust any doctor who told me that a VBAC was safer. It would be rather obvious that this was being said to parrot trust policy or to cut costs. It's fine to have a discussion on the pros and cons of either mode of delivery but to categorically call one safer is wrong IMO.

NiceTabard, I am inclined to agree that a VBAC is most certainly riskier for the baby. I am not sure what is riskier for mum- a pulmonary embolism is as bad as a uterine rupture, but less likely to occur. Only the lady herself can decide between the two options.

"What gets on my nerves is that possible post birth recovery difficulties with cs are told in detail yet similar risks for vb are ime not mentioned at all. I know so many women who have been utterly unprepared for the long term damage wreaked on their bodies by vb and I also know lots of women who held back from getting help as vb is "natural" and so the after-effects are as well so don't make a fuss type thing."

I absolutely agree with this! The risks of a VB are rarely mentioned to women even though the consequences of a VB can be far more devastating than those of a CS. (I have a friend living with incontinence caused by anal sphincter damage during a forceps delivery).
It irks me when all these pregnancy brochures insist that VB has a shorter recovery. It does not always.I have had a VB that took me 18 months to recover from and an ELCS that took 2 weeks.

I wanted a VBAC for ds2 and the midwives and Doctors were both very supportive of that. However I stated that if the labour was not progressing well I wanted a c-section I didn't want a forceps delivery.

I had a long labour, longer than they agreed they would let me go but all three parties were in agreement to let me continue. Then the labour stopped, the contractions just faded away. The midwives told me that I was going to have a forceps delivery despite my wishes not to. The registrar and senior midwife had an argument next to my bed as the registrar was of the view that a c-section was safer. Then the registrar examined me and said that I wasn't fully dilated which didn't surprise me as I didn't have any urge to push. Cue more arguments between the registrar and midwife before the consultant came along and whipped me off to the theatre for a csection.

Up until this point I was extremely satisfied with my care but then I felt that my wishes and my safety were being put at risk because midwifery staff are in favour of natural births.

I've noticed most ladies who are saying their choices were supported wanted a VBAC. We if you want what they want you to have, then obviously they will be enthusiastically support that choice.

There are so many threads on mumsnet itself about women who want repeat c-sections are being refused. :(

Tungthai, your experience is not at all unusual. In fact you are lucky that the consultant at least favoured a c-section. I know two women who had forceps against their wishes- one ended up fecally incontinent and one had a brain damaged baby. I think forceps are medieval tools of torture and I genuinely think they shouldn't be used as often as they are.

The second sentence was meant to read like this-

"Well if you want what they want you to have, then obviously they will enthusiastically support that choice."

Well said Peace but what I find so odd is that natural birth is seen as a feminist issue when it is nothing of the sort.

I could understand it in the days when women were forced by male obstetricians to give birth on their back and be subjected to a variety of instruments of torture to extract babies.

I think what the feminist movement missed was exactly the point you are making so well. It has never been about 'natural' birth. Feminism should be about respecting women and the choices they make - the imposition of natural birth is as much misogyny as the paternalistic obstetrics practiced in the past.

The tricky thing is that in the past it was mainly men doing it to women. Now it is just as often women imposing it on other women.

But then, women in their thousands opposed women suffrage...so nothing new I guess

Ushy

I agree with everything you have written.

Certainly a woman who chooses a natural birth should be supported (and IMO most of them are supported within reason). However, women who want ELCS and epidurals should equally be supported and it shouldn't be up to government funding bodies or health care professionals to take that choice away from us.

I agree that feminism should support women's choices.

However, I disagree that it is routine that women are supported to have a natural birth if that is what they want. I wanted a natural birth for DD1. What I got was little support for the pain I was in, a dismissive attitude (because I wasn't in active labour. Never mind the fact that I was into my third day without sleep and felt like I was being kicked in teh back by a horse) and pressure to accept interventions that I didn't want. I think natural birth is supported in much the same way breastfeeding is supported - lots of talking about what a good thing it is but very little in the way of solid knowledge and support for women who find that difficult.

Similarly women are encouraged to VBAC in many areas, yet they are also hamstrung by so many procedures and rules that many of them will never succeed (some would obviously have not done anyway, and those who want planned sections should be supported 100%) because they are clock watched and tied down. Other ways to ensure safety are available -but they need better equipment and more staff.

Feminism should be about every woman being properly supported in her birth choices, whilst recognising that sometimes every plan needs to change. Sometimes that means a theatre full of people to help deliver your baby surgically. But equally a natural birth may need support and it shouldn't mean one disinterested locum drifting in for 10 minutes every 2 hours.

I could weep when I think of all the women I know who have had unnecessarily traumatic birth experiences because of the chronic under funding and the failure to truly listen when women speak - both before and during labour. I don't buy the 'well the NHS is underfunded' argument either. You wouldn't perform even fairly minor surgery without all the people that surgery required present and correct in theatre- so why we let women labour in that way is beyond me.

Women should be supported in the choices they make about how they want to give birth. Whether that involves an elective c section or a quiet room with a birth pool and candles. Give them the information, allow them to choose and back up that choice.

You can be bloody sure that if men gave birth we wouldn't have hospitals pushing them into vaginal births after previous birth trauma, routinely performing sweeps and internals without expressed consent and refusing effective pain medication.

AmandaPayneNeedsANap, I don't dispute what you're saying at all. I was merely speaking from my experience. My friends who have wanted natural births have been encouraged and supported by NCT and NHS midwives. I always wanted an ELCS or at the very least an epidural. I was first denied the choice and then shamed, guilted and judged for my preferences.

I think the system is so broken that nobody is getting what they want. They seem to think that encouraging a VB or breastfeeding is the same as forcing it on women who have made informed choice not to do it. All the while women who want to have natural births and breastfeed somehow end up not doing it.

Like yourself, I don't buy the "nhs is underfunded" argument either. There is no excuse to treat pregnant women badly and to deny them choices over their own bodies. If this isn't a feminist issue, I don't know what is.

Sorry Peace, I wasn't disagreeing with you exactly. I was mostly responding to Ushy's comment that "I find so odd is that natural birth is seen as a feminist issue when it is nothing of the sort", which was a follow on from what you'd said. Sorry if I wasn't clear.

On your second paragraph, I also think that there is a lot of encouraging natural birth and not much enabling of natural birth. Much like breastfeeding. And the women who 'fail' at natural birth are also guilted and judged in some quarters (though possibly not as openly) . I agree, it is a broken and misogynistic system.

Amanda what I meant by natural birth not being a feminist issue is that

there is nothing feminist in browbeating women into something that some women don't want.

The genuine feminist cause is enabling women to have the choice that they want - whether that is caesarean or an 'enabled' natural birth.

I agree with you though, a broken and misogynistic system.

Ah, sorry I misunderstood. Totally agree with that - there is nothing feminist about railroading women.