C-sections

[vittoria]

I have read the recent reports about NICE's guidelines to make women who are 'too posh to push' go for vaginal deliveries instead. I can't tell you how insulting I find these views. I was severely traumatised by my daughter's birth and these days I find it difficult even to walk into an NHS hospital again. I would never consider having another baby unless I could be assured I could have a C-section, preferably privately because I have lost trust and respect for the NHS after the appalling treatment that was meted out in the hospital my daughter was born in. I wish I could write to the Nat'l Institute for Clinical Excellence to tell them what I think about their attitude - cracking down on inappropriate and unnecessary caesarians whilst still giving women the choice - what a joke!!! - but I suppose they would bin my letter. Any other views? No insults please.

[sft42]

According to Nice's figures 1 in 5 women are having C-sections...this far outweighs the actual clinical need figures for mental and physical reasons which is thought to be only 5%.....you are taking a broad outlook on a national problem and turning it into a vendetta against you and your views which is simply not what is being attempted to achieve....it's proven that it's far better for both mother and child, in both short term and long term health if birth can be natural....clincal intervention should be the last resort (though I would happily give an epidural to all women...in lebour or not :>).

Any "bad" experiences in any hospital are regretable of course but this can surely be minimised by choosing your own midwife and making sure you are happy with the plans beforehand.....simply letting people choose to have surgical procedures when they aren't clinical needed isn't a great road to go down for numerous reasons.

[vittoria]

I have to disagree. Nobody is talking about forbidding cosmetic surgery and I suspect that is far more dangerous than a C-section. So why bully pregnant women like this? Furthermore, my experience is that you don't choose your midwife; you get what's sent to your room. In my case I had 4 different ones (over 3 shifts) none of whom I had ever seen before. There are various reasons why I am not having another baby, the birth is not the only one, but the fact remains, I would be too frightened of being told I cannot have a C-section to even get pregnant again. We talk about pregnant women's choice, but I do not feel free to make a free choice whether to get pregnant or not with that nightmare dangling over me.

[vittoria]

I have to say something else. First, I don't think it is a vendetta against me. NICE don't even know I exist!!! Second, you say it is thought that the no. of women who need C-sections for mental or physical reasons is only 5 per cent, but only the woman concerned knows whether she has mental reasons for wanting a C-section. Nobody else can say, oh no, it is not what she really wants. Plus, even if it is only 5 per cent, this is kept artificially low because there are lots of women like me, who are too traumatised to get pregnant again. The real number is higher.

[vittoria]

One final thought. If doctors want a woman to have a C-section, perhaps because she has pre-eclampsia, they bend her ear telling her how safe it is. If she wants a C-section, they bend her ear telling her how dangerous it is. Ironic isn't it.

[kags]

I think that the "too posh to push" tag line, and even the term "elective caesarean are very damaging. I did not have c-sections for either of my children, but I have seen many friends have them, and I can certainly say it is absolutely not an easy option for the average woman, who does not have a full-time live-in nanny to help with the immediate aftermath. Most people get a convalesence period after surgery, a new mother gets sleeplessness, huge hormonal changes, a massive change to her life, and the notion that she has somehow not quite performed her duties as a woman. Many "elective" c-sections are carried out because there are risks with a vaginal delivery, the mother may have indeed elected for the c-section, but it is a bit of a Hobsons choice. vittoria, you had a terrible experience, have you had a chance to talk through your experiences with a support group? You were unlucky, and need support in deciding about future labours, and that would include not being made to feel you are being "too posh to push, obviously you are not, and your own well-being is paramount. If you, on consultation with medical staff decide the best option for your family is to have a c-section that nobody has the right to judge you on that. This is completely different to someone choosing to have a c-section to fit in with their schedule. Having said that, if that person is paying for their own health care, than I do believe they should have the right to make choices about their body.

[Gef]

kags said, "Having said that, if that person is paying for their own health care, than I do believe they should have the right to make choices about their body." Does this give them the choice to chose their own body over the health of the baby? (PS I know that there are many very good reasons for a section.)

[kags]

gef - I don't necessarily approve of the decision to have a c-section on purely non-medical grounds, nor do i necessarily approve of breast implants or cosmetic surgery, but we live in a free society & all these things are available to the people who choose to take the associated risks. I just don't think it should be publically funded. If the "unnecessary" c-section is putting the child at risk, then I would hope the doctors would counsel the mother out of it, but ultimately it is her choice. I think the greater risk is to the mother in any case. Many women who have c-sections for medical reasons feel guilty about it, and it doesn't help to keep going on about how much better a natural birth is. Yes of course it's better is everything goes marvellously naturally, but I am concerned that over regulation may make it even more difficult for women with genuine reasons for needing a c-section to make an already difficult decision.

[tracymort]

Well I don't know what happened with your first birth but it's very sad you had a terrible time but it doesn't mean the next time will be the same. I for one was not happy with my 1st birth being induced uneccessarily (at only 7 days over but I knew no better then) which leads to intervention etc The second time around and was well informed and it was wonderful. You can also pay for an independant midwife. they don't have the same restraints as the NHS midwives have. Anyway back to your traumatic birth they really should have gone over it with you afterwards and offered help. I don't like unecessary sections but i wouldn't have said yours was a lifestyle choice, you have a credible reason for wanting one imo. They are talking about women who just happen to fancy one. i am on the maternity services liason committee as a laymember and the stories i have heard will amaze you. One lady wanted a section so she could wear a certain dress to a wedding the week after! here are some links that may help you - http://www.aims.org.uk/ http://www.ima-acceptance
.org.uk/ hth

[tracymort]

oops that last link kind of got lost in there - http://www.ima-acceptance.org.uk/

[Janetex]

Vittoria, I agree wholeheartedly. My daughter is an only child and I'm lucky to be alive.

[sft42]

Why ask a question, ask for other views, and then rant against anyone who doesn't wholeheartedly agree with you?

When looked at as a whole a large number of C-Sections performed are done for lifestyle reasons and not clinical need and this can't be right mucking around with a natural process just to fit in with someones life........unless a child has/is been carried dangerously over term then they should hang fire and wait (baby knows when he's ready to show up)....I used figures from NICE published a few years ago (I remember them being quoted as I was doing some work at the Royal Victoria Hospital at the time) and they had taken a great deal of time and effort to get them as accurate as possible.....you are just automatically taking an opposite viewpoint due to your trauma, understandable but not a balanced stand I feel.....I think the figure is accurate....Of course Doctors will try and use a little fear to get patients to make the choice that they think will be clinically best (safest) for them....It would be foolish to think otherwise...patients haven't gone to med school and studied for years so the doctor will try and use a gentle armtwist to get you to take the course he thinks will be best for you.

I think it's awful that you had a bad experience in childbirth but your experience doesn't speak for the majority and you are not a clinically trained obstiatrician so I don't see that you can comment on others cases.

All you wanted to do was have a rant at the NHS which has failed you....fair do's.....it does a great job for the vast majority of it's huge case load of patients and I think that gets forgotten sometimes....Why ask for others opinions if you are only going to badmouth and ignore them and carry on banging your point forward?

[vittoria]

sft42's comments are defamatory and totally out of order. I only have to quote some here: ".....you are taking a broad outlook on a national problem and turning it into a vendetta against you and your views which is simply not what is being attempted to achieve...." next "Why ask a question, ask for other views, and then rant against anyone who doesn't wholeheartedly agree with you?" next "Why ask for others' opinions if you are only going to badmouth and ignore them and carry on banging your point forward?". I had asked for no insults and I can do without being defamed - because what sft42 has done is defaming me - by accusing me of turning a national problem into a vendetta; describing my opinions as ranting; and accusing me of badmouthing those who don't think like me. I am doing none of these things and sft42 appears to be the one who can't accept other people's points of view. Obviously he or she feels he or she knows better than anybody else in view of his or her area of work, but those at the receiving end of the NHS's "care" beg to differ. I am free to express my opinion on this site. I am sorry sft42 feels he or she must call it "carrying on banging my point forward". Incidentally, there is a article on today's Guardian which expresses my views rather well. I am supporting women's right to choose and not to be threatened by doctors. I am appalled that sft42 condones doctors' practices of lying and deceiving patients. It says a lot for sft42's attitude that he or she euphemistically refers to doctors lying and deceving patients as "using a little fear" and similar reassuring language, whilst reserving strong, emotional, manipulative language to describe me and my views.

[Katiebee]

My take on this was that they are trying to reduce the number of C-sections which are being carried out just for convenience sake because the mother fancies one, as tracyh has mentioned, ie medically unnecessary C-sections, and I agree with this. After all, a C-section is surgery with all the risks that go with it both to mother and baby and to just decide to have one because it fits in with your social calendar isn't really a good enough reason. However, I'm sure any caring obstetrician would agree to a C-section if he felt it was in the best interests of mother and baby and I can see that vittoria may well be such a case in view of her past history. I am talking, here, about NHS care. Private care, however, as we all know, is a different matter and where money is involved it might not be so easy to persuade either clinicians (as caring as they may be) or patients to go down the natural childbirth route. If a doctor is offering a private service and accepting payment for it, then I suppose he would have to go along with what the patient wants unless he felt it was totally and dangerously the wrong thing. I'm afraid these days money talks, and who am I to say that if I had money I wouldn't want to use it in this way? This report might have some effect on the NHS side of the coin, but whether it will persuade the private sector is another thing.

[Miss Zippy]

At the end of the day, it all comes down to money. It costs the NHS, on average, an extra �1,000 to deliver a baby by c-section than a natural birth. I'm not a mum and don't pretend I know all the complications posed by either a natural birth or c-section, but it is a shame that a woman's right to choose is being taken away. I'm sure most everyday women who opt for c-sections don't do it for convenience, like the 'too posh to push' tag suggests. If a woman is genuinely traumatised at the thought of a natural birth, whether or not it's due to a previous bad experience, then it's a sorry state of affairs when a developed country forces her to suffer the pain and trauma of such childbirth. Provided the risks of a c-section to both the mother and baby are fully explained to the mother, it should be her choice. I'm not sure who mentioned it in their post, but judging by the experience of friends and colleagues, you certainly don't have a choice as to the midwife who actually delivers your baby; it's pot luck who is on duty at the time.

[kags]

The consensus seems to be that regulations to cut back on Lifestyle c-sections should not in any way be allowed to impact on the ability to make an informed decision on medical, emotional or psychological grounds. vittoria, whilst i don't agree with sft42, there is truth in the fact that you cannot generalise from your own experience (although we all do it of course!) What you should draw from this is that we all have different experiences of childbirth, and you deserve better treatment than you had first time round. In order to get that, you need to somehow come to terms with what happened, this will allow you to be strong and calm when dealing with doctors and obstetric staff in future. There are many, many wonderful caring medical staff, just as there are arrogant, ignorant ones - the dividing line does not automatically fall between NHS and private. hospitals

[vittoria]

For reasons of space I cannot write all of my thoughts, but if I were having another baby (which will not happen for a no. of reasons) I would choose between the two extremes of a private C-section or an independent midwife at home. I had wanted a home birth with my daughter but my husband would have none of it. In hospital I was doing very well until the midwives started bullying me to make me comply with their rules and regulations - to cover their arses of course. They started the "cascade of intervention" that ended with me trussed up like a chicken. There was no problem, no foetal distress, no nothing, only this sadistic insistence that they had to follow the procedures. I still remember the name of the last, the worst of the midwives and I curse her everyday. I still shake when I remember it and it's more than 5 yrs ago. Anyway, I am not generalising on my personal experience: I am not saying that everybody should have a C-section, far from it. I am only saying that women should be free to choose. Doesn't anyone detect the contradiction in the NICE's sentence "cracking down on unnecessary and inappropriate caesarians whilst still giving women the choice"? There is a value judgement in that sentence: if a woman wants a caesarian, her choice is inappropriate and unnecessary, she can have all the choice in the world bar the one she wants.

[sft42]

Here's a thought then....what actually was your question in the first place?

[vittoria]

I wonder why I get the impression that sft42 has got the hump because I stubbornly refuse to give up my unreasonable views and adopt his or her expert ones... you may re-read my original msg if you wish. Other people are free to express their opinions, and I am free to keep mine (which sft42 rather rudely calls "banging on").

[vittoria]

Just what are sft42's qualifications then? I quote a psg from of of his or her msgs: ....Of course Doctors will try and use a little fear to get patients to make the choice that they think will be clinically best (safest) for them....It would be foolish to think otherwise...patients haven't gone to med school and studied for years so the doctor will try and use a gentle armtwist to get you to take the course he thinks will be best for you. unquote. Very very very good. How unfortunate then that drs spend so many years to learn how to leave some women traumatised and psychologically scarred for life. And all to cover their arses in case they get sued for med neg. It is much more difficult to get damages for mental scars than physical scars so drs/midwives will go for the mental scars anytime.

[secretspirit]

I think it's ridiculous, but then I think the whole cult of pain relief free childbirth is crazy (would you have a tooth pulled without anaesthetic because it's "natural" - NO). It's proven that it's less traumatic for the baby to be pulled out quickly during a c-section than squashed through a birth canal so I don't think it's black & white. Don't think I believe that caesarians are great, personally I would have a vaginal delivery because I hate hospitals and would want out as quickly as possible, plus I don't think I could cope with that kind of abdominal wound. One of my best friends had a c-section and still gets flashbacks because she didn't want one and hated the experience. However, if they push too much on how caesarians are wrong I think they will create a lot of negative feeling among women who have had them, plus people forget how many lives they have saved - both mothers and babies - in urgent circumstances.