Should C-sections be a right? Are some women too frightened to push?

October 31, 2011

The news that all women are going to have the right to Caesareans, regardless of medical need, worries me.

Not because I don’t believe it’s a woman’s right to choose how she gives birth: I do. And as someone who had a traumatic delivery experience I can totally understand that some women just don’t feel able to give birth vaginally.

But the reason it worries me is because of the potential impact on the NHS. It’s already overstretched. Can it really cope with more and more women demanding what is, essentially, an operation, with all the staff that entails?

And is it really not possible to help women to give birth vaginally without making it a traumatic experience?

I’d love to hear your views.

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  • ruth davies November 23, 2011 at 8:05 am

    I think it’s very worrying. I wonder what will happen when the very important staff are in the middle of operating on a woman who didn’t ‘want’ to try giving birth naturally when someone with a genuine emergency comes in with need of immediate attention. While I agree with some of the things you have said, I really don’t understand why a woman who feels she can’t give birth naturally would have a baby in the first place. It’s not like we don’t know the procedure. We now live in a world where we can have whatever we like but this seems a step too far to me, some things are should just be the way they are. It’s only my opinion and I’m sure there is every chance I could be ‘wrong’ but I personally feel that making this a choice will encourage people to have this major op when really we should all be trying to avoid unnecessary medical procedures, surely?

  • Best of BritMums Blog Carnival – 8th November 2011 | A Small Hand In Mine November 8, 2011 at 10:11 am

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  • Louise November 1, 2011 at 8:19 pm

    This really is an odd one and I’ve no idea how it has come about. I have recently had an elective section (previous crash section under GA) and was told my a number of health professionals that I was lucky as they are stopping elec sections wherever possible. It seems strange that they are now giving it as an option without any real reason?

    However, having said that I am very much pro choice. I was all prepared to give birth naturally first time round but was unfortunately rushed to the operating theatre for a CS within hours of starting contractions. So second time around I decided I wanted to ensure I was awake for what would be my final birth.

    It was the best decision I could have made, the birth was calm, emotional, exciting, memorable basically everything I could have hoped for. I held my little girl within 20mins of her entering the world and in the mean time she was held next to my chest by my husband. I breast fed her in recovery and am still breast feeding her now and she’s six months old.

    Within 24 hours I’d showered, dressed, walked to the breakfast room in the ward and was home 48hrs after her birth. A week later I walked to and around the local garden centre with very little discomfort.

    For me an EC was a very pleasurable experience and I am grateful that I had the choice.

  • Rebecca Ring November 1, 2011 at 7:48 pm

    My first pregnancy ended in an emergancy section due to my son being distressed and not tolerating labour. While I was pregnant I was horrified at the idea of needing a section but when it came to it I had no option. Unfortuantly 24hrs after my section I suffered a reaction from having surgical intervention and ended up spending much of my sons first week in and out of consciousness and do not remember any of that time which should have been precious, I breastfed him for the first 24hrs and then was unable to due to the reaction I had experienced. When I fell pregnant again I was determined to expereience a natural birth but unfortunatly the hospital where I was despite claiming to encourage VBACs did not do much to support my attempt at one and again I ended up with an emergency section. Again I started to experience the same reaction I had had the time before. However I discharged myself after 24 hours and managed to reverse the reaction at home. Then when I came to have my third son I was told I would have to have an elective section. This time however I was under a different hospital and my experience was so much nicer, it was calmer and I was given my son to hold and feed while the surgery was completed. I am now due to have my fourth section in March next year and although I would have loved to have experienced a natural birth with at least one of my children I understand now that due to risk factors and previous circumstances it was not to be. The most important thing for me is that my children were born healthy.
    However it makes me cross when I hear about celebraties and others wanting a section due to them wanting to plan when their child arrives for convinence etc or because they want to look their best for an event 3 weeks after birth. A c section is major surgery and should only be carried out after careful thought and on medical terms only.

  • kathleen November 1, 2011 at 7:44 pm

    Hello, I’m back for more. You know I love it.

    I’ve read a bit more about this and this subject has basically been a media dream to whip people up.
    They are draft guidelines, which means they may still be scrapped.
    The studies used to draft the guidelines have been described as poor by the NICE (National Institute of Clinical Excellence). Passing guidelines based on poor clinical evidence would be pretty poor by their standards.
    Guidelines are just that, guidelines. They do not have to be followed by doctors. Following clinical guidelines does not stand up in court, only clinical reasoning and best evidence do, so doctors will probably be more inclined to advise along the basis of this than just doing ‘everyone’ a section. I don’t think they’ll be passed.
    The other thing that annoys me is that we’re already pitting woman against woman. I think the majority of women still want a natural birth, a responsible Obstetric team would advise this every time. Have faith in you fellow ladies, ladies

  • Sian November 1, 2011 at 8:36 am

    I have to say that i’m infuriated by people who feel that they are entitled to a C section on the NHS just because they aren’t willing to attempt to give birth in the way nature intended.

    We can bang on about ‘our right to choose’ as much as we like, but please spare a thought for the millions of women around the world giving birth on a dirt floor without anyone to hold their hand or mop their brow let alone discuss pain control options.
    We are privileged to have the NHS and we shouldn’t forget that.

    If you want a cosmetic section, save up and go private.

    (If you are a woman lucky enough to give birth in a hospital in Bangladesh, this is the luxury that awaits you).

  • Rosie Scribble October 31, 2011 at 5:13 pm

    I asked for a C section because I was too scared to give birth naturally. I am so pleased I did not get it. I could have had it if I really wanted it, but instead I was offered a lot of reassurance and in the end my daughter’s birth went smoothly.

  • Expat Mum October 31, 2011 at 2:52 pm

    I don’t think enough people appreciate that a C-section is major surgery. Not only would elective C’s be riskier than most vaginal deliveries, they are an incredible financial burden on an already stretched health system.
    Having had two C’s (for 2 different reasons) with a normal vaginal delivery in between them, I cannot believe anyone would opt for a C. Yes, vaginal delivery can hurt like hell, but it’s usually over once the baby is out. C-sections take a long time to completely recover from and your stomach is never the same with that scar there.

  • From fun to mum October 31, 2011 at 2:07 pm

    I am all for the right to choose, but the issue here is a bit complicated. I feel that if the NHS is prepared to allow a healthy woman to choose a C-section, which has costs involved as we all know, over a natural birth then it should also be fair for the NHS to invest in yoga classes, reflexology and hypnobirthing classes and all those tools that are out there, often not too cheaply, for those who do want to have a natural birth.
    In the end, a choice is really a choice when both sides have been given the same funding and one freely choses what’s right for her, whatever choice that might be.

  • Stacey October 31, 2011 at 1:20 pm

    This really is an interesting debate, with equally good arguments on both sides.

    Speaking for myself, I am a fat woman so was told during my first pregnancy that I would have gestational diabetics, probably get pre eclampsia, probably have a large baby and would probably end up having an emergency section. In the end I delivered naturally with my first and second child. My worry is that women who are perfectly willing and able to deliver by themselves will be frightened into a section because of the scary possibilities of vaginal birth, not really considering the effects of a section.

    Although I was open to having a section if necessary I was clear with all the medical personnel I saw that it would be a last resort – the thought of a major operation like that and the recovery on top of having a new baby seemed like madness if it was not a life saver.

  • Susan Mann October 31, 2011 at 9:57 am

    My first birth was traumatic & almost ended in an emergency section but thankfully with the aid of forceps I didn’t need to. My second was even more traumatic and ended in an emergency section. This made me unable to hold my baby or breastfeed for the first 24 hours. I think you should have a go at a normal birth and use a section if it’s medically advised. It takes a lot longer to heal and is hard going on your body. If I have another I will be advised for a section because of previous history, pre-eclampsia and kidney problems. I will be considering all options before going for a section.

  • Karin @ Cafe Bebe October 31, 2011 at 8:58 am

    I’m in a position for my second pregnancy where I have risk factors that have referred me to the consultant to have the discussion about elective c-section. The risk factors (age, previous emerg c-sec, asthma) do not green-light me for “medical necessity” but have directed me to consultant-led care. A “Utopian” birth would never really be possible for me, considering these risk factors. Were I to go forward with VBAC I would have to go straight to the monitored midwife unit where I would have to be monitored from the get go. I believe, from my experience delivering my daughter 3 yrs ago, that medical monitoring & drug intervention resulted in us ending up with an emerg c-sec. I know every pregnancy/delivery is different but I do not want to go through all of that intervention and monitoring to potentially end up in the exact same situation with a traumatic emergency c-sec. My 1st delivery was horrid & I still have issues with that. However, that c-section did not in any way, shape or form prevent me from bonding with Ella. Yes, recovery wasn’t a piece of cake but I managed and by taking it a bit slower from the beginning, I was fine. I now have a low-lying placenta with this 2nd pregnancy (in addition to my other risk factors) so will be finding out (in 2 wks) whether I move to “medical necessity” after my 36 wk scan. I want my final birth experience to be as calm and positive as possible and I feel that the only way that will happen is with a c-section. I know all of the risks but I also know that the likelihood of me delivery vaginally and safely is minimal. What I don’t appreciate is the government deciding for me that because they want to keep natural birth rates high, that every woman should be encouraged/required to do so. Shouldn’t it be after a discussion with consultant/midwives/patient that those decisions are made? And ultimately, I do wonder what cost SAVINGS there might be with an “elective” c-section as even though there’s a major operation involved with a consultant obstetrician & anaesthetists, there would be less cost and drain on midwife demands as when you’re scheduled for an elective c-sec, you don’t need constant monitoring prior to delivery as you would do when admitted onto a labour ward. Perhaps there are no savings but when a woman comes in for an elective c-section she would not need 1-2 midwives by her side in the lead up to entering theatre thus freeing up those midwives to attend to other women in labour. It’s a volatile subject and one that should be a discussion and agreement between the mother and her consultant, not the government, in my humble opinion. Sorry for rambling!

  • Ali October 31, 2011 at 8:54 am

    I think that is mad. After a C section you are limited to do things for a good while after.

    Surely by giving the option Mum’s to be are going to be given the message that a natural birth is in fact something that should be avoided.

    I was very lucky with my two as they were both born without to much trouble but I certainly wouldn’t opt for a C section.

    Also agree with the ‘too posh to push’ thing. A huge percent of people look up to celeb’s and want to be like them, gladly I not one of them.

    Ways to help people relax would be more use than giving them a mixed message that pushing is a more painful option.


  • kathleen October 31, 2011 at 8:43 am

    And one more thing, they keep mentioning different celebrities having sections and being ‘too posh to push’. How do any of us actually know that? How do we know each of those names didn’t have a genuine medical reason that they just choose not to share with us? Grrr! Right I am going now.

  • kathleen October 31, 2011 at 8:40 am

    The reporting on the NICE guidelines has been put forward by a number of publications in a sensationalist manner. The ‘too push to push’ phrase is something that really bugs me. I’m not posh and I didn’t push but I wanted to. My second was an elective but only after all the facts were collected and after discussions with midwives and consultants. It was essentially a team decision between me and the disciplines.
    I think better education about what a casarean section actually entails, the risks, the extended recovery time, the potential risk of scalpel injury to the baby (they cut T’s head). I’ve worked in Orthopaedic clinics and even though a Consultant offers an operation a great number of people say no once they’ve been fully informed about what the procedure involves.Better team communication between midwives and consultants. In the majority of areas they work separately but I think if they worked more as a multi disciplinary team then more sections could be avoided.
    And another thing…
    It does annoy me that the saving of NHS money is down to pregnant women again. How about the hundreds of people who don’t turn up to appointments (costs hundreds of pounds for missed consultant appt), smoking related illnesses and time wasters and drunks in A & E. I’ve worked the other side of the fence, we had very different thoughts on where money could be saved (but we were never listened to).

  • Nicki Cawood October 31, 2011 at 8:36 am

    This is a curious one. I have two children, have had a quick “normal” birth in hospital and a CSection (elective but advised as a result of gestational diabetes and a whole host of other goodies).
    The amount of care I received was much more staff-intensive after the CS, especially when I had a very severe allergic reaction to the drugs in the epidural. While I do think that it is a good thing that Mother’s wishes are being considered like this I have to agree with Liz and say I am worried about the impact on an already overstretched service.

    The time is right for women but possibly not for the NHS. I hope a lot of research is being done into how this will affect the after care of all postnatal patients, those that have CS’s and those who do not.

    If the doors are to be thrown wide open for CSections then I hope there will be more provision for information on the physical and emotional effects of having surgery for pregnant ladies to help them make the right choice for them.

    This is a great post Liz and I’ll no doubt add to this later but I’m looking forward to reading what other people’s opinions are.

  • Kate Taylor October 31, 2011 at 8:31 am

    I had an emergency section due to severe pre-eclampsia, I was really ill, I was terrified for my baby’s safety and it was done because it had to be done. Choosing to go through the process for no medical need to me seems like total madness, I had a catheter fitted, a spinal anaesthetic which took 4 attempts to get in, I was cut open while I was awake and couldn’t hold my daughter straight away as I was full of drip lines. It was AGONY afterwards, I had to have painkillers I would never had chosen as I was breast feeding my daughter, which was practically impossible as it was so painful to move with stitches in my stomach and cannulas in both hands, my legs were numb for hours and then my stomach hurt for months.

    Walking, sitting, sleeping were all agony for weeks afterwards, just when you really need to be able to do the basic things properly.

    My daughter was and still is absolutely fine and totally oblivious to her entrance, however nearly a year on I am very wary of any kind of medical situation and still have pain in my back where the spinal went in and my scar is still painful.

    Apart from the physical side to having a section, the demand it places on the NHS is huge, there were at least 6 people in the operating theatre.
    Its amazing that it is possible to intervene in such a way when the need arises but people were designed to give birth and surgery should not be the easy and normal method.

  • Kat October 31, 2011 at 8:28 am

    I was reading an article about a hospital in Romford with horrible midwives. It quoted one woman as saying that if she didn’t push the midwife said she would cut her. She wasn’t even fully dilated. I can see how this sort of article could scare any first time mum to prefer a c-section as to being herded through the birthing process like cattle. Apparently this hospital is under review and is being sued by quite a few different patients. I personally haven’t given birth with the NHS or used any NHS services since I have been in the UK, but from the stories I have heard it sounds like the midwifery departments of the NHS are already over burdened. I don’t know what the solution is, but I am sure that having more qualified midwives who aren’t as stressed by their workload and tempted to stress mum’s out might be a good start in cutting the number of c-sections.

  • lucy October 31, 2011 at 8:19 am

    When I was pregnant with my first, now 12, I met another mum due the same time as me. We spent a lot of time together and she made it clear she had no intention of giving birth naturally. She got her way, constantly telling the midwife she had a birth phobia, was having nightmares, it was putting a strain on the relationship (it wasn’t).
    Her c-section scar didn’t heal, got infected, she had severe PND, she thought her body would snap back into shape, it didn’t. One day she said “I wanted a section so my vagina would stay tight, I’m paying a terrible price. I wish I’d been more like you”. I could not believe a major operation was preferable to going with nature.
    Giving birth isn’t meant to be a laugh a minute, whatever way that baby comes out, your body will change irrevocably. The end result is worth it. Another friend had 2 vaginal births and then a section on her third, she said the section was worse.
    My OH reckons in a few hundred years babies will gestate in incubators, he may be right!