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Is it right for a woman to demand a Caesarean?

Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
If they feel that labor is to much of a traumatic experience and are scared of the pain?

The reason why I ask this is because the missus wants one for the above reasons. I know you can say "if you don't want the pain don't have children" or "be more careful" if it was unplanned, but that aside.... I obviously have no idea what it's like to give birth but I do however feel that a Caesarean isn't to be used because you don't wanna go through the pain, I think it should only be used when it has to be used.

I have also read on the net (dunno how true) that a Caesarean poses higher risk of death, infections, and other trauma than it does when having a vaginal birth.


What are you opinions?
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Comments

  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    I believe in a civilised society, a woman should have the right and access to however she wants to give birth, whether it be squatting under a tree in her back garden or a planned c-section. Although my personal preference is to be where the good drugs are :D

    There's a lot of negativity surrounding women who want c-sections - but think of it this way - it's major abdominal surgery which carries risks and requires a longer recovery - with all that in mind, the fact that they would still want a c-section after that tells me that it's with a damn good reason. Childbirth is no picnic in the park, and if someone is scared of pain associated with a vaginal delivery - why should they be looked down upon. We recently had a patient who wanted a c-section because she had suffered sexual abuse as a child, and knew she would start to have panic attacks if people touched her genitals. In the eyes of Joe Public, that's an elective section in the books, so she must be too 'posh to push' (a phrase I fucking hate). Another patient had previously had a crash c-section (under general anaesthetic) she said the most terrifying thing in the world was to wake up not knowing whether her baby was alive or dead. When the midwife was pushing for a VBAC, she refused as she wanted to be sure that she could be awake under elective conditions, than try and labour being terrified that she would be rushed to theatre again.

    Vaginal births can be hugely traumatic for a variety of reasons (and a lot of NHS hospitals downplay the risks and aftermath because of the extra £££ for a section), if you look at some of the stories on the Birth Trauma Association, some of the women there have subsequently asked for sterilisation or terminated any other pregnancies because the idea of going through all that again fills them with dread. Birth is something largely out of people's control, which a lot of people for many reasons would rather be in an environment where they know what's going on and have some degree of control over.

    Bear in mind that someone's birth can impact them greatly, and it's the woman who has to go on and raise the child with whoever else. I wouldn't like to put someone through something that they utterly didn't want and then think, "Ok, that wasn't so bad, enjoy the next 18 years, tata!" :no:
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Surely an epidural would be a better option to avoid the pain as it will take less time to recover. I am no expert though. But obviously as go away says there are reasons where its a good idea to have an elective caesarian but if it's just the pain aspects then why not have an epidural?
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Often once you suggest the epidural with a trial of labour, some people go for it. But you have to bear in mind that a lot of staff won't top it up towards the end, so the woman would be able to feel pushing - some people are happy to go with the longer recovery of a section if it means they don't have any traumatic memories of the birth - it really depends what the patient's fears and expectations are.

    Plus, in some centres (some ;) ) the decision to have pain relief like epidurals sometimes depends on the midwife's preferences rather than the woman's. Another topic entirely :D
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    So long as the risks are not seen as unacceptably high, I don't see why it should be an issue, or indeed why anyone other than a mother-to-be should have a say on it.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    i think caesareans should be allowed if the woman is actually terrified of labour, as long as theyre made aware of the risks involved.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    i think caesareans should be allowed if the woman is actually terrified of labour
    I suspect today most people are... ;)
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    No.

    Unless they pay for it themselves.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    It is portrayed at least in the media as a terrifying and painful ordeal. I mean, I'm sure it is both, but women have been having babies for as long as there's been humans and they're survived! That sounds a bit draconian of me actually, what I mean is labour probably gets a lot of bad press (whether rightfully or wrongfully) and probably gives a lot of first time mothers a lot of nerves on top of the ones they already have. Although at least according to my sex education lessons the woman's vagina is fully capable of giving birth naturally without assistance... but with all the medical intervention shown in the media now you would be forgiving for believing othewise.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    No.

    Unless they pay for it themselves.

    Any reasoning behind that? Or just 'cos?
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Jamelia said that her hernia hurt way more than giving birth. ;) There you are fellas, told you they were exaggerating. :p
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Jamelia said that her hernia hurt way more than giving birth. ;) There you are fellas, told you they were exaggerating. :p

    Have you ever had a hernia? :p

    Apparently they are the very embodiment of pain! Your internal organs 'popping out'.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    ShyBoy wrote: »
    Have you ever had a hernia? :p

    Apparently they are the very embodiment of pain! Your internal organs 'popping out'.
    This.

    Although I can't remember mine because I was 7 weeks old, but I'm sure if you ask her, my mother will describe the screaming :p.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    ShyBoy wrote: »
    It is portrayed at least in the media as a terrifying and painful ordeal. I mean, I'm sure it is both, but women have been having babies for as long as there's been humans and they're survived!

    A lot of them didn't! Until the last century there was a high risk of dying in childbirth
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Aladdin wrote: »
    I suspect today most people are... ;)

    why? I wasnt
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    The NHS shouldn't be spending money on people's whims when there's no solid medical reason, shyboy.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    The NHS shouldn't be spending money on people's whims when there's no solid medical reason, shyboy.

    Well, do away with all free contraception then, because there isn't really a medical need to be on it, unlike someone with angina would need GTN. There isn't really a 'medical need' for pain relief during simple things like dentistry either, just suck it up and get on with it. ECT is really pushing it on the NHS budget when they put people under general anaesthetic too, people seemed to manage back in the 1940s without it.
    I mean, I'm sure it is both, but women have been having babies for as long as there's been humans and they're survived!

    The lucky ones who had straightforward pregnancies and straightforward deliveries survived. Do a little research and take a trip to an old cemetary and see how many graves there are where a woman has been buried with her infant. People in the West especially take for granted lower maternal and infant mortality rates; childbirth is like the sea - you can get some enjoyment from it, but it's unpredictable, raw, takes no prisoners and for that it must be respected, so it might be worth treating those who go through with it, with a little more dignity.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    go_away wrote: »
    The lucky ones who had straightforward pregnancies and straightforward deliveries survived. Do a little research and take a trip to an old cemetary and see how many graves there are where a woman has been buried with her infant. People in the West especially take for granted lower maternal and infant mortality rates; childbirth is like the sea - you can get some enjoyment from it, but it's unpredictable, raw, takes no prisoners and for that it must be respected, so it might be worth treating those who go through with it, with a little more dignity.

    I'm well aware that of course there are complications and infection in particular was an issue but my argument was that the media propagates a the idea that vaginal childbirth is dangerous, unpleasant and painful. Also the dignity comment I hope wasn't implying I'm being disrespectful? I made a fair point.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Dangerous - it can be depending on what arises if complications develop, more common in developing countries than here for obvious reasons. Unpleasant and painful is more subjective and depends on the individual and their own experiences. From what I've seen anyway is that doctors and midwives do their utmost to put someone off having a c-section if it's requested, with a lengthy conversation about the risks involved, but the risks of vaginal deliveries are downplayed a lot, almost to the extent that it's painted as risk free.
    Also the dignity comment I hope wasn't implying I'm being disrespectful?

    Wasn't aimed at you, I should have done some more quotes to be more specific. Don't know who said it at this hour, think it was something along the lines of 'people's whims'. Yeah, say that when you have a pair of chamberlain forceps coming towards your chuff :cool:
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    ShyBoy wrote: »
    my argument was that the media propagates a the idea that vaginal childbirth is dangerous, unpleasant and painful.

    Erm isn't it?!?!?!

    There's still an awful lot of things that can go wrong, and still do, otherwise they wouldn't have c-sections in the first place.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    i do think a lot of doctors are too quick to recommend C sections. Not so much in the UK but in America and Australia there is an artificially high level. and i think with the over medicalised way that childbirth has developed, i believe that intervention leads to more intervention and a lot of that could be reduced if women just ha more realistic expectations and also faith in their own bodies, not to mention only hearing the horror stories.

    I think a lot of people think that having a caesarian is going to be the easy option - a tiny cut and thats it, baby out, youve got a virgin fresh fanny and youre back to normal in no time. In reality it is major abdominal surgery, takes much longer to recover from on average and a more painful recovery, plus the scarring. I cant get my head round why some people would choose that as their birth of choice, but they do, and its no skin off my nose.

    Theres nothing like pregnancy and childbirth to make a woman feel vulnerable and out of control, so im all for giving women as much choice as possible
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    kangoo wrote: »
    Erm isn't it?!?!?!

    There's still an awful lot of things that can go wrong, and still do, otherwise they wouldn't have c-sections in the first place.

    It's relative though, that's what I'm saying. There's already an elevated level of risk but because of how the media propagates this information it puts people off having natural birth over a caesaraen.

    We should be informing women that yes natural childbirth is scary but also its the safest way to deliver for them and the baby and that the pain can be controlled, and that really women have been having babies like that since the dawn of the human race so they feel at least a little reassured.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    ShyBoy wrote: »
    It's relative though, that's what I'm saying. There's already an elevated level of risk but because of how the media propagates this information it puts people off having natural birth over a caesaraen.

    We should be informing women that yes natural childbirth is scary but also its the safest way to deliver for them and the baby and that the pain can be controlled, and that really women have been having babies like that since the dawn of the human race so they feel at least a little reassured.
    exactly.

    on one hand youve got the media saying how awful childbirth is, and then on the other hand youve got them slagging off women who are terrified and demand a caesarean
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    The US has developed the culture it has, not because of cutting happy OBs, but because families and lawyers have created a culture where some doctors feel that they now have no choice but to be more aggressive in their treatment. If you demand an outcome where a baby is absolutely fine with no hypoxia etc, then you can't express outrage when someone's risk assessment changes as a result.

    Look at the majority of litigation payouts, and most of them come down to the payout being given because a c-section or other intervention was not done sooner. I think in Illinois in 2007, out of the malpractice judgements, $142 million was paid out - and in all of the cases, it was alleged that a section should have either been performed, or performed sooner than it was. I will try and find the source for it, but the site is here http://medicalmalpractice.levinperconti.com/birth_injury/

    If people want to work towards reducing the c-section rate, it's going to take a long hard look in the mirror and think about the bottom line. If someone says to an OB, "I want the perfect baby and if you don't perform, I will do my utmost to destroy you financially and professionally," then don't take too much surprise when they start being more trigger happy with intervention.
    lot of that could be reduced if women just ha more realistic expectations and also faith in their own bodies

    I think realistic expectations would help a lot, I think birth can produce a better outcome overall for the woman at least if she goes into it with an open mind. I don't belong to the school of 'Trust Birth' because I think that in itself can set people up with unrealistic expectations.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    im not sure what you mean by the school of "trust birth"

    I agree that the threat of litigation is probably the reason for the raised levels of csection
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Just to provide some context around child birth and death, historically.

    Studies, such as those of the Dublin maternity Hospital, had around a 1 - 2% mortality rate each year up until the 1850s, when the study stops. That means that any woman having her first child had a 1 in a 100 chance of death, and given larger amounts of pregnacies in the last century you can imagine the odds for someone having a fifth child.

    At times the states were even higher - Vienna's General Hospital had 15.8% of childbirthing women dying in 1842.

    It should be noted that this is often linked to infection and childbed fever, something that's been massively improved but the main point still stands. Child birth in nature and especially in mammals isn't something that's automatically safe or easy.

    Countries with poor health care continue to maintain very high maternal mortality rates - The MMR is the number of maternal deaths per 100,000 births. Sierra Leone currently leads this sad league table with 2,000 deaths. So 2% or 1 - 50 of all pregnancies end in death.

    Obviously this isn't that relevant to the bigger picture of health-care supported/pain relief based natural birth vs. caesarean but it is worth mentioning that 'natural' childbirth is in no way an automatically safe proceedure.

    http://en.wikipedia.org/wiki/Historical_mortality_rates_of_puerperal_fever#Yearly_patient_mortality_rates_at_the_Dublin_Maternity_Hospital_1784-1849

    http://en.wikipedia.org/wiki/Maternal_death

    More on topic though - friend of my just went through a long (50+ hour) labour. Are we actually certain that an organised surgical proceedure is actually cheaper than traditional childbirth? Just wondering since money seems to be the issue for some people.

    Caesarean sections are pretty closely linked to mortality rates as well - for the last couple of 1000 years they've been used after the mother died during childbirth - not until 1500 is there a recorded case of a woman surviving the c-section. And of course for all the stuff above about mortality rates, in 1865 the mortality rate for a c-section was 85%.

    The Great Lakes region of Africa in the mid 19th century apparently imployed regular c-sections with a vastly superiour survival rate to those proceedures used in the West.

    Anyway, enough of this... *must put down wikipedia and go into the office*


    http://en.wikipedia.org/wiki/Caesarean#History
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    They hold conferences every year in the US (I think) and basically infer that childbirth is inherently safe http://trustbirthconference.com/

    I remember reading that a woman (on a community that shall remain nameless) who was 43 weeks pregnant was asking for advice and had symptoms suggesting that there was foetal compromise. She was being told to trust birth and supported in her decision to have an unassisted birth. The baby was born unassisted, and suffered severe brain damage. She insists that the outcome would have been *exactly the same* had she been managed in a hospital.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    im not sure what you mean by the school of "trust birth"

    I agree that the threat of litigation is probably the reason for the raised levels of csection

    From a quick google I'm guessing this is a quote that shows what the 'Trust birth' philosophy is -
    “. . . if you ‘trust’ birth, and refuse to accept the fact that birth is inherently dangerous, you will be rewarded with the birth experience that you desire.”
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    “. . . if you ‘trust’ birth, and refuse to accept the fact that birth is inherently dangerous, you will be rewarded with the birth experience that you desire.”

    :chin:
    Countries with poor health care continue to maintain very high maternal mortality rates - The MMR is the number of maternal deaths per 100,000 births. Sierra Leone currently leads this sad league table with 2,000 deaths. So 2% or 1 - 50 of all pregnancies end in death.

    Guess they should have been more trusting? :yeees:

    I think the concept of natural birth is interesting - it means many different things to different people. Some think it's a vaginal birth, some consider it vaginal birth without intervention or pain relief, some consider a birth can only be truly natural if there is no monitoring during pregnancy, including ultrasounds, and tests for gestational diabetes (although in those circles, they don't believe GD exists).
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    oh i see. Well no, but they are two extremes tbh. I think in the vast majority of cases, birth is a natural normal event with good outcome.

    On the other hand I am all for medical advances and tests. I think theyre very helpful.

    I think trust birth is one extreme and trust doctors is another. There are plenty of stories where horribly mismanaged births go wrong that probably wouldnt have if doctors and midwives werent so keen to stick to their timetable of how it shuld progress.
    Ignoring signs of foetal distress at 43 weeks is negligent, as would be ignoring them at any time and unassisted birth is bloody stupid, although i can understand the desire
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    I don't understand the reasoning behind unassisted birth came about. I don't think there has ever been a time in history where women were deliberately unattended? Being at home with a midwife or 3 I get, but to go it totally alone - for what benefit if any?
    I think trust birth is one extreme and trust doctors is another. There are plenty of stories where horribly mismanaged births go wrong that probably wouldnt have if doctors and midwives werent so keen to stick to their timetable of how it shuld progress.

    I think it depends on the kind of doctor/midwife you trust. I wouldn't be so happy going to a Harley St doc telling me my baby is too big and that we should schedule the big day (ideally on a Thursday) :chin: But in one of the hospitals I did my OB/GYN-diabetes thing, I would happily put my self (and bubba) in their care. What pisses me off about the NHS is the lack of continuity of care and would rather get to know my team than seeing a different person at each appointment.
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