need info

[AnyDream]

I will jump in here and say that even after my first quite mild post the OP was quite "*****ly" & defensive in her responses. I suggested she read further with a book recommendation simply because it's important, no matter what you consider an ideal birth, to have a broad understanding of the benefits & possible pitfalls. To prepare oneself to have the best possible experience. I'm not convinced that experience as an RN is the best way to get this info. I think there were some legitimate attempts in this thread to voice a concern over the need for an empowered decision. I don't think anyone was asking the OP to justify her decision, rather to arm her with information that will ultimately lead to her having the best possible birthing experience she can, even if that is by CS. However this is supposed to be 'support' area within the forum, so it's a pity the OP didn't leave feeling supported.

[Schmickers]

You know what? I think that in my enthusiasm to try and help someone make an informed choice - a truly informed choice - I may have been insensitive, and for that I apologise. I'd like to think I am a big enough man to admit when I am wrong, and several people have suggested to me that my passion might be interpreted as judgement of the OPs choices. For that I am sorry.

This forum is an area that aims to support women from two main groups - those women who, through medical necessity or genuine emergency, have been left with no choice other than to have a caesarean birth, and those women who have been persuaded to have a cesarean in the past and are coming to terms with the fact that this decision might have been a poor one.

This is no "official policy statement" of any sort - it is merely my interpretation of the two largest groups of people who use this forum. I apologise if it sounded otherwise, and I am not trying to marginalise anyone else who has chosen to have a caesarean section that is not included in the two groups I outlined above. I'd like to think, though, that my point still stands:

To flippantly suggest that you want an elective caesarean and to persuade doctors to support you, you will go "the psychologically traumatised angle" is disrespectful to both those groups.

Which I believe it is.

I will bow out of this thread, now, as I think it has become controversial enough, and once more, offer my apologies to anyone whom I may have inadvertently offended. If anyone has any more concerns about anything I have posted, you can feel free to PM me, to email me, or to discuss it with any of the other moderators. Also, you can feel free to use the Report Post button in the top corner of any post you are concerned about - posts reported in this way go straight to the entire moderating team to be discussed.

[Miss H]

I think the OP is no longer reading this and maybe we should too. It's gone somewhere that was not intended. We all have our reasons for doing what we are doing and unless someone is being offensive or causing immediate danger to themselves or someone else, I don't see why we can't welcome them on this forum and have open discussions without anyone feeling offended. I didn't know that this forum was only for certain people. I have only known it to be supportive, informative and sometimes good for a giggle.

[fionas]

I hear what you're saying Marydean but I also think there's a time and a place to start offering information. Meringue stated on several occasions that she did not want information about the pros/cons of caesars - I can understand why she would have felt she wasn't being listened to. Instead, people kept pointing her in the direction of information that she'd clearly said she didn't want. Now obviously we are a well-meaning bunch on BB and we want the best outcome for her but we're banging our heads against a brick wall if we don't listen. We may have to agree to disagree but I don't think Meringue was treated respectfully and we are meant to be about gentleness and respect.

[skeetaboat]

I have to say that I agree with Fionas.. If Meringue had stated that her reason was physical birth trauma that she herself had experienced during a previous birth, and she'd researched her choices, yada yada, and decided she wanted an elective c/s, would she have been repeatedly reminded that in terms of risk, she was making the sub-optimal choice and should read up more? Or would she have recieved support to take charge of her birth and seek out appropriate support people who would be sensitive to her needs (while being gently reminded that her next experience could be totally different given the right support and info, etc)? I think the latter. And I don't see why she deserves less than that just because the birth trauma she has experienced was vicarious.

[fionas]

Yes, I agree skeetaboat.

I also think that if we accept that a positive frame of mind towards birthing affects a woman's outcome then we should accept that a negative/fearful frame of mind is possibly going to adversely affect the woman too. And we don't change a woman's fear by continually pointing out to her that her version of research/information is invalid. We do it by firstly inviting her to talk more about her fears. I didn't see anyone (myself included) asking her to share her experiences of what she had witnessed and how she felt about it.

[Visitor6]

......You don't have the rush of love and nurture hormones after bub is born, like you do after an uninterrupted vaginal delivery. You and your baby miss out on the whole physiological process and the coctail of hormones (oxytocin, adrenalin, nor-adrenalin & prolactin) that happen with vaginal delivery and missing out on this complex hormonal ****tail makes bonding much harder and also increases your chances of postnatal depression. So just bear this in mind so you are not surprised if you have bonding issues after your caesarean. Because it is very common. I can comment from experience in that department also.....

I'm not trying to discredit your post Mama spice however I think there's scope for a few more maybes and cans. Your body will still pop out sufficient noradrenaline and adrenaline I'm afraid. Once our bub was with his mum the bonding happened fine- it wasn't had to bond with a beautiful little man. The mild flowed just fine.

Post natal depression and the scope of emotions isn't just related to hormones alone and the relative absence of them following a Cx section. The simple change post pregnancy in hormones isn't too dissimilar...PND isn't just a chemical reaction.

I think what it says is for every outcome with negatives there are ones with positives. All part of the informed choices game I think??

I think too that this thread has the potential like others where opinions seem to creep in uninvited, well intentioned but uninvited nonetheless to deteriorate. It's the nature of sensitive areas that can carry a lot of passion; people just love to let their 2 cents in.

[Inanna]

I would be interested to know if you can elect to have a c/section in SA... Most public hospitals will not do an elective c/section without a medical reason.. That could be a psych report as well - as a psychiatric reason (PTD) is certainly a medical reason. The reasons for this is because c/section is a much higher risk birth to the mother & baby statistically than vaginal birth. The cost is higher to the hospital and all of those things that you would already know.

SB it is actually a fact the quote Mama Spice gave - women who have natural (that is they are not medicated, no instruments etc ) births have a lower incidence of PND, birth satisfaction, bonding issues and breast feed at higher rates and for longer. This is just because our bodies work intricately and birthing triggers those responses.

I wish you an empowered & fully informed birth Meringue.

[Visitor6]

SB it is actually a fact the quote Mama Spice gave - women who have natural (that is they are not medicated, no instruments etc ) births have a lower incidence of PND, birth satisfaction, bonding issues and breast feed at higher rates and for longer. This is just because our bodies work intricately and birthing triggers those responses.

Understood, naturally. How silly of me to miss that.

[Winter]

I really enjoy your posts Stretcher Bearer, except when you are being facetious.

[Visitor6]

Sorry Winter, I'm not totally unawares, so sometimes posts the imply give the impression in my eyes that I might be naive just bite at me and I get caught in the emotion of it all......

[Winter]

It's great having you around SB because you're not naive at all, I love having a paramedic hovering around, good for advice & inside info...oh the things you'll have seen!

Inanna, correct me if I'm wrong, but you're only pointing out that intervention free vaginal deliveries give these benefits (lower incidence of PND, birth satisfaction, bonding issues and breast feed at higher rates and for longer) at higher rates, not that these things CAN"T happen if you have intervention or a c/s? All those hormones kick in regardless of birth method right? I had a c/s and apart from birth satisfaction I haven't had PND, bonding issues and am still BF 11 months along.

[fionas]

Even with a VB, there's absolutely no guarantee that there won't be interventions just because you don't plan on having them. Sure, aiming to avoid them is a good start but it will come down to the length of labour/position of the baby etc. etc. not just willpower.

I had a very long prelabour and by the time I got to hospital I'd had 7 hours sleep in three days, my baby was posterior and apart from being buggered, I have an unstable pelvis. I chose an epidural to rest and the hours where it kicked in were the only hours in almost two years that I was pain free. I pushed for three hours, had forceps, didn't feel any rush of love towards my baby just sheer relief and exhaustion. Milk didn't come in until Day 6 because I wasn't resting and was encouraged to breastfeed for up to 1.5 hours, take a half-hour break and try again

There's a balance to all this stuff. I got the balance wrong last time.

[Inanna]

Winter many people refer to a natural birth as one where the baby comes out of the vagina... My point was that there is more to a "natural birth" than a baby exiting ones hoo haa!

Winter I hear you my love. It's great that you have been able to breastfeed & have had no PND issues. Of course not every woman who has a c/section will not succomb to PND or not breastfeed. It's just that your risk is increased. It's increased due to many reasons - but all related to the c/section.

Of course women who have a surgical birth get a hormonal response. We know though that it doesn't occur in the same way. We know if a woman goes from pregnant to mother with no labour process that she will be more likely to have the issues I mentioned. It's a bit like saying my great Uncle Pete smoked two packets of winnie reds, drank a bottle of scotch a day & worked in an asbestos plant. He's still alive and well... Well, we just know that those things will increase the likelihood of problems yk?

I have had a baby by emergency c/section. I found it incredibly bizarre to go from pregnant to a baby with no process... I have breastfed for long periods all my children and my milk came in witha vengence by the clock and I had oversupply. I didn't havae this with Imogen. In fact everyone but me had given up on me producing milk at all! I know I was in a very different situation being critically ill myself... But having numerous "natural" births to compare my experience to it was significantly different. Even birthing my Goodbye babies - I remember being confused at the elation I felt, waking in a day or two to a bed full of milk... Many women who birth their sleeping babies report similar. Even though their baby has passed, is still and quiet... They feel incredible happiness for a time (albeit short) at the birth of this little person... It's something that women who deliver their passed babies by c/section or if their baby had died some time earlier by d &c often don't feel.

C/section is a necessary, life saving wonderful procedure used correctly. It isn't a safe short cut to a "calm" birth. I guess my situation is different to the OP in that I have actually seen maternal death & fetal death via c/section... I have also seen completely farcical outrageously unecessarily damaging vaginal births.

What makes the difference is education. All the available education we have says that women who have a woman known to them assist their births, feel safe and supported, are educated about the process, have trust in their care providers birth with less pain, greater satisfaction, have less intervention, breast feed for longer & have less reports of PND.

We know that PND can be genetically linked - meaning you may have a predisposition depending on your familial experiences. We also know that breastfeeding is hard work initially - in that it requires support, education & understanding of the process. So, again it's about education. Support. & acceptance of the process...

[fionas]

What makes the difference is education. All the available education we have says that women who have a woman known to them assist their births, feel safe and supported, are educated about the process, have trust in their care providers birth with less pain, greater satisfaction, have less intervention, breast feed for longer & have less reports of PND.

Ianna, I totally agree with you but ... would you also agree that no matter how well a woman is educated about birthing and how to avoid interventions, that sometimes intervention is required? To those of us who have had interventions, it sometimes feels on BB that the problem was that we weren't educated enough, not that y'know what, sometimes it's just plain and simple necessary. I'm not saying it was in my case BTW - I think using optimal positioning techniques and having an experienced doula/IM with me MAY have made a difference to the length of the labour and DD's position and avoiding positions that exacerbated my SPD would have been a good idea and may have made my recovery much shorter than 18 months.

I guess sometimes I feel that women are given the impression that if they want a natural birth and are mentally committed to it, then they will get it. I don't see nearly enough emphasis being placed on the things you mentioned or on positioning techniques, pain management techniques (I know the use of the word 'pain' is anathema to some people) and all the PRACTICAL things that women can do.

[Inanna]

I've gotta get a chook from the cow paddock... BBL!

[Rosie's Mum]

I am expecting that people may find this post controversial but here goes.

We are so lucky to be debating this, we are one of the first generations in the western world to be so focused on the "experience" of childbirth. I know it was always there, I know the hormones kicked in when you did 100 years ago but it was bl**dy dangerous. There was a very real chance you or your baby or both would not survive. We have now eliminated so many of the dangers of childbirth that we can make birth plans, we can have any number of drugs to reduce the pain, we can have intervention if it's needed or even if we just chose to.

I totally get that there are good births and bad births, some are exhilarating and some are disappointing. But if you end up with a healthy baby, a healthy Mum and no irreparable damage to either I would say that is an awesome outcome.

I don't want to diminish people's birth experiences, mine was certainly not ideal but compared to doing in a hut in Uganda it was perfect.

I don't want to be a Pollyanna about this but I think we might all be a little more accepting of our own experiences and other peoples choices if we remember that childbirth is dangerous and to run the gauntlet and come out the other side with a healthy baby is enough.

[Inanna]

Ianna, I totally agree with you but ... would you also agree that no matter how well a woman is educated about birthing and how to avoid interventions, that sometimes intervention is required? To those of us who have had interventions, it sometimes feels on BB that the problem was that we weren't educated enough, not that y'know what, sometimes it's just plain and simple necessary. I'm not saying it was in my case BTW - I think using optimal positioning techniques and having an experienced doula/IM with me MAY have made a difference to the length of the labour and DD's position and avoiding positions that exacerbated my SPD would have been a good idea and may have made my recovery much shorter than 18 months.

I guess sometimes I feel that women are given the impression that if they want a natural birth and are mentally committed to it, then they will get it. I don't see nearly enough emphasis being placed on the things you mentioned or on positioning techniques, pain management techniques (I know the use of the word 'pain' is anathema to some people) and all the PRACTICAL things that women can do.
__

I'm back... the chooks are laying all over the shop at the moment & they seem to hold on until they get in the paddock...

I would agree with you Fiona that sometimes intervention is necessary no matter how well educated a Woman is. I was very well educated & I transfered from a homebirth to hospital. My first labour was 33 hours & my baby was posterior and born with a brow presentation. It was horrific. However, because I was informed I made informed choices about weather or not to agree to the c/section. (I didn't). I was able to choose not to have narcotics as I understood all of the benefits & the cons (I didn't). I made a choice to have an epidural as due to such a long labour and days prior of very strong pre labour I literally hadn't had meaningful sleep for approximately 5 days. I believed in my body, I believed in the process & I knew I needed sleep in order to birth. My epidural was actually the epidural from hell where I (nurses always seem to have situations where what can & will go wrong does! ) had a dural tap where the spinal fluid continues to leak causing a terrible headache and pain...

So, absolutely Fiona I am in agreeance that sometimes intervention occurs. Because like all things birth is an unknown. We know that mostly intervention occurs due to length of labour. That if it's not what is deemed "acceptable" by the particular birthing facility you are in OR the particular care provider you have - you will likely have intervention of the syntocinon variety. Then that opens the door for a cascade of other interventions.

However, this brings us back to what is normal. I challenge that it's not "normal" to labour attatched to a machine, in a room full of people you don't know or perhaps ran into once or twice at the coffee machine... That it's not natural to be taken from your environment to birth.

Birth is a miraculous and sacred event (yes I am saying it again!) & we need to educate ourselves, surround ourselves with the best support available. Birth isnt' the time to have your bestie with you if she had c/sections or hadn't had kids or thinks waterbirth is dangerous. This is heavy life stuff. It's not even the time to have your husband/partner there if he can't be there for you emotionally and doesn't have faith and trust in your body.

We as women need to own the process & experience. That isn't to read some literature of either support or denigration of natural birth and make a decision. It's about really going inside. Thinking about what birth is and means. What you need to feel safe & supported & seeking that out. Demanding that. Interview your care providers. You are paying them. If they fall short - you need another. You are employing them. If their practice doesn't suit you - seek one that has ethos you agree with.

Informed choice isn't about hearing negative stories and basing your decision on it. As Schmick said: most damage to pelvic floor is done prior to birth. C/section Mamas have these issues too.

I personally don't believe that we should have elective non medical c/sections. That's how strongly I feel. I don't think it's my right to demand major surgery. I think if I'm that afraid I need to work on that fear and concern. No decision is best made from a fear perspective.

There are many women who for psychological reasons have chosen c/section - again this is a medical reason. However, if a fear is so deep and great that you choose major surgery clearly that fear needs to be worked at...

Rosies Mum: Absolutely birth is dangerous - when it is made from an uninformed perspective & when decisions are made from fear... I've actually seen birth in third world countries and to be honest they were bloody awesome! Of course not all third world countries/situations. Clearly not as due to sanitation & lack of education women and babies die.

It is more dangerous to have a surgical birth without medical reason.

I actually don't think agreeance is support. I think support is often kind challenge & respectful disagreeance.

I don't want to be a Pollyanna about this but I think we might all be a little more accepting of our own experiences and other peoples choices if we remember that childbirth is dangerous and to run the gauntlet and come out the other side with a healthy baby is enough.

I can't agree with the above. It's not enough for me & for many other women. To have my birthing process interrupted, invaded is devastating for me. Birth is meant to be the full package. The pregnancy, the relationship with your baby inutero, the growth that rises from the lessons learned from that pregnancy, the labour, the birth of the baby, the birth of the placenta, the breastfeeding... The connectedness with other women that birth brings. The connectedness with partners. The connectedness with oneself.

I hear that you feel this way - & that is yours to feel. However, for many of us it's not enough and we strive for the ultimate. Satisfaction all round. Yes, as Fiona pointed out sometimes things don't go to plan. However, when qa woman remains empowered through decisions made from education - the experience often is still very very empowering. Mostly though it's a learning. Women walk forward from their births feeling that this huge experience has taught more. Has molded them more. Has grown them more...

I think that is the gift.