Fiona: My response to your SPD question...

Firstly how you birth is your contract & your journey & I couldn't say what is best for you. I too have had SPD. I had it with my first and through all of my subsequent pregnancies. I found the belt just didn't work. I also found the exhaustion at not sleeping like nothing I've ever experienced...

I had a posterior labour that started with cx 2mins apart and continued that way. I have not had since in any labour or situation felt such excruciating long lasting pain. In second stage I pushed for 3 hours. So, I am just establishing a personal understanding of SPD. I also had to work at a desk job as I couldn't lift my legs high enough to climb hospital stairs & getting in and out of cars was hellish...
Rollling over in bed at night would cause me to yell out. I believe that it's important to exercise. Movement is essential so that you don't seize up. It hurts but you need to keep going. Water exercise helps some women but I personally didn't get relief from it. I took supplements, I had accupuncture but by the 3rd pregnancy I resigned myself to the pain.

I can't explain why but during labour the SPD didn't even affect me. I used water - which was like heaven for me, I rocked and squatted and did things I hadn't been able to do for months. After the birth I was sore for a few weeks but it basically began to improve soon after. With Imogen I still have some of the associated pain. Despite yoga, massage, rare albatross feather massage () etc etc etc. So, I can't really explain how it was okay for me but it was.

I am not alone I have spoken to many women who birthed fine with their SPD. Of course not everyone. I would just like to offer that it is quite surprising how restricted you can be and then labour comes and it seems to just be okay... I know there are a few BB Mamas who VBAC'd with SPD & it didn't hinder their births...

How I see your situation is that it's yours. What I would suggest is that you really go inside yourself and uncover your feelings, ideas, views, fears... Make a decision from a knowing place. I know that if you have severe SPD that that would be seen as a medical reason. I can tell you that I too had severe SPD where physios told me I'd be in a wheel chair and I swung from the wardrobe, climbed in and out of a birthing pool and basically didn't sit still... So, perhaps it might be right for you to go into labour and see how you go. It also might be right for you to have a c/section...

I agree in principle, but this doesn't account for those of us who have processed our issues through deep therapies like rebirthing etc, did our research & preparation, and faced our first births fearlessly and in a state of complete self-awareness and clarity, and yet were still traumatised by the circumstances surrounding our births. Not every woman gets a choice over her birthing care providers - think regional areas - and often women are promised a standard of care when they meet with midwives etc but by the vagaries of hospital staffing & the reality of routine practices end up with a completely different experience to the one promised. In my case, I was issue-less when I entered the birthing suite, but horribly impacted for well over a year afterwards - the physical healing alone took 18 months - and no amount of debriefing, counselling, contextualising, healing, etc afterwards could induce me to go there again. Ironically, after my calm and empowered 2nd birth by maternally requested C/S surrounded by people who really cared about my wellbeing - this experience was healed deeply in me. So deeply that I felt from that point onwards that I could indeed contemplate another fearless VB, should the need ever arise.

I guess I'm saying that an empowered birth, in the sacred sense and in the context of the larger arc of life, can occur regardless of VB or CS. It's really important that there exists a space like this on the forum where those of us who find ourselves taking the CS journey - no matter what the reason or whether any one else thinks it's valid - can get information and support.
You are so right Marydean sometimes women are promised an experience or a method of birthing & they don't receive it. I too was clear when I birthed my first child & my experience also scarred me. Mostly as I was so informed and educated & it still happened - so Goddess help the uninformed was my thought... I was bullied, disrespected and treated like a naughty child. I was threatened. I understand... You are also correct with saying (essentially I believe) that due to the way the system is we (women) are often let down. That is why we as Women & Men who care about birth need to stand up and speak what we know and want. The system has to change and alter to suit the client not the system.
I hear what you say about regional centres - I had to travel 40 minutes to my nearest hospital and that's close by Qld health standards. However, about support. We do have a choice. We need to choose our support very wisely. It's integral to a positive outcome. Now more than ever Doulas and IM are almost essential to a good outcome. In almost every town there will be a wise woman, a doula - there will be someone. So Women need to put it out there that someone will come into their life to assist them to birth positively. Advertise. Seek it out!