Why all the opinions on c-sections?

[Tobily]

But it's coercion or bullied consent Catherine, not true consent. If a dr say's your baby is in distress (caused by induction or whatever) and needs to come out now, you are hardly going to refuse the section. The fact is, that women shouldn't be put into that position in the first place.

This is exactly what I was getting at (in a longwinded way LOL)

By the time my c/section was called, it probably was "medically necessary". DS was in distress, his heart rate had dropped to 70bpm and he was pretty well stuck - as evidenced by the bruise on his head when he came out.

But it was the events leading up to that happening that was the problem. I had GD, was told I had to be induced 2 weeks early. Had ARM, which led to a synto drip, which led to an epidural, which led to being stuck flat on my back hooked up to monitors. So by the time DS was distressed, there was not a damn thing I could do about it. I couldn't reposition to help him move, because I was paralysed.

So when I'm in that vulnerable position, with a baby in distress, sure by that point the c/s IS necessary. But had my OB not led me down the induction garden path in the first place it would probably have been very different.

Had I been left to go into labour on my own - and I could have been since there was absolutely NO evidence that DS was having any problems, or was big, and I wasn't on insulin - I highly doubt his birth would have ended as it did, since I had already previously given birth vaginally with no dramas.

This story is told time and time again around here, I am by no means on my own in having had this sort of experience .

[BellyBelly]

See all this discussion is wonderful, because we are seeing the beginnings of an era where women will take back their power. It has been surrendered to the medical profession for so long, and now, many women are starting to question it, so I see it as great. The woman and her carer need to share a special relationship of respect where each can trust the other's judgement - it isn't a bullying or power struggle situation. Carers need to share decision making with women (giving their advice still of course) and it needs to be a respectful and balanced process. But Obs are so over worked and in demand these days, that many feel that it's their way or the highway and this is how they do it... not vey empowering or confidence boosting at all. I can see their temptation to get things over quickly. I have felt it being present at 2 or 3 day long births!!! But you need to stick it out for the best outcome. Another reason why one-to-one carers have such great outcomes, they have time and patience for their women.

[Julie Doula]

Most people would agree that a c/section for a genuine emergency or complication is a positive. For some women, even though they know the c/s was necessary, they may still have a sense of grief or disappointment, especially if they were really hoping for a vaginal birth. Even when a c/s is genuinely life-saving, along with the sense of relief that you and the baby are safe, may well be other feelings if the way events unfolded were scary or traumatic.

The conflict comes when there is a growing number of women who look back and feel that the c/s was not necessary, or that they were pressured or even tricked into, or that they missed out on information and support or simply *time* that could have helped them avoid major surgery.

In Brazil, the c/s rate is 80%. That is a cultural issue - not a medical or scientific issue. When a c/s is based on evidence-based care, it is possible to find resolution, to feel it was a "no regrets" c/s - that you did all you could, but in the end it was needful. But to feel that you had an unnecessary c/s because your maternity care was NOT based on scientific best practice, is why many women regard c/s in a negative light.

I would not mind a life-saving c/s, yes I'd be disapppointed but I'd also be relieved and grateful. I would mind it if I knew i had been bullied or coerced into it by a system that holds my instrinsic ability to give birth in doubt or contempt.

There is a schism in Australian birth services. The philosophies and techniques of two models of care - the obstetric model, and the midwifery model - are quite different. When women have naively assumed they are the same or similar, and go into an obstetric system expecting that they will be supported to give birth, many end up feeling either that the system failed them, or that they failed (even sadder). Many then come out of thinking 'well I'm sure going to choose a different model of care NEXT time' and go onto to have a better birth experience that suits their unique needs better.

The difficulty arises when women do not realise the huge difference in the two models, and go into birth either not realising the difference, or not aware that midwifery model options are available to them, or that they are both safe and effective. It is a set-up for birth trauma - when women expect midwifery model care from an obstetric system. It is only well into the cascade of interventions that they start to realise that they'd basically been 'had'. This is where much distress and disatisfaction with high rates of intervention (including c/s) and birth trauma comes from.

I agree totally with informed choice, and would only say, it is fine to choose elective c/s for various personal reasons, and it is fine to choose the obstetric model of birth for various reasons, or to desire a setting that has access to specific interventions such as induction, epidural, etc. These is a place for the appropriate use of these interventions and for this model of care. However, on the basis of the saying, "if I don't know what my choices are, I don't have any", if alternative approaches to birth such as the midwifery model are not equally supported, and made equally available to women, and equally encouraged, then the 'menu' for birth choices is narrowed, and that is not 'free choice'.

I would encourage any first time mother to know that the modern medical model for birth is not the only way or the even best way, and to pursue knowledge of both approaches, and most of all, to be pro-active in choosing the kind of care you think would best suit you. This will not prevent a low percentage of life-saving interventions & c/s, but you may well be able to avoid being carried along by a domino effect of one intervention leading to another that results in an unwanted or avoidable instrumental or surgical birth.

Maternity services in our country ideally should be presenting a truthful picture to our birthing populations, that includes a realistic picture on pros, cons and alternatives, but given that this is rarely the case, it is we women who have to be a bit skeptical, questioning, assertive, and pro-active in getting the birth care we each want.

The article 'Fish Can't See Water' by Marsden Wagner of the WHO is a good place to start researching this.

My heart goes out to every woman who has ever been let down by the limitations of our current system and suffered as a result. By telling your stories, you are being so very brave and also contributing to our collective wisdom, that will help other young women know their rights and choices - I applaud you.

[BellyBelly]

Exactly Julie, I am grateful we have this technology, but I do not want it used needlessly on me and if someone in power abused my trust, I would be very upset.

[Keira]

Trinnie - Thankyou for pointing out how ignorant i am and correcting me on the words "most" and "some".

What if we are informed, we have done our reading/research we have TRIED to ask questions on BB and we still make the choice to have a c-section... and i'm referring back to my original question - WHY ALL THE OPINIONS?

If someone chooses to have one, why do people gasp in horror about it?

[Aranah]

So how is a woman in this situation able to decide if it is a genuine emergency or not?

This is what bothers me about this debate, and it's the only thing, is yes, I see the point that OBs are classing things as emergency when they are not. But what does one do? I know a website can't advocate to ignore the OB because that would and could be somewhat dangerous. But when it's talked about on here and women go into ir uncertain, it does make it hard. If one is told by an OB that a baby is in distress or in danger and they need to get it out now, what do we do?

Really, there is nothing we can do. Noone can say it's right to ignore that advice because we simply don't have the medical knowledge to do so (well most of us here) and imagine if we refused surgery and the OB wasn't lying and was right and something happened to the mother or baby.

I feel that us as women have this information said to us, but really there is nothing we can do. I guess we can question an OB at the time, but as most of us who have been in labour know that that would be hard thing to do when you are in that state of mind.

So I guess that it lies with changing OBs perspective, or insurance or whatever it is that makes them do these deemed emergency c/s that is not an emergency. And also things like inductions and epidurals which can lead to it. Women can't and shouldn't take the guilt of an unecessary one themselves. (BTW- I'm not saying that anyone is trying to make anyone else feel guilty in this discussion.)

[LG]

Keira, I'm not sure that they do gasp in horror. Do you mean here on BB? I haven't seen any of that.

[Keira]

LG - i've seen the gasps of horror, i've even been laughed at - to my face, and heard stories about bullying all because of c-sections!

My OB recommended i have one due to a medical condition i have - and i'm not going to divulge as to why either, there's no point!

[becmc]

What if we are informed, we have done our reading/research we have TRIED to ask questions on BB and we still make the choice to have a c-section... and i'm referring back to my original question - WHY ALL THE OPINIONS?

You asked why we have opinions, because we have been through the experience of a c/s ourselves, and I would never give my opinion on something unless someone specifically asked. But trust me, once you have a baby, or as you know before you even have a baby there are people who give you their opinions on anything and everything. That's life! You will get opinions on how to feed your bub, dummies, solids, sleeping, clothes, everything you can imagine. There are always opinionated people who will tell us what they think even if they are not asked. You just have to learn to ignore them.
Unless it a condition you are aware of all through pregnancy then it is a bit hard when you are in labour to get other information. You obviously started this thread because you are annoyed about people having an opinion so perhaps you should have stated that in your original post because i got the impression you actually wanted to know about why people had opinions which comes down to having an experience.

If one is told by an OB that a baby is in distress or in danger and they need to get it out now, what do we do?
Really, there is nothing we can do.

Not true. You can take an independant midwife to hospital with you as an advocate and for a second opinion.
Which I wish I did for my first birth.

[Julie Doula]

You can take an independant midwife to hospital with you as an advocate and for a second opinion.

Good suggestion. That's where you begin to realise there is a big difference between the obstetric model and the midwifery model - and that we've been misled to assume that there is only one way and that that way is in fact scientific .... sometimes, it is not. A second opinion from someone with a different philosophy and approach to birth can greatly widen options and possibilities for you.

[~Flossie~]

Keira - all the best with your c/s

[Berry]

Keira - I am on the same page as you here!

Caesarians are available not just for medical reasons but to provide an option which may make life easier for birthing women in a variety of ways.

I think obstetricians are sometimes unfairly criticised for a rise in planned caesarians, when the trend is because this is an option more women are asking for. And who cares anyway if there is a rise in planned caesarians in Australian society??? There may also be a correlating rise in the amount of birthing women feeling happy and liberated.

[joralyd]

catherine, I would disagree with you that the general community believes women who have had c/s's are failures. In fact i think people are too quick to opt for a c/s without properly evaluating the risks, pros and cons.

I'm not sure who wrote this but it stuck in my mind and I thought I would reply.

I know the risks I know the pros and cons, yet I'm still choosing an elective C for the birth of my 3rd child and it's my choice, yet I feel like I'm judged for this, it may not be directly but just the fact that people feel they need to "inform" me of the risks, I have educated myself, asked many many questions and opinions and C/S is what myself, dh and my ob have decided.

I had an emergency C for my first and chose an elective C for my second due to breach baby, I felt this was the right decision for myself to make and I wouldn't dream of pushing my opinion on any other mother to be. All I wish is that I was given the support and understanding by my fellow mothers. I agree with most of what people have said here but my concern is not for the statistics or the causes or the place of birth or who you choose to deliver your baby but more for the mental well being for c/s mothers and the lack of support, comfort and understanding given.
It's so sad but there is a stigma attached to c/s births and this makes women feel ashamed and hurt I can say this because I feel it and I would hate for another mother to go through this also, but I know they do.

[Berry]

I'm really sorry Berry but caesarian section is definaltely NOT safer for the baby.

This must be a matter of opinion, but I'd rather go by my obstetricians expert knowledge and trust that a caesarian is without a doubt safer for my baby.

[Tobily]

I think there is some major confusion in this thread.

No one is saying that elective c/section should not be available to those women who want it after making an informed choice.

The concern is for the majority of women who go into hospital expecting a vaginal birth and come out with a belly wound.

They are two VERY different scenarios and alot of posts here are attempting to compare them, or lump them in as all the same.

I couldn't care less if someone has an elective c/section - their body, their baby. But that was not the birth I wanted, or many others here wanted. But that's what we got. Naturally we feel ripped off, and traumatised by that, which is WHY so many of us have an opinion about c/sections in general. That is WHY it's such a heated topic.

[BellyBelly]

I posted the directive in May as well as studies in the news forum

https://www.bellybelly.com.au/forums...ad.php?t=36829 (NSW directive)

[BellyBelly]

Apparently it already has.

[Julie Doula]

2% of c/s are as a result of maternal request.

It's the rise in unplanned, not-desired c/s as a result of the medicalisation of birth, that is causing so many women to experience c/s as 'negative' (well, it was, for them - understandably).

C/s is available as a funded option.

Homebirth, another effective way to avoid birth trauma, is not available as a funded option.

The cultures where women are more liberated have very high rates of homebirth and as a result, excellent peri-natal stats. The cultures where women are more oppressed (I'm talking 'first world' here,) such as Brazil, have the highest rates of c/s and intervention.

While we applaud c/s, including elective c/s, as an option, to have that available but homebirth, and other midwifery-model approaches to birth less available or accessible, is hardly liberating.