Why all the opinions on c-sections?

[Berry]

I think there is some major confusion in this thread.

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

You would feel ripped off if you went through a long painful labour only to be given an emergency caesarian at the end. But I don't believe this happens frivolously; obstetricians have to be an advocate for baby's safety and unfortunately sometimes this involves overriding the requests of an emotional mother.

[Liz]

I'd rather go by my obstetricians expert knowledge and trust that a caesarian is without a doubt safer for my baby.

I think obstetrics is one of the fields we fail to get second opinions on (perhaps coz it costs so much to shop around for an OB?). If someone recommended bowel surgery for me for a certain condition, I'd be running around seeking alternatives and second/third opinions. But it seems if a c/s is recommended, few people are questioning it, and yet it can involve the very lives of both mum & bub.

I do wonder at how many OB's when recommending c/s mention the knock-on effects of c/s, such as the possible effect on breastfeeding, impact on future births etc etc. It's usually the here and now that they discuss, getting the baby out... not worrying about what happens after that. From what I've read, often they don't even speak of the 'general' risks of having c/s surgery, all mum's are told is that they have to have one.

[becmc]

And let's not forget that you have to sign a consent form for a c/s, unlike natural labour, so if something happens during surgery you cannot sue because you have signed a form, whereas if something happens during natural birth the obstetricians are more liable. I reckon that is a huge incentive for them wanting to do c/s's.
I agree with Flea, personally I have been referring to emergency c/s done without good reason, not elective. I don't care if people have elective c/s. Doesn't make any difference to me, I have no opinion on that one way or another. What does concern me is emergency c/s done unnecessarily and having another woman feel the way I did. I wouldn't be human if I wasn't concerned about that.

[Berry]

I do wonder at how many OB's when recommending c/s mention the knock-on effects of c/s, such as the possible effect on breastfeeding, impact on future births etc etc. It's usually the here and now that they discuss, getting the baby out... not worrying about what happens after that. From what I've read, often they don't even speak of the 'general' risks of having c/s surgery, all mum's are told is that they have to have one.

The ob I have now is the 5th one I have encountered during my birthing history and I have discussed with all of them their views on c-sections.

My ob addressed all of these points: breastfeeding - no problem; no evidence to indicate giving birth by c-section leads to less successful breastfeeding. Milk does take slightly longer to come in, but this doesn't effect the baby; they get to feed on colostrum until the milk is fully flowing.
Re future births - my ob suggested that having my second c-section now may hinder my ability to ever birth naturally again, but that I can quite happily have a third c-section should I want to.
Re general risks of c-section - my ob has clearly let me know that as a mum I am more at risk having a c-section than a vaginal birth, in light of the usual risks of surgical procedures.

[Inanna]

Isn't it wonderful to see all of this discussion from such spirited and intelligent women. It's fabulous.

I am confused Catherine and I will say offended. I am a huge advocate of women's choice. I am very very pro choice. However, I lament when choice is not evidence based. Because often when it's not, when a decision is made that the woman does not feel in control of, or understanding of there is often much struggle afterward.

You are saying c/section is best for you and others are saying that wasn't their experience. Why is that a problem? These women have every right to convey their feelings about their birth. If you choose to feel it's about you then that's your journey. But we can't put a lid on peoples experiences so others dont' feel put out. I have had great fanny births but that doesn't mean I would never choose c/section if it was necessary. Or an induction. And, it would never enter my consciousness that I would be judged for it. Goodness me. But I do know what it's like to be judged for my birth choices... When you birth in water, at home, with other children present, no obs, candles, co sleeping, demand feeding, extended breastfeeding, tandem feeding... the list goes on. Some folk find that foolhardy. Folk who don't know the stats, the who recommendations... So judgement I do know about. So, to be accused of judging another woman for her choice is hurtful to me. But perhaps that's my hormones, my sinus infection and the time of day...

Kiera: I too must have misunderstood your post. I thought you were asking why people had opinions. So, I offered why it was so from my perspective. I didn't understand that wasn't the question... I hope your birth is all you hope for and you have a great experience.

I just want to reiterate. I said it in my first post but I want to say it again. I completely understand why women choose a c/section. Psychological reasons for c/section are very real and great. I have a great many friends here on BB and in RL who would consider a c/section due to experiences losing a child, sexual assault, birth trauma etc. They are real reasons. I want that to be heard. Its quite irrelevant if I think they are valid reasons, they are valid for that person, for that birth. I would walk over glass to support a woman through that experience (and I have ).

If a woman chooses a c/section that's her choice. Many of these women didn't choose a c/section. They did not have the birth they wanted and they feel pain around that. That is valid and real.

This is always a hot topic. I am not sure precisely why. It seems that folk find it hard to own their choice. I know of one gutsy lady here on bB that chose c/section and had her own midwife. She had the birth of her choice. It was informed and what she wanted. I am certain she felt empowered and LARGE. She didn't have regrets. It was an informed choice. I didn't want to mention names...

Flea and the other Mamas are saying that they feel they didn't have that choice. I hear that and I am so sorry...

So, please don't throw around blanket statements about women not supporting each other. WE need to hear each others stories, if someone doesn't want to do that then don't read the post, but don't stop the process of learning and hearing and healing that comes with discussion .... please. We all deserve to be heard. I learn something new each time I read a post. That is a wonderful thing.

[Julie Doula]

I've just read the report from the National Caesarean Awareness Day Forum - “The Caesarean Section Rate is Rising … Let’s Talk about it” held in September 2006.

Does anyone have a more recent report?

[Inanna]

I don't Julie...

[Liz]

The ob I have now is the 5th one I have encountered during my birthing history and I have discussed with all of them their views on c-sections.

My ob addressed all of these points

That's good to hear I would like to think my OB will be as forthcoming with all the info should the need arise. Trouble is I probably will never know coz I'll be the one quizzing him first LOL, so I'll be pumping the info out of him rather than him volunteering it.

[Inanna]

Your point is a very valid one Liz and I am sorry I missed your post...

The problem with "emergency c/section" is that women don't get the chance to shop around. They are often told... We have to get this baby out now.
As a consumer we need to ensure our care providers ethos can be married with our own. We need to interview them for the job. I learnt this the very painful way.

We need to say in this situation what do you think/believe. What's your policy on c/section/induction/wwaterbirth/painrelief...

I don't want to come across as obs bashing - because I am not. Like one of the earlier posters I truly believe we have to take some more responsibility for our outcomes. That only happens when we choose to educate ourselves.

Women who are supported in birth by another woman trained to do so have better outcomes, fewer interventions and greater birth satisfaction. It's a fact.

[christy]

I was never asked to sign a consent form?? I can't remember that... I just remember being told this is what is happening next & I asked "is my baby in danger? NO am I in danger? NO, then why? In case you get in danger" I asked for more time & then again in 2 hours was pushed again... after a while it became more risky but I think that women often don't know that they have a choice. I wasn't given choices I took them myself.

[Inanna]

Christy, perhaps your husband signed the form? A consent form HAS to be signed or it's assault. Surgery cannot be performed without it. It's illegal...

Unless you are deemed of unsound mind or are unable to consent to surgery. Then your next of kin has the ability to do this..

[Liz]

Flowerchild - yeah, I guess I was thinking more of scheduled c/s. Certainly no time for OB shopping in labour!

I guess I should quiz my OB now, altho, in everything else he has been VERY supportive, so I do have a lot of trust in my OB. I've almost heard a sigh of relief from him when discussing some of my decisions. heh. My OB seems to be very hands off, and is happy to be.. I think he knows I only see him as a just in case LOL. (I think I should make him earn his fee a bit more!). I guess that's one reason I prefer to go private with an OB. I love the idea of homebirth with midwife care, but I have a couple of specific things that I feel more comfortable with knowing I have a supportive carer should the situation arise. It could be deemed unneccessary I guess, but I like knowing who my Dr is at the end of the day.

[monnie]

One of the reasons I think this is such a 'hot' topic is that even the professionals can't agree...much the same reason as ADHD is such a 'hot' topic...

Certainly for me...so far...trying to make an 'informed' decision when so many disagree is incredibly difficult...almost impossible...

From my experience (which is incredibly limited to date...totally admit that), I've come across huge variations in opinions amongst midwives and amongst Obs.

I'm due to give birth in 3 weeks...how I'm going to do...still not sure..

I have had uterine surgery in the past and this is what is complicating the picture...

In the past 5 weeks, I have seen 3 Obs...2 have told me I would be crazy not to have a c/s and 1 has told me that I probably don't need one...

I've read all the scientific articles I get my hands on (done a thorough literature search through medical journals)...and they are inconclusive...

I've ploughed through numerous forums...and get confused...

Even our antenatal classes (which were run by 2 different midwives), gave different opinions...

So as hard as I'm trying to make an informed choice...it's so confusing!!! Always in the back of my mind is the "what if I don't have a c/s and something happens?"...then there is the "what if I do have a c/s and I actually never needed to?"

It's just so confusing (think I've already said that!)...and it's no longer 'me' that I need to be worried about...it's my baby...that's a huge responsibility to carry...

Sometimes with information and knowledge, you can become even more confused...and as much as I'm a believer in 'instinct', we also live in a society that is reliant on intellect and I wonder how well honed my "instinctive skills" are these days!!!

[BellyBelly]

Doctors Fail To Discuss Caesarean Options

[kiki]

Berry, It's fantastic that you have a good relationship with your OB BUT it is because women like you put so much trust in one person without doing the research themselves that they end up with unfulfilling birth experiences like some of the people posting in this thread. The risk of morbidity to the baby following an unecessary caesarian section IS 3 times higher than following a vaginal birth and this is researched and proven fact. Kelly has posted the link so have a look if you like and maybe take it your OB to show him, you may enlighten him on something he didn't know either then other women under his care can have the correct advice. Don't get me wrong, I'm not having a go at you I actually feel sorry that the OB that you obviously put alot of faith in is telling you the wrong thing- he has no right.

[paradise lost]

Wow, here i am coming in at the end....well maybe it's not the real end, but so far, it's the end

Keira, i think now it's become obvious why people have opinions and there are as many reasons as there are opinions. Some have chosen c-section and regretted it, some have had a necessary c-section, some an (in retrospect) unnecessary c-section. Some have had problems, some have avoided problems. Some, especially here on BB, have done an awful lot of research and reading of medical journal articles, WHO reports and other research in this area and are extremely well-informed, and possibly feel they should share that knowledge to give others the benefits of it. This is a forum for discussion, discussion without opinion is statement of fact. Opinions, here, are what makes BB an enlightening, supportive, caring, educational place.

I'm sorry you've felt you can't share why you need a c-section, but we are none of us psychic. Those who have had terrible c-section experiences and want to spare another going through it aren't trying to hurt you, they're trying to help you. If this whole thread was a result of a comment made by someone in those circumstances, perhaps it would have been more enlightening for you both to PM that person about it. My opinion of c-section, and why i have an opinion of c-section, is not going to clarify that situation for you. I have to admit that i wonder if your reluctance to share is because you will be told what you don't want to hear, that you don't NEED to have a c-section. If you WANT to have a c-section your needs are irrelevant, why does it matter what others opinions of c-section are if you WANT one?

My own personal opinions....

My good friend texted me a year and a half ago to tell me "it's begun!" She was 10 weeks more pregnant than me, and we were both excited that her baby was about to put in his appearance. It was her second kid, she was 38+3 pregnant. She was booked into her local hospital which doesn't have Obs, only midwives as their Ob centre had been moved to another city. Everything had been fine. I heard nothing more and i left her to it as her 1st labour had been long and "is he here yet?" isn't what you want to hear in labour! 3 days later her husband texted to say her son was born by emergency c-section at 4am and they were both fine. I gasped in horror. Why? Because i've known my friend since we were 10 and 11, she has already had a natural birth and BFed that baby for 2 years, i *know* her, so i knew it must have been bad for her to have surgery and i was really extremely worried about my poor friend having to have major abdonimal surgery at some ungodly hour in a strange city. I called and got the details. After 36 hours of labour she was dilated to 6cm and her midwife realised she could see a bum, he'd turned breech in early labour and was now tucked tightly down and unable to turn back. They transferred her to the ob centre and she opted to labour on and deliver vaginally (something which many obs don't "allow"). After 72 hours of labour, stalled for 5 hours at 7cm, having had no sleep and unable to have an epidural as the Ob needed her to deliver on her knees for him to do the vaginal breech catch, she was so exhausted she consented to a c-section. When they took him out it was clear her son was wedged in an odd position, with one thigh "locking" the other and hindering his descent (like a lotus position almost). Obviously her c-section was for the best, but without all the details i was really frightened for her. She is done having babies now but if she had another one and had an elective c-section i wouldn't gasp, she's experienced both births, both recoveries, hers would be an informed decision not based on fear or ignorance or misinformation.

I had a homebirth. I was told REPEATEDLY that they would kill my baby, there would be no equipment, i was irresponsible, i was stupid, i was (said smarmily) "brave" - a favourite with condescending doctors and midwives who preferred the hospital setting! I was in short treated like an hyterical, uneducated, hippyish idiot. I too did my research. There's more than one way to skin a cat, and there's more than one place to birth a baby! Those who choose c-sections aren't alone in being bashed for their choices. At least (in aus) your choices are funded!

Berry,

obstetricians have to be an advocate for baby's safety and unfortunately sometimes this involves overriding the requests of an emotional mother.

does this mean if i am an Ob and i can't be bothered having someone fetch you water i can say you are over-emotional and don't NEED a drink? Are Obs super-beings who are never tired, never hungry, never wanting to stay away from work over the weekend? Are they all without exceptions wonderful people who act only in the interests of the baby and the mother and never in their own interests? Do Obs never make mistakes? Who has to LIVE with those mistakes - the mother and the baby, NOT the Ob. The issue as has been said again and again is NOT women who have informed c-sections, that 2% is perfectly entitled to their birth choices. What about the 25% who have c-section forced on them? Are they all just being emotional? Why does THEIR pain and desire to birth vaginally not have a right to be addressed, defended? You obviously know what is involved with a c-section and the recovery etc. and it is very likely that you will have no regrets from going your chosen path - the c-section crisis isn't happening to women in your situation. You KNOW the risks, you CHOOSE your birth. All power to you and the best of luck on the day and a happy babymoon.

It is not difficult to state a disinterest in opinion contrary to one's own - in posting for others experiences with MMR i stated that i had done my agonising and just wanted my question addressed, not the topic. I ONLY recieved what i asked for. No, not all stories were of no-worries vaccinations, but forewarned is forearmed. No-one questioned my decision and i have seen in other threads that some of those who advised are against vaxing for ther own reasons. They didn't push it on me.

If we state our needs they can be met. If we state our boundaries they can be respected. If we are clear and kind, we will be met with clarity and kindness. There may be people on here who do not UNDERSTAND why you want a c-section, but there is no-one who wishes to hurt you. All those who question do so in the belief that they will be saving you suffering.

If we do not question we cannot learn.

Bec

[BellyBelly]

Awesome post as usual Bec. Bravo.

[paradise lost]

Thanks Kelly - it's a bit mammoth as usual... Anyone who manages to get to the end of my posts - kudos!

Bx