Why all the opinions on c-sections?

[Keira]

Hi all,

I was just wondering why so many people have so many opinions on c-sections...

I'm not saying that i'm "for" or "against" anything, but i'm rather curious as to why people have so many different views about a procedure that is in most cases medically necessary and life-saving.

I've mostly heard only negative things about c-sections in general, and rarely have i heard anyone say they were happy to have had a c-section, even if it saved theirs or their baby's life.

I'm not trying to start a controversial thread, but rather an intelligent "conversation" on an interesting issue!

[castle]

I think your statement, "that in most cases is medically necessary and life-saving" is, in itself, the controversial part about caesareans.
There is general consensus that the current Australian c/section rate is too high (varies by hospital and state), which should mean that some of those are not medically necessary or life-saving.
Some women do elect c/sections for psychological reasons, especially as a repeat c/sec or following a traumatic loss or delivery, which they have a perfect right to do. Apart from that, most women are told that the operation is medically advisable or life-saving. Of course there are many situations when it is. I have a friend who had a complete placenta previa (placenta implanted right over the cervix) and a planned caesarean is the only option for mother and baby's survival in that case.
However, after the fact some women question whether theirs were really necessary. In an emergency situation, many women feel pressured by the rapid unfolding of events and wonder later whether they made a good decision, or if they had the right information to make one. It is certain that some doctors and hospitals have much higher rates than others, and it's been proven that that is NOT directly related to the number of high-risk patients they see.
There is no one answer because it is not a simple black and white issue. There are many factors: the current medico-legal situation, the trust that a woman must have in her doctor, consumer control in health care, decision making under pressure, a woman's natural desire to do all she can to preserve her baby's health and life...those are just a few of the many, many things that come into play.
I have had a caesarean, two VBACs and another caesarean. Both c/secs were emergencies and done for completely different reasons. I am grateful for both and I think that many women would say that about theirs. I am happy to share more about either delivery (or any of my deliveries!) if you are curious.

[Inanna]

I think that is the nature of birth Keira. Birth has been put in the closet. And slowly it's emerging. Women in times past would discuss birth, assist in each others births, talk talk talk.

Something changed and that discussion ceased to a degree.
Places like Belly Belly have helped it to "come out". Women discussing their experiences is an essential part (I believe) of the birthing journey. Hearing how things were for others. They don't have to be the same us us and we don't have to agree but it helps with the knowledge base, opinion base... The decision...

C/section is major surgery. Major surgery isn't something to be entered into lightly. As women and consumers of the birthing system we need to be fully informed. Women need to take some control of their experiences and their bodies (I believe) in order to have a fulfilling birth experience. Evidence based decisions are important. (I believe this fervently and passionately)

I will disagree gently that c/sections in most cases are medically necessary and life saving. In some cases of course this is true. But for some women they will choose a c/section for psychological reasons - it's a huge one. This may not be life threatening or medically necessary. But for that woman in that birth it's important... There are also a small group of women who will choose c/section for no other reason but convenience.

So, in order to make an informed choice I think it's important to firstly study, read, seek out a number of medical opinions. READ READ READ. Then hear the stories of other women. The good and the not so good.

Birth satisfaction is statistically lower in women who have a c/section. Now, I would suggest that these figures are so for women who have not sought out and made an informed choice. I don't know but I feel that this would be the case...

C/section is not bad - or a no no. I believe what women need to do is make tht decision after weighing up all the negatives and posittives.

I know there are a number of women here on Belly Belly who choose c/section for psychological reasons. For them the benefits outweigh the risks. We all have our stories. No one is judging that. This is a place where we can find out some information that is evidence based. Discuss this with other women who may make very different choices to us. But it is done with safety and respect.

Sometimes ideas are challenged. Challenge, I believe is a good thing it can help us to think "why am I feeling like this..."... "Where did I get this idea"... "is this left over from my mothers/grandmothers stories"...

I heard a prominent tv personality talk of her birth experience. She had an elective c/section because her mother was afraid for her as she'd had a terrible brith experience... Now, is this a good reason to have major surgery??? To please another??? Perhaps in the end it is for her... We can't be the judge of that. But challenge that is respectful may help her to seek out more info...
Her decision may still be the same but her decision would be made from a place that wasn't so fearful...

Your question is a good one... And I am sure you have seen the many articles that Kelly has put together on c/section. C/section has saved many lives. Conversley babies still die in c/sections and mothers do too. It's not always the "safest way" to give birth. It's one of the ways to bring a baby into the world. Certainly for some births it's the safest way. It's the right way for some women in some births. My hope is that all women make the decision to birth their babies (whateave that way is) after making a decision after having all the risks and benefits.
How to bring your baby into the world is a decision that needs to be made after seeking out factual information. (I believe)

As women sometimes we only want to hear the "good" stories. The ones that support our decisions. I believe in order to make an informed choice we seek out first facts and listen to other women too. Women are wise. We have a wisdom that spans millenia.

[Berry]

Yay for caesarian births! My little girl was really struggling when delivered by emergency c-section at 27 weeks - we were just so relieved to have this procedure to get her out quickly and safely. Her development, at 2 years old, is fantastic and there are no problems from her prematurity. I dread to think of the outcome had she been born naturally.

I'm opting to have a c-section for my third - among other reasons it is safer for the baby. I have had one natural birth and one c-section, and I actually preferred the process of the caesarian and feel better about going that way than considering a VBAC.

[Adnil]

I can understand your question Kiera, I really can. I think sometimes it probably does seem that way. I think though that most of the opinions are not so much against C/S, but are against unnecessary C/S. It is absolutely true that C/Ss can save lives & I think we are very lucky to live in a day where most deaths can be prevented. I guess the problem is that the intervention sometimes comes in too soon. Women are pressured to have a C/S for 'failure to progress' for example, when nature could just be left longer to folow it's course. DYKWIM?

I can see the downside of the C/Ss that happen in our society, in that it probably is too common. That said, I have a problem also with anyone telling me that I did the wrong thing (I had an elective C/S). I think it's important to point out the pros & cons of anything and to be honest with each other. But in the end, it's not up to anyone else to judge. I have no doubt that every one of us does what we believe to be best for our babies & ourselves. And that's what matters.

FWIW - I've had a C/S, and I really don't want another, for many different reasons. I do tend to point out to people who ask, the negatives of C/S. But I hope that it never comes across as judgemental, because that's never the way it's meant. I guess it is such a personal thing that it can be pretty sensitive to us all...

[becmc]

I think it is good that people have opinions on this sort of thing because it makes women get informed about the choices they are making for their body and their baby and not necessarily just take their doctors word for it which may not always be the be all and end all.
My c/s was a supposed emergency, my son was severely distressed, well that is what they told me and dh in labour, but now I have my notes and that is definately not the case. They pretty much exaggerated everything to get me in for a c/s. My midwife (for my current pregnancy) is absolutely appalled at the outcome of my first birth and what the docs said to us which wasn't true. So imo women should get all the info they can about particular procedures, what is involved, and why they may need it, and have an advocate there with them to try to help get the outcome that they want.
And in my case it is not the actual surgery that traumatised me so much, it is more the fact that me and my perfectly healthy baby were seperated immediately for no good reason. I don't think women are aware that that does happen, and they should be told. They should also know they are the customer and have the right to request/refuse anything.
I also don't believe that most c/s are life saving and for emergencies. A perecentage of them are, most definately, and we are very lucky that we have such a drastic outcome that can save lives, but alot also could be avoided if doctors didn't try to manage every aspect of birth when it should be left to the women and let nature take its course, which lets face it, birth is natural (for most people).

[CatherineL]

I think perhaps women are feeling bad or guilty for c-sections because there are so many people telling us it's bad, life threatening, it isn't natural and if we plan better and right it won't happen etc. and women are coming out feeling like failures because they didn't endure a 'natural' birth. I've said it before and i'll say it again, i refuse to go in to birth fearing c/s - I am going to try my gawd damd hardest and if things don't turn out favourable in the way i had planned, then i will have no guilt or fear over a c/s as long as my child will be born healthy.

[Emma1979]

i haven't had time to read every response, but just wanted to say that i had a c section tentatively planned but went into labour a few days before... it was the worst experience of my life and after 28 hours and 10cm dilated, resulted in an emergency c section and because the labour was so far advanced, i lost a litre of blood and had to have a blood transfusion... if i had to go through labour again i seriously don't think i would have another baby, honestly, it was the worst thing in my life and i often have nightmares about it... i am LOOKING FORWARD to having a calm, planned c-section next time around... i tell any of my friends considering having a baby who would prefer an elective c-section to go right ahead, having gone through such an awful labour i can completely understand those wanting to avoid it.

in my situation it probably saved mine and my baby's life who was in alot of distress trying to come out naturally.... i can only say good things about c-sections, however the circumstances in which i had to have one were not the best and it was terribly traumatic. next time around it won't be though!

[maddysmummy]

i am LOOKING FORWARD to having a calm, planned c-section next time around... i tell any of my friends considering having a baby who would prefer an elective c-section to go right ahead, having gone through such an awful labour i can completely understand those wanting to avoid it.

i agree with you.. you story sounds like mine except i didnt go into labour i was induced!

[trinnie]

Keira, thank you for starting a debate about this topic. Please don't take this the wrong way, but it is ignorant and naive to say that c-sections are "in most cases medically necessary and life-saving". This is simply not true!! Yes, it is undoubtedly true in some cases but too say that it is true in most cases is highly controversial.

I believe that no-one ever has the right to comment negatively about how a woman chooses to give birth, whether that be by c-section or not. It is a highly personal decision and no-one can say how they would react in any given situation.

The most important thing is that women have choice, are informed and decisions are not imposed upon them by a highly interventionist and conservative medical profession. The aim of BellyBelly, I believe, is to educate about birth choices so that woman can be happy and content that whatever choice they make is the right one for them.

Me - my son was born by c-section under a general anasthetic. Did I consent? Yes, I did but under the duress of being refused medical treatment if I did not consent. It was therefore not full and free consent. I was admitted to hospital in a hurry because of bad test results! I was told that if I delivered my baby vaginally there was a high chance (up to 20%) that he would bleed into his brain and therefore the outcome could not be guaranteed, also there was a possibility that I could also die!!! I had lost a baby and was told that I could lose this one. I begged to be allowed to deliver vaginally but my OB told me that he would not treat me! I was undergoing treatment in hospital and didn't have the strength to find another OB after being admitted and undergoing treatment.

The risks I was told by my OB were highly exaggerated!! HE WAS WRONG!!! The chances of anything actually going wrong with my condition were minimal and actually on a par with something going wrong in a VBAC, so very small indeed! There was actually NO reason for my c-section!!! I have since had other medical opinions to support this!

I never heard my son's first cries. I never had that first newborn cuddle. I never saw him as a newly born bub. My first sight of him was nearly 2 hours later and he was clothed!!! I have no birth experience at all and the sole reason being medical conservatism and ultimately, incompetence.

No woman should have to go what I went through.

What I went through in having a c-section under a general cannot be justified as an emergency or life-saving for me or bubs. In some cases, there is no other choice but this was not situation in my case.

I still struggle with having being denied a birth experience and I truly hope that no-one else here ever has to go through it without it being a true emergency!

I think most of the negative opinions on c-sections come from women being denied true choices! C-sections are not wrong, but they are wrong when the justification for them given by a treating doctor is wrong and based on false information and ignorance!

[Tobily]

but i'm rather curious as to why people have so many different views about a procedure that is in most cases medically necessary and life-saving.

This is pretty much where my problem with c/sections starts and ends.
Australia has one of the highest rates of caesareans in the world. The World Health Organisation recommends a rate of around 5% (I'm haven't got time to check these figures but I think they're close, someone will correct me no doubt ). Australia's averages around 30% I think, in some private hospitals it is MUCH higher. So there's a huge discrepancy between the 5% the WHO thinks are medically necessary/life saving, and the 30-something percent that are actually being done.
What are the reasons for that additional 25%? They are not done to save lives, and mostly they're not even done for the convenience of the mother. They are mostly done because some obstetrician is freaked out about getting sued.

It's a disgrace.
I have been on the end of what I believe to be an unecessary c/section so this topic is close to my heart.
If I for one second believed my son would have died during that labour I would've been in the OR without a second thought.
But the fact is that he should never have been in the situation that caused him to get distressed in the first place. I was set up for a caesar without my even realising it. It is for this reason that I'm still having trouble dealing with his birth, nine months down the track. I squarely blame my OB for that (and myself since I went along with it. But at the time I didn't know any better). I do now, but other women after me will continue to be subjected to unjustified, unnecessary birth trauma because they believe that their doctor knows what's best for them, under any circumstance. I no longer believe that doctors (or surgeons god forbid, which is what ob's are) have any place in normal birth.

[becmc]

Wow, Flea and Trinnie, thankyou for posting, I am glad I am not the only one who feels their c/s was unnecessary.
I will never get over it, however, I spent so much time feeling guilty about feeling ripped off by the experience, iykwim?? Everyone says, but you have a healthy baby, which is of course the most important thing, but not the only thing that matters.
But you know, I said for ages, I blamed the hospital and ob for what happened. And then when I hired my doula, who has had a vbac herself and was traumatised by the first experience, she said that for ages she blamed the doctors, and she then realised the responsibility was actually on her for not being informed in the first place! So, now I believe, that yes the doctors need to get their act together, but we also need to get informed and know our rights before going in there.

[aussienic]

I say *yay* for c/s.. I had one natural text book labour the MW said... I was dead against a c/s but had one with my 2nd chose it for my 3rd and choosing it again...

[Inanna]

:hugs: Trinnie, Flea and Emma...

[CatherineL]

What i can't understand is, why are people so obssessed with the figures? At the end of the day isn't what every mother wants, a healthy child despite which way it was born into the world? And regardless how the mother births or chooses to birth her child, shouldn't she be supported? Isn't that the right of freedom? Isn't that what Australia is renowned for? Isn't that what this very website is for - so we as women can choose how we wish to birth in whatever way that may be?

[becmc]

The thing is though, Catherine, and what concerns me is that women are being talked into unnecessary c/s that therefore put their baby in more danger.
If women choose elective for whatever reason, and know the risks and are happy to go with that because of personal reasons then that is great for them, but those of us that are coerced into unnecessary surgery are putting our babies at more risk, and I think that is what needs to be addressed.

[Tobily]

What i can't understand is, why are people so obssessed with the figures? At the end of the day isn't what every mother wants, a healthy child despite which way it was born into the world? And regardless how the mother births or chooses to birth her child, shouldn't she be supported? Isn't that the right of freedom? Isn't that what Australia is renowned for? Isn't that what this very website is for - so we as women can choose how we wish to birth in whatever way that may be?

Absolutely Catherine - everyone wants a healthy mother and baby as the outcome.

But being treated respectfully and having a positive birth, and also getting the outcome of a healthy baby, are NOT mutually exclusive. Women can and SHOULD get both.

I have no problem with women exercising their right to make an informed choice and have a caesarean if that is what they want.

What I do have a problem with is being lied to, bullied, coerced and pretty much physically assaulted. Having my choices taken away, my wishes ignored, and my dignity as a human being completely disregarded.

That is effectively what happens to women who go into birth in hospital without doing research as I did. Hospitals are primarily looking out for their own best interests first, and the emotional wellbeing of the women in their care is pretty low on their list of priorities unfortunately.

[trinnie]

Having my choices taken away, my wishes ignored, and my dignity as a human being completely disregarded.

That is effectively what happens to women who go into birth in hospital without doing research as I did. Hospitals are primarily looking out for their own best interests first, and the emotional wellbeing of the women in their care is pretty low on their list of priorities unfortunately.

Oh Flea - you are so like me!!

Yes, ladies the emotional wellbeing of the women in their care is pretty low on their list of priorities. I BEGGED the maternity unit manager, herself a midwife, to refer me to a counsellor so I could talk about what had happened - she REFUSED and point blank told me that there was no-one she could refer me to. Another midwife at the hospital had told me to talk to the manager because she could she how badly I was struggling. Fat lot of use that did me - they simply do not care and I did told her I did not feel comfortable asking my OB - especially because he refuse to treat me as I wanted to be treated!!!