Why all the opinions on c-sections?

[Berry]

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.

How much more research do I need to do??? I have spoken in detail with five obstetricians, been to caesarian as well as vaginal ante-natal classes and asked millions of questions, given birth vaginally as well as by c-section, I have two shelves of maternity/pregnancy/baby books include recent books about caesarian and vaginal birth and have read them all, I am an active member of 3 pregnancy forums, and I have spent hours at Melb Uni researching obstetrics and related journals when I was thinking of doing a paper on AND/PND. So please don't suggest I haven't done my research. And by the way, to clear up another presumption, my obstetrician is FEMALE.

[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

[Trish]

Fantastic post Bec. There is no way to compete with that. You've said it all.

[castle]

Great post Bec. I gave the first response to Keira, knowing that there would be a snowstorm of others
Just thought maybe I'd amplify my own response a bit. I've had 2 c/secs, both of which I'm grateful for. I was highly informed all the way and had chosen carers with very low c/sec rates, both times. My first (first birth) was a situation similar but not quite as bad as Bec described with her friend...yes I probably could continued to labour but it would have been long, exhausting, & could likely have required a c/sec anyway. Because I had bent over backwards to choose an environment and carers who were committed to vaginal birth as the norm, the advice to have one carried more weight. Although I felt and still feel that it was the right decision, even so it took me a full year to really come to terms with it.
Following that I had 2 VBACs. Neither were particularly easy births...I seem to specialize in long labours and babies who present in less common ways Both were totally natural deliveries. Having experienced both, there is no comparison between a caesarean and a vaginal delivery.
My next c/sec was for completely different reasons: PPROM and poor doppler flow to the placenta. We scheduled a c/sec but ended up with an emergency one because I went into labour. Again, I had a midwife and supervising OB who were very committed to VBAC and recommended a caesarean with reluctance. Once more, I could have insisted on a vaginal delivery if I wanted to. My doctor told me that if the labour went very quickly and I ended up delivering vaginally, before I got into theatre, that probably all would be well anyway. I felt comfortable, although very disappointed, with the decision for a c/sec because I was very well informed and felt that my doctor and I were on the same page.
Being interrupted by little ones, so I can't finish!!

[gina]

Hi all,

What a great debate. Everyone has an opinion. I agree with all of you. Its what you feel comfortable with and what happens at the time - two different stories! I am 22 weeks pg with twins and have been told that due to a weak uterus that it would be more than advisable that i have a c/s. I am scared as hell. I would otherwise have to consider that i could haemmorage with a v/birth as i would put too much pressure on my insides as i have had 2 ectopics. So like you all have said so well - it depends on the situation. I am scheduled to have my baby boys at 36 weeks. I wonder if this is actually going to happen. Everyone wants the best for thier bubs and for mum. Whatever decision is made is going to be ok and the right one at the time. Regrets in life will happen with anything. As long as the health of yourself and bubs is taken into first priority and decision you are on the right track to see your beautiful baby.

xoxoxo Gina

[fionas]

For a first-timer at 37 weeks, I would like to thank BellyBelly and Kelly for the massses of information and opinions on these and other topics. It can be confusing but hey, that's life and we all have to make decisions that we're happy with.

I'd like to ask/suggest the following:

1. Could someone (possibly a doula group) please lobby for greater transparency in obstetrician's caesarean rates. As a first-timer, I was unaware of how heated the caesarean debate was and the implications it may have for me when I first chose my obstetrician. And although I'm not a unassertive person, there was something about rocking up to an obstetrician asking to know his c-section rate that scared the bejesus out of me. Now, if I had a list on BellyBelly which gave me an obstetrician-by-obstetrician breakdown of c-section rates, that would have allowed me to have made a more informed choice. By a complete fluke, I've ended up with an obstetrician who has the lowest caesarean rate in Melbourne (Guy Skinner) so I'm absolutely delighted with my 'choice'. I'm not saying that the medical fraternity would welcome such a list and that it would be as simple as I'm making it sound but ... I'm a great believer in taking something difficult and making it happen. At the moment, it is reasonably easy to access c-section rates for hospitals but this doesn't really help as it's the ob you're primarily dealing with.

2. Someone else has touched on this but could someone please advise on your rights re seeking a second opinion during labour? I'm not talking a doula here (and I'm not saying that doulas aren't a good idea but at the moment the majority of women in hospital deliver WITHOUT a doula so let's address the reality of the situation first). From the posts in this thread, the main bone of contention seems to be that women can be advised to have a c-section by obs who are overstating the danger of the situation. In those circumstances, I imagine, it would be very difficult to remember all the ins and outs of an article you read on BellyBelly but it may be possible to get out that you'd like a second opinion. I realise this is not ideal and may not be practical, but I would just like to ask whether anyone has done this and with what results?

Fiona

[Julie Doula]

1. Could someone (possibly a doula group) please lobby for greater transparency in obstetrician's caesarean rates.
2. could someone please advise on your rights re seeking a second opinion during labour?

Good suggestions. I would strongly suggest widening the choice from choosing between obstetricians/hospitals to including birth centres and Independant Midwives.

You will get varying opinions within the medical model, but if you carry your research & questioning wider than that and seek a second opinion from personnel skilled in the Midwifery Model, you will get a completely different philosophy, solutions & alternatives. Choices you are not likely to become aware of, if those you are polling are staff within the medical model.

Ways & means by which one can do this:

* Consider alternatives to having an Obstetrician as your lead careprovider
* Consider alternatives to a hospital as your choice of birth place
* If you do wish to have an Obstetrician, get a second opinion from an Indy MW, just as a way of comparing
* If you feel you may wish to have access to a second opinion in labour, hire an Indy MW to accompany you - BB's Alan's sig says: "private midwifery for home and hospital".
* Search the midwifery, especially the homebirth midwifery community for information, not only medical journals etc.

These steps will surely yield different information and options. This knowledge may then serve to either help you feel confident to choose a different model of care OR it will serve to help become even more sure that what you've chosen is desirable.

[BellyBelly]

But WHO is trying to talk anyone out of a C/S? Come on, give me some proof. This gets mentioned all the time, no-one is hammering anyone here to change, this is just an exchange of information from many women. This is the reality of a forum.

forum

noun
1. a public meeting or assembly for open discussion
2. a public facility to meet for open discussion

WordNet® 3.0, © 2006 by Princeton University.

Some women know something others may not so they are sharing what they know or have learnt, sadly some the hard way...

I'm getting quite fed up that people think that anyone is trying to convince anyone to do anything - no-one here is - in fact if anyone in this thread is intending to change someone's mind, can you please put your hand up? Because all I see it as, is people sharing what they know and have been through. I truly, truly, truly, do not care what birth anyone chooses, absolutely nothing to do with me, does not effect me and I don't get paid for each person I 'convert' LOL! Why would I want to change someone who has nothing to do with me?

I do believe in sharing information so that others reading discussions don't read that 'my baby was too big for my pelvis' and think that is gospel and quite common, and could be a problem for them. I want them to know that hey, this is very rare and there are options. So I am not trying to convince or change anyone, I am just hoping that it will help others keep their mind open and not believe everything they read... they need to know they need to do their homework. Some in here have done that, great! So no need to feel guilty or bad or attacked for your decisions if you have.

Again, I really do not care what birth people have. People pay me to help them have the birth they are planning, vast majority that goes to plan and everyone is happy. I don't feel a need to do that for strangers unless they ask me for help specifically of course. I do know many women want genuine help and information and thats why they come to a forum (again, see definition above).

I personally feel that if I was to let a comment go, like the pelvis thing, I was doing a disservice, especially given my role and involvement with the birth industry - I don't want those people thinking I have great thoughts and ideas and my heart is in the right place, but let my forum be like all the others and don't act on what I believe in when I have such an opportunity to give a different view. I also feel that I should be able to contribute on my own forum. Sorry if people don't like it that I take part and interact with the people in my forum and I know some of you have this 'authority' complex, but I know many women have had empowering births as a result and I think I have been extremely fair on the forums. Some women have not seen any benefit in what I say straight away, some it has taken their next birth... but many do have great births because they wanted to know and have read something I have contributed.

So lets get back onto supporting one another, accepting that we all have something to bring to the table and not shooting anyone down just because they have a different opinion. We can all share based on our own, unique experiences and if you put all of those together you can be in a great position of power. You might find another question you would like to ask your doctor. You might find another alternative you would like to discuss with you doctor, that you wouldn't otherwise thought of.

You are the one who chooses to feel attacked, victimised, guilty, ashamed, embarassed, angry etc... sorry but we are not in control of that. If anyone says or does anything that we believe to be inappropriate we will deal with it. But I think everyone needs to realise that this is not all about them. This is the nature of the forums, BellyBelly will always have an infomative and educational tangent. I wont give advice on anything I do not feel I have facts to back it up and there are plenty of other places on the web, which let conversations go in their own directions - without support or information from intelligent, strong and empowered women, if you find BB too confronting. But I think you will find no matter where you go, people are going to disagree with you about something, if not birth, then parenting etc. Look within yourself and ask yourself why this is effecting you so much.

No-one knows anyone's real background, we are not mindreaders so don't lash out for people sharing information if it's not in line with your own beliefs and experiences.

[becmc]

Caro, I do agree with what you said and that post from Kiki is presuming that Berry has not done the research already. Sorry Berry that you feel people are questioning your decision.

I think we have to agree though, again, that the majority of us are talking about emergency c/s's during labour due to poor advice from obs.

[becmc]

Fiona,
The best way for a second medical opinion would be take a private midwife to hospital with you, which I was going to do for this birth but then we decided on homebirth.

Just from my first experience,
I was induced due to being ten days over but baby and I were fine, my first big mistake, the ob actually told me there was no way I would go into labour naturally! (midwife probably would have suggested waiting a bit longer),
In full on labour was made to lie on back, was told baby was in severe distress (midwife would have suggested changing position as lying on back cuts off oxygen to bub causing distress, midwife would have told me babies heart rate only went down to 120bpm which is far from distressed),
after c/s baby was perfectly fine but taken away from me immediately and i was wheeled to recovery alone (midwife may have suggested to me that i request holding baby and dh/bub to come to recovery).

That is just an example of things that can happen and at the time you don't really think any different but having someone there with a second opinion really can make all the difference. I firmly believe I would have avoided my c/s had I have had a private midwife there.

Private midwives can't do anything medical in hospital, but can certainly offer advice and be an advocate for your rights.

[Inanna]

Monnie: I hear you and I understand :hugs: It is a minefield of information out there. I can't comment on your situation as I don't know your medical condition... However, uterine surgery does not usually preclude a woman from a vaginal birth. Sometimes more information can be confusing - it sounds like you have done lots of reading and interviewing of carers... I hope that whatever you decide you feel at peace with.
I don't think people are saying a woman should not have a c/section - no-one is saying that. You will be supported whatever your choice... :hugs: I understand that great responsibility with that little person inside. I also agree as a collective we have at times become out of touch with our instincts. But they are there. If we sit quietly and let it happen... Sometimes things can become clearer...

I loved your post Bec it was excellent.

I think we need to hear others without defense. When we feel defensive it's about us not about the other person. I think that's what happens sometimes with these discussions. I too think Berry that your story is quite different from many of the others on here. You have made what you believe to be an informed decision. You feel very at peace with that decision and have weighed the risks and benefits.

The other women did not get that chance. It's a bit like comparing apples with oranges in my humble opinion.

If you choose a surgical birth or a natural birth and you are fully informed and comfortable, you have an advocate, good support and confidence in your carer that's going to give you the best birth experience.

Women are having their babies surgically removed from their bodies when they feel they have not been given the full story. This is a huge issue for these women. For some women the process of labour and birth is very very important. So, when that process is halted and a differing path is taken it can cause trauma. Interestingly women who have really educated themselves, have good birth support/advocacy and confidence and belief in their bodies have very few interventions.

Caro: I disagree that this is a hammering... I think this is an exchange of opinion, experience and a sharing of knowledge. If a woman feels torn that says she hasn't come to a place of comfort with her decision. That's okay - that's how decisions are made. Again, it can be confronting if perhaps you hadn't thought of that scenario or this... Why are we so afraid of the challenge of a differing opinion/experience/knowledge base?

Hoobley had it in one. It's about kindness and support. Understanding that we don't know what happens for another in their heads in the wee hours. But I passionately belieave we shouldn't just shut up and not express our experience and knowledge in case someone feels miffed. When the sharing is done as respectfully as it has been in this thread it can only be a positive for women and for birthing...

[Astrid]

One thing that has been assumed here is that all women are choosing their ob's, well that is not the case if you go public. It is really the luck of the draw as to who is on when you are in labour. So no shopping around to be had, in my case I would never have chosen any of the obs who I had dealings with during my pregnancy and labour.

As for judging, we all get judged. I am judged for having an emergency c-section. I am judged for being upset that I did not get the birth I want. I am sneered at and looked at like I am freak for still wanting to have natural vaginal birth 2nd time around (if there is one) and for having wanted one for my first birth. As mums and as mums to be we need to develop thick skins.

[BellyBelly]

Lynn I agree that most Obs do what they think is best at the time, they are trained that way and of course, who is going to go against their own training? So I think we need to look further back than just the Obs, the training is just as important to tackle. Many ob practices/polices in hospitals do go against WHO and other recommendations for optimal birth outcomes. There is a difference between latest technology and quality of care.

[BellyBelly]

I can understand you feeling that way too Lynn, I am sorry for your loss hon.

[Inanna]

:hugs: Lynn if positive thought and support mean anything this time you will win. We can't change the past and make it better but we can make next time different...

As Kelly said I believe that obs do do what they think is best at the time most of the time. Sometimes though some care providers (midwives are not exempt here!) find it difficult to hear women. Our "system" is not set up so that a woman and her care provider know each other. When we have midwifery one on one care or an obstetrician that is willing to sit and listen and talk. We talk of our fears and our joys. It sets up a support system. This can be difficult with an obstetrician. Simply the time restraints and the manner of what the care is. Obstetric care is medical care. Now some of us need that for some births. What a blessing we have access to it. But we shouldn't take what we are given if we are not happy. This person is going to share the most intimate moments of our life. We hve to like them, feel safe with them, have a belief that their opinions and options are congruent with ours. There is no point liking someone if we want to have a breech vaginal birth and our obs says no way! Or if we want a water birth and our obs says no way! We need to treat finding a careprovider as we would any service. We dont' and we shouldn't settle. Sometimes we have to make some allowances, some room to move and change... That's flexibility and it's important in all human relationships.

I think everyone wants the outcome of a healthy live child at the end of the birthing process. Emergency c/sections are an absolute blessing when they are needed and warranted. Some women have c/sections for reasons that they believe are not warranted.

For me the process of labour and birth is sacred. I believe there is an importance to that process, that the labour gives birth not just to a child but to a mother. No matter how many times a woman has become a mother each time is different and I believe important. I know when I birthed my tiny still baby - I felt I had given him the passage. I can't explain why or how. It somehow felt complete. Devastatingly complete but complete.

Now, if I need to have a c/section because my body can't get this baby in my belly out. Then I will thank the Universe for the scalpel. But my obs knows this is my last resort. That FOR ME FOR THIS BIrth I want to heal. I want to give life through my vagina. I want to touch that head as it crowns and hold that little person like I will never let go... That's what I need for me. I have chosen a woman care provider/obs who respects my choices and I respect her. I am growing to trust her and I certainly respect and am in awe of her support of women and their birthing choices. This is what I need... The road to finding her was treachourous! I interviewed lots before I could sigh and say... I am good!

For a woman who has said goodbye before she has said hello sometimes the fear is too great. The pain and memory is too great. How beautiful that we have choice. We have support and kindness and understanding. We have access to information and knowledge.

You will birth *Hope* Lynn in the best way for you and you will be fully supported and helped through that process...

[Berry]

I think its great to talk about the pros and cons of things but if someone is near birth and has made their mind up to have a C Section for various reasons hammering the cr$p out of them isnt going to do anything but confuse them and upset them before their birth....IMO

Thanks for your understanding, caro - I think you're making a really important point here and well done to you for having the courage to speak out.

I made up my mind at my first ob appointment, not lightly but after much indecision and considering options and information from lots of sources, that I will go with an elective caesarian this time. I am due to give birth in a couple of months, and it is quite an anxious time especially as last time I gave birth circumstances were perilous particularly for my baby. I come on this forum in the hope of feeling supported and to get feedback and information. I think healthy debate is great but only if it is constructive, not aggressive criticism. I may be in the minority by choosing to have a caesarian, but isn't this all the more reason to be allowed a little morale-boosting encouragement? My emergency c-section last time was to save my baby's life, not some whim of mine, and I feel a little upset about generalist talk of unnecessary emergency c-sections (even if not specifically targeted at me, it is still hurtful) as I saw my almost lifeless child emerge to be whisked off to NICU, followed by a rancid deteriorated placenta and you can't tell me I didn't really need an emergency caesarian.