Vaginal birth dying out?

It's seems like vaginal birth it dying out to the "easier" option of Cesar I am the only one if my friends who has had a baby via the conventional route all my friends were scared into cs for big baby (4kg) or breech when she was already 4cm or just plain not wanting to go through labour.

Am I silly for thinking I would try to deliver vaginally in those circumstances (no offense to people who have to have cs) I just think cs is used unnecessarily sometimes especially for the risks associated with it

I think any kind of natural birth is abnormal, particularly in private hospitals. When the midwives all came to check me on shift changes after DD3 was born, every one of them first asked to see my epidural site, and then all of them made all sorts of surprised mutterings that I didn't have one. I'm all for intervention when its necessary, but when a woman who births vaginally without an epidural is considered a rarity there is something definitely wrong.

Everyone has the right to choose the birth they want, but hopefully they're making those choices with all the facts

There are different types of breech presentation - some are deliverable, so are not...So unless you know the specifics, then I would probably give the benefit of the doubt to care providers and the woman making the choice.
But yes, caesareans are often performed when not medically necessary, or when medically necessary due to other medical interventions that were unnecessary in themselves.
Really though, it is the woman's choice - even if you don't like or agree with her choice - so long as she is making an informed choice from evidence and not fear, then one can't ask for anything else.

Lulu, its funny you mention epidurals. When i was in prelabour with DS i was being monitored and an OB came in asked about DD's birth and i mentioned she was posterior and the first thing she said was "oh so you had a c section?" i said no and before i could go on she said "you would have had an epidural then?" and i said no again and she looked shocked and then gave me a hi 5 and said i was 'super mum' and that a lot of women opt for either.

It is used unnecessarily, absolutely. There's lots of evidence of that. But ultimately, it's each woman's responsibility to chose the way she wants to birth. It is unfortunate when women get bullied into a certain route, or when they simply don't know they have options. It does make me sad. But it's not my birth. I used to feel differently about this, but now I realise that not much will change, and it doesn't bother me. The only time it does is either when women are bullied and badgered into a birth that isn't necessary or good for the mother and baby, or when the choice to have a certain type of birth impacts negatively on another, ie when say, episiotomies are so common in some hospitals that its assumed the mother will be fine with it, and so lowers the status quo for everyone. That's wrong. Yes our birth culture is a lot more medicalised...my view is, so long as it doesn't impact negatively on how *I* want to give birth (which unfortunately it sometimes does) it's not my business. I try to block out negative, counterintuitive births to the one I had and the ones I want to have, because in my later pregnant state I find them derailing and unhelpful.

I'm all for informed choice but to be honest I don't see much of it when it comes to birth choices. It's not informed choice if you're too scared to say no, and I see a lot of 'informed choices' like this. Blindly believing a care provider with out seeking any information yourself and thinking you are fully informed:( I was guilty if this twice 21 years ago.

I hope natural vaginal births don't die out. Maybe the trend will come back around to natural births again.

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and said i was 'super mum' and that a lot of women opt for either.

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I think that's part of the problem though LMS. I got that sort of comment too but I don't think its helpful. Am I proud of my two drug free births? Yep, but no more so than my induced, epiduralised birth of DD1. I birthed three children without complications for me or them, but no birth was any more of a victory IYKWIM. Maybe if birthing wasn't turned into an extreme sport by some women and lots of HCP things would be different

The CS rate is now on the decline in the US, I will see if I can find the source for that tidbit, but I read it in the last few months. So I like to hope that the message is getting out there women ourselves must take back not only the power, but the responsibilty, of birth and pregnancy choices. I agree with PZ. In this day and age, there is no excuse for a middle class woman not to use the information she has free and very easy access to to inform and empower herself.

I think we all have our own experiences which are valid but I haven't really witnessed any of these things and I had one birth with a couple of puffs of gas that I soon ditched and one drug free in the private system with a private OB (same one both times)... no forceps or tearing or cutting. Nobody ever made a big deal out of it really, it just was. In my first birth I was offered gas which I tried but disliked, I wasn't offered anything further (and during transition got a little irrationally annoyed in my head but was thankful afterwards lol). In my second I wasn't even offered gas. Both times bub was put on my chest to feed while the cord was still attached, I never asked for delayed clamping but they waited and I heard the midwife explain to the student midwife there about delayed clamping too which impressed me after all the horror stories I've heard it just wasn't my experience at all. I never had the gbs swab, I only had one scan with either pregnancy (morphology at 20w), I never even heard the terms stretch and sweep or induction (although first came spontaneously at 38w and second at 40w 3d so might have happened later). I was encouraged into the shower, to move, to use the birth ball and to birth in a more squatting position (although ended up on my side in bed because that was what was comfy for me, they always supported my choices although explained how squatting would assist and offered ways to support me being on my legs I just really wanted to lay down lol). They were really hands off and felt led by me.

I think there are some places swinging back to a more 'natural' approach. Or maybe I just got lucky, I'm not sure. I don't really know much about anybody else's birth, I was pretty surprised how it never really came up at mother's group or anything. Maybe that is part of the problem, nobody talking about it?

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The CS rate is now on the decline in the US, I will see if I can find the source for that tidbit, but I read it in the last few months. So I like to hope that the message is getting out there women ourselves must take back not only the power, but the responsibilty, of birth and pregnancy choices. I agree with PZ. In this day and age, there is no excuse for a middle class woman not to use the information she has free and very easy access to to inform and empower herself.

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I heard that somewhere too Lime about the declining c/s rate. I completely agree it is so easy to find information yourself these days. I guess not everyone is motivated to, or maybe it just doesn't occur to them to do so. It doesn't help that mainstream TV shows and movies etc still hardly ever portray a natural birth. You get more laughs from the comical 'I want drugs or a c/s one' so with that and consulting with your OB, and there are fewer that will lead you in the direction of natural, or even give you both sides of the coin. Hopefully the change will start with the doctors and nurses and filter through.

The rates have a long way to go at private hospitals in WA. There was an article in The West last week I think saying we had the highest in the country, and the four biggest private maternity hospitals were all up around or above the 50% rate for csections.

It's probably just the people you hang out with, it's quite the opposite among my friends. Most who have had c/s births planned vaginal births and a lot have planned or plan to plan (lol) VBACs afterwards. I actually thought the the amount of people planning vaginal birth, and particularly planning informed, empowering vaginal birth, is on the rise again. Although that might just reflect the people a associate with...

I think the focus should always be on calm, mother-centred, informed, empowering birth, regardless of the mode, but this would require effort of the parts of the medical staff, the birthing mother, and also the media for portraying such bizarre ideas about birth, and people around the birthing mother to stop perpetuating the c.s/v.b divide. Of course, vaginal birth is normal. Being cut open isn't normal. But it is still birth.

If a mother is informed, and makes the decision best for her, who can say that she right or wrong? Something I have been thinking recently is this idea of 'medically indicated' cesareans and unnecessary cesareans, and often if a mother chooses a cesarean without a physical health condition that warrants it, there is this idea that she is wrong and obviously uninformed. BUT, what is she chooses a cesarean for mental health reasons? Mental health is as relevant and as influencing in this argument. So this mother, she makes an informed decision, but chooses not to share her reasons with anyone. She doesn't want to talk about her reasons, and uses an 'excuse' to get you off her case... immediately she's labeled - uninformed/manipulated/victim of the system... It's a sticky grey area because someone very pro-vaginal can come across as being very ignorant and arrogant for assuming that she is uninformed and assuming that because she is physically healthy that she is making the wrong decision. But of course, how do you know this is the case, that she is making an informed decision and not being manipulated as a matter of conveniance? Should we assume mothers are informed or uninformed? Who holds the responsibility of informing women about birth choices?

Interesting ponderings.

Who holds the responsibility of informing women on birth choices? In this day and age, ourselves! There is no excuse not to, there is no reason why it isn't possible, only ignorance. Do women need good supports around them to help them make that happen? Absolutely! Is that the case for every woman? Sadly, no. But there really is no excuse to be uninformed in modern day Australia, it's a choice to stay in the dark.

Do you think its all ignorance though PZ, or still some of that mythical god like view some people have of doctors? I tend to think a lot of people still have the view that if a doctor/OB tells them something, then that's the absolute beginning and end of it all.

I see nothing wrong with choosing a c/s for mental health reasons, nothing at all. Mental health is no less important than physical health and both go hand in hand. As for responsibility of information, it should be the responsibility of the woman's care person, be it doctor, midwife whoever IMO. Unfortunately this seems to be a diminished practice for a lot and honestly if you don't have an excellent doctor or midwife willing to give you all of the actual facts, it's probably in your best interest to find out for yourself. I honestly think most doctors now believe what they tell patients without using any common sense or initiative. I question any doctor who will willing give the option of an elective c/s for convenience reasons, i.e. going on holiday or wanting a certain date for the birthday, I just don't think the benefit out weights the risk in those type of situations.

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Do you think its all ignorance though PZ, or still some of that mythical god like view some people have of doctors? I tend to think a lot of people still have the view that if a doctor/OB tells them something, then that's the absolute beginning and end of it all.

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Some ignorance, but like you say a lot of people still think doctors are god like. We shouldn't have to question our medical professionals, we should be able to look to them for guidance and facts, which you just don't always get these days.

I think that giving absolute faith over to an OB (or any care provider) without knowing why they are is ignorant, so to me it's the same thing itms?

I absolutely agree Willow, just I don't think its the case. I think some are great, but not all and you really need to do your research first to make sure you get one those beliefs are in line with your own. I want to thump my SIL for her choice in OB (she's looking at her second csection soon), but its her choice. She's an intelligent woman with all the access to information I have, so I need to respect her decision however much I disagree with it.

I had a scheduled CS with DD at 38w1. This wasn't my preference, nor that of my ob but based on the information we had to hand the choice we made. It's been both a good thing and a bad thing for me.

We (DH, me and ob) took over 2 weeks to make the decision and I researched everything I could get my hands on, both IRL and URL.

I didn't have the birth I had planned and hoped for, but the choice we made meant that DD arrived safely and healthy which may not have happened had we ended up in a situation with an emergency CS

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I had a scheduled CS with DD at 38w1. This wasn't my preference, nor that of my ob but based on the information we had to hand the choice we made. It's been both a good thing and a bad thing for me.

We (DH, me and ob) took over 2 weeks to make the decision and I researched everything I could get my hands on, both IRL and URL.

I didn't have the birth I had planned and hoped for, but the choice we made meant that DD arrived safely and healthy which may not have happened had we ended up in a situation with an emergency CS

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That to me is a completely informed choice. Sorry you didn't get the birth you'd hoped for. but a healthy baby is paramount. Well done for researching all you could .

yep. what Willow said. Good on you.

I agree with willow Emma that seems well informed I'm not saying that some cs aren't needed they are there for a reason

I owed it to myself and my gorgeous girl do to all the research I could and check every option I could. I wish that everyone had the confidence and support to do what I did

If the c/s rate is declining in the US, I wonder if that's related to the new policy in some states or hospitals that noone is induced before 39 weeks without a very good medical reason.

That's good to hear though because every American pregnancy show I've watched has a lot of cs and intervention

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If the c/s rate is declining in the US, I wonder if that's related to the new policy in some states or hospitals that noone is induced before 39 weeks without a very good medical reason.

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I'd say this would be a big factor. But also, the rate of instrumental deliveries and epidurals is still inclining. So less babies born surgically but still a huge number instrumentally.

Not around these parts. I have lived in this town for 4.5 years, know of about 2 dozen babies born and none have been c-sections.

I am one of three sisters and I also have a SIL. Between us we have six children. We all live in major cities with access to all possible health care options. Three were c/s and three were VBs. interestingly, every one of the c/s was in a private hospital. Two of the VBs were in a public hospital and my DD2 at home.

Of the c/ss, one was 'elective' on the advice of a risk-averse ob, one followed an induction and another the usual cascade of intervention in a private hospital. In the care of midwives, the other three births were completely problem-free and intervention-free (one a 'risky' VBAC).

Choose your care providers carefully, as well as where you give birth. Unfortunately, the statistics do represent the majority of women.

I went through private hospital for my vag delivery and I do worry about how much they intervene I'm very lucky that I had ds very quickly all my friends who had cs were also at this hosp but the alternative is an overfilled understaffed public hospital where I live

One alternative is the public hospital... ;) You could birth at home! :D

I think the hospital you birth at has a huge amount to do with it as well. DS was breech,and I was quite set on having a c section, and while I was waiting for the ultrasound to see how he was laying, 2 of the midwifes came in with info on breech birth, and offers to put me in contact with other mum's they knew of that had birthed breech babies. He ended up being in a position (I think it was frank breech) that a c section was the better option for me, much to the midwives dissapointment. With the twins my ob pushed and pushed me to have a vbac. I wasn't really keen on it - call me uninformed or whatever you like, but it was what I was comfortable with - and ended up really hating him, but he managed to bargain me down to if my body went into labour naturally, then we would 'go with the flow'. Well, he got his vbac :), and I must say it was amazing. We were transfered to a larger city hospital after the girls were born, and the nurses there said there was no way the hosptial would of let me have a vaginal birth there. I always think how lucky I was to have our hospital, and for all their support and advice, I would hate to think how much pressure you would be under if your hospital used the same measures to dissuade you from your choice, rather than support a vaginal, vbac, breech etc birth.

C/S rates at private hospitals are really worrisome. Too many first time mothers being induced (with the very high likelihood of a c/s) and then not being 'allowed' to VBAC.
Informed consent is crucial and often absent. Unfortunately sometimes it doesn't matter how well informed you are....

I wonder how much impact the push in Australia (and government pressure) to join private health funds is having on birth statistics?

Since birthing dd2 I have been astounded by the number of people shocked that I was "allowed" to to deliver vaginally. With a private obs, no less! And sadly a number of friends were told that they had to have a c/s due to breech presentation. They couldn't tell me if bub had been frank, footling or flex breech, and hadn't even been offered ECV or scans to see if bub would fit. Most tried chiro and/or acupuncture, but didn't question their caregivers about other options.

I'm so glad my obs respected my wish for a vaginal birth. There is now a breech clinic at Westmead so had he pushed for a c/s I would have gone there. But I live in the catchment area for that hospital - it's a shame that so many obs and midwives lack the experience. When I had the ECV (bub turned three times and flipped straight back) and obs gave me paperwork for scans, the midwife wished me luck but said not to turn up on her shift as "breech births are scary" :-(