*rant alert*
The Observer, Why Mothers Should be Offered Caesareans.
Job to know where to start on that one, though “f*ck off you stupid, ill-informed Daily Mail style ‘journalist’ bint” might be quite a good start. 🙄
Judging by the comments on the Observer Blog quite a few people feel the same.
Why shouldn’t we offer caesareans to non-medically indicated but frightened of labour (and frightened of a ‘too saggy for sex vagina’ (hand me that patriarchy file!) ) women? Oh now let’s think… because it costs twice as much, because it’s major abdominal surgery, because it leaves you with significant danger of a baby with birth difficulties, of having bladder damage, it heightens your chances of PND, because it is a MAJOR operation, you stupid woman. Honestly, when in danger of having nothing to write for your column this week, let’s go for adding hype and hysteria to the mystery of natural childbirth shall we?
Why don’t we offer caesareans to mothers who just want them? Do we offer colostomy bags to people with slight constipation? Get a life Jo Revill and talk to your sister about her caesarean in a few months; 13 days after does not a full emotional picture make. And if you ever make it here, read a few of my post caesarean posts in the “rant” section here. I might even provide you with a decent story. Jeez, my Dad has always been proud of his professional status as a journalist for a National Daily; you make a mockery of it, woman.
*end of rant*
layla says
Merry, I couldn’t agree more.
Missy’s death was absolutely tragic, I can’t imagine how her family are going to manage, it is completely devastating. I believe she had an amniotic fluid embolism, which isn’t really related to the section though.
merry says
I wasn’t aware that was what it was called so didn’t realise it was not something that could happen during any type of birth. I meant to blog my sadness about it earlier in the week; it just sort of popped out there.
I stand corrected by your greater wisdom 🙂 I’ll edit that bit out since it isn’t relevant.
Doesn’t alter the fact that touting c/s as a safe and desirable option to preserve ones body for sex or because it all sounds scary or painful isn’t a good thing though. Nor suggesting that choosing a c/s for no good medical, or precious baby reason (which i understand), makes any sort of economic sense. 3 unneccesary sections cost enough extra money for one addition cleft operation, or heart defect operation or whatever.
I think journalism of that type sucks and it’s my blog and i’ll say it if i want to 😉
Debbie says
WAHEY you found your rant button! You’re not broken after all!
Actually it was possibly all your ranting on this subject that totally put me to rights on the issue before Jaws was born – much less likely to be bullied, so rant away – people will find it very informative.
Jax says
None of you noticed my comment in the thread on the above mentioned blog then? It’s there…
merry says
I found it 🙂
Hey Debbie, glad to be of service 🙂
merry says
I too can put in a very good case for essential ones. I’d be missing a daughter without one.
TBH though, while the evolution of small hipped babies is convincing in some ways, i think the sad fact is that lots of emergency sections happen because of poor labour care and lack of true choice and information. “Yes you can labour but you must lie on your back with this monitor on to PROTECT you” not being much of an informed choice. And even then, emergency sections are one thing, vanity/choice for social reasons ones are quite another.
And equally while i can, as i say, vouch for a genuine section, too many people get told that they’ve “had their babies life saved” and believe it – it simply isn’t always true. i doubt a medic would sidle up afterwards and say “Bad choice, unneccessary. Sorry bout that.” We’d sue.
Take one man’s post in that thread of comments – undiagnosed twin, one was born, they administer the jab to contract the uterus and bingo, one brain damaged, half crushed second twin. So he believes sections to be safer; perhaps because no one has ever said “if we hadn’t immediately administered that jab and had waited to see if your wife needed it, your daughter would have been born safely.” It is amazing what you can do with spin.
As well informed and coherently cynical as i was about my chances of a normal delivery for Josie, it was WEEKS before it occurred to me that when i got co-erced into a section for her there were NO medical indications for it at all. No one was suggesting either Josie or i were in danger. And they still got me. If i was less clued up, i might still believe they saved me. They tried to tell me afterwards that it was because they were worried my womb would do some strange ring constriction thing, yet my learned friend HJ tells me this only happens with first time mothers anyway.
Spin, spin, spin.
merry says
Elderfairy, yes i removed it because i mistakenly understood that the complication was a c/s related one, the only place i read about it sort of read as if it was. I know her c/s was necessary; if there is no route out, there is no route out.
That aside, the complications of a c/s gone wrong are hideous. In fact, i’ve just been reading one story that makes me pathetically grateful i got out of Josie’s birth with my womb. At least, i assume i still have it…
Carlotta says
I agree entirely that inessential c/s seem an utterly ridiculous idea, but I would put in a very good word for essential ones, (given that huge swathes of my family would either be dead or never had existed with out them.) I do sometimes wonder whether the increased c section rate may be related to the third and fourth generations of c section families who would otherwise have died in natural childbirth.
Elder Fairy says
I don’t actually understand what’s going on anymore..so I’m just going around putting my twopenneth worth in. The blog ring that Missy was on (I know it)….has our blog ring always been in contact with it? I also thought it so tragic about what happened with Missy…but that must have been a case of HAVING to have a C/section.
When I once had to get past a obs. consultant when I was planning one of my home births, she was pregnant with her second child and had scheduled her c/section already. She’s also had her first by elective…she wasn’t that happy to ‘permit’ me to have my own home birth and told me that she had chosen c/section because (with a scoff)..”…I know all too well the dangers of a natural birth!” ffs (FFS!). I do see the point…if I screw my eyes up and bang a metal tray over my head repeatedly. Having said THAT if I was preggers again and had good information that a C/section would save my babes life..of course I’d blummen well go for it..
Claire says
I too totally agree with you Merry, I wouldn’t have my son without a crash c-section but maybe if I hadn’t have been co-oerced into certain things during the labour I wouldn’t have needed one. In my case, it is alleged that they had ten exact minutes to get him out before certain death, but if I hadn’t had been subjected to so many v stressful and painful internals I don’t think I’d have needed the epidural which lead to two hours of pushing and his HB disappearing! Oh and I was induced too – young and stupid that I was at 21! I should have stood my ground but was convinced at that time that as he was an IUI baby, conception date and therefore due date were an exact science and at 10 days overdue he needed to come out.
Non-essential c-sections shouldn’t be allowed imo – it’s like some kind of fashion craze in this world atm.
Next time (if I ever get there) I’m staying at home with an independent midwife in a pool.
Elder Fairy says
Must make a confession here. After three down to earth non-waterbirth homebirths (Oak even delivered Ash himself cos the midwife didn’t get here ‘on time’ (ho hum..am not admitting anything)), I am aware that if there was any chance I had to go to hospital to give birth I would be so afraid of what they do. So we are definite (at this point) that we are not having any more babes.
That’s my excuse and I’m sticking to it (chortle!). Having said that, I worry for my little sister, my daughter..and bang on all the time about the virtues of home birth OR informed empowered hospital birth (erm..is that possible?) I am very pro-home birth, but cannot be anti-hospital birth because what also makes me sad is the too new agey home birthers who plan their ‘relaxed’ home birth like a military campaign – and who sneer at other women for prefering hospital birth. Wherever we give birth we should feel safe without the need to over plan, FFS – that should be every womans birthright.
Elder Fairy says
Argh, sorry Claire..didn’t mean the comment about the non-waterbirth..water births are great… If it’s an independant midwife you’ll be wanting, you should check out Sarah Montagu – she is top banana.
HelenHaricot says
i was debating whether to write anything at all, and thought, ah what the hell! Lots of you – Merry espec, know what i do for a living – and I’m proud of it! I realise i am fair game for shooting down in flames, and can live with it.
Elective caesareans at maternal request
does not protect against incontinence or prolapse unless you only intend to have one child and have the section by 37 weeks – at which time 8% of the baies require to go to SCBU for usually a 24 hour stay for transient tachypnoea of the newborn.
the royal college did a survey with the DoH on how many elective caesareans are being done for maternal request – this number is not huge [don’t remember off top of head] and it includes those that elect for a caesarean after having a single caesarean, as the advice given is for VBAC [apart from a few special circumstances]
Elective sections for indications
i can’t see how these can’t be offered. Just cos they are offered does not mean that they have to be done. Due to a rather duff international multicentred trial, all breech presentations where version fails or is not wanted are offered the choice of caesarean or vaginal birth. All previous traumatic deliveries may be considered – if someone has such a horrendous time from a vaginal birth or a particularly gruesome tear, I think that it is unethical not to consider other options for them – though the actual choice is the mothers to make.
emergency sections
There are true emergencies and failure to progress type emergencies. i have done unnecessary sections for ‘fetal distress’ our techniques for identifying it have a reasonably wide margin for error, and I would prefer to risk doing unnecessary section than choose to do nothing, leading to a fresh stillborn baby, or a severly handicapped baby. In the consent, I always tell people that I wont know till the caesarean is done whether it was the right thing, and I do actually tell them at caesarean afterwards – as we always measure the babies blood gases, and these give a fairly acurrate view. No one has sued yet!
Homebirth
well, i wanted one, and instead the midwife bailed out on me, so have a very relaxed hospital waterbirth.
Can you have an empowered hospital birth – actually i think you can, but I agree it isn’t so easy, and that is because of the tying in knots that UK guidelines do for midwifery and medical staff. Being informed beforehand is the best option, and having a strong birthpartner, who feels free to ask the questions.
i don’t beleive I know all the answers, and nor do the colleagues I work with. We work within the hippocratic oath of do no harm, and our mantra is safe mother, safe baby. For me, that will always be more important than mode of delivery, and to be honest, I am not at all apologetic about that. I will strive to help a mother achieve a healthy vaginal delivery, but by the time I am involved, things are already medicalised – not by me.
Hmmm, prob bad posting – may ask merry to delete if not too clear?
Amanda says
I looked here last night and read and thought about, I was born by emergency C-Section, I was 2 weeks early but very ill in special care for the next 2 weeks, but I’m still here. I have’nt had a C-section but a lot of my friends have, I know recovery takes longer than a natural delivery it also has an emotional impact. I think sometimes it is necessary, I had a difficult delivery with my 1st baby and finally she was delivered by forceps, she was in distress I was exhausted and I was told that if they could’nt get her out then I would need a c-section, tbh I would have agreed at that point, IMO there is always a risk, and although my ideal birth would have been a water birth at home (its never happened), I’m just happy(?) that I’m o.k and they are o.k.
merry says
Emotional impact is something that i could never had believed until it happened. I agreed with relief to Fran’s section. I virtually snapped their hand off after 18 hours stuck on a bed with the world ad his wifes hand up me.
Helen, you are very clear – and anyway i have no problem, nor ever had or ever will have, sections with indication. Let’s not forget i was booked for elective for Josie after 2 weeks of bullying convinced me it was the right thing for us. Nor do i have have any issues, or any associated trauma, with Amelie’s birth. It needed to be that way and it was. They saved her life. End of story.
But i can’t and won’t condone illinformed journalists ranting about how medical births are best for all mothers and babies; she’s batting from a mad angle anyway as her notion of childbirth being the way it is starts from a perception of medicalised, interventionist birth. I mean honestly Helen, if someone came into your office with this article and said “give me a section, look this woman says i ought to be entitled to one” would you really agree that was a sensible use of NHS money? I think you’ve got more scruples than that 🙂
Sections are for need and indication. I’d have been perfectly allowed to have a section for Maddy; look how wrong they’d have been to make me. If i’d gone in for an elective for Josie, i don’t believe my grief and anger could have been contained and controlled post-birth the way it has. I doubt i’d have been anything less than a crushed wreck. Whole mothers and babies are vital of course, but it is important people don’t sell sections as the only way of definitely achieving that because it simply isn’t true. They are surgery and surgery is not a natural process; it is dangerous by default.
Anyway, this rant was most certainly not directed at medics, least of all you Helen(you know you get an automatic exemption here anyway) but at the journalist who was talking out of her not-yet-saggy-fanny.
HelenHaricot says
yeah, I know that Merry.
i also disagree entirely with the concept of any surgery on demand on the NHS.
but I just thought I should come out and be counted with my LSCS views at least once!!
And they re generalised btw everyone, not focused on Merry and her obstetric history!!!
merry says
And while it may be tmi, i can vouch for it not being vaginal delivery that kills off your pelvic floor!!!!!! 😆
Katy says
pelvic floor? Whassat then??? Never did find mine before, during or after carrying Becca!!!!
As for c. sections. i have a sort of mixed view on this. I did feel that I had a very scary picture of what could go wrong with my “could be 8.5lb or even more” baby if she got stuck in my “petite” pelvis (it’s well padded okay???) by the midwives and had little confidence in the local hospital anyway as I’d been kept in at 20ish weeks next to a woman who was in slow labour and given no pain relief becuase “if we do you won’t be able to have anything when you really need it later” However, in hindsight, I had very painful SPD and she was 9lb 13oz with a fairly large head and several hours after my waters let go she still wasn’t even a teeny bit engaged let alone heading out. I would, however, not go straight for a c. section if I had the chance “next time” unless I was really sure it was the only sensible option. I would also want Helen on hand to be sure I wasn’t being conned, several other good blog ring friends to beat off interfering peeps with brooms and a breastfeeding councilor camped out at my bedside to prevent me from weakening and agreeing to “just a drop of formula from a spoon” (no getting excited though, not gonna happen is it?)
HelenHaricot says
ah Katy, I do hope it does happen for you. you had one miracle, and although we don’t like to be greedy, a blessing as well for you would be nice! [thats how we think of ours anyway.]
SallyM says
Helen, with respect to you personally the official advice might well be for a VBAC after one section but I can tell you know that what actually happens is a totally different ball game and only if you are completely clued up do you have any hope of avoiding the emotional blackmail that goes into getting you to agree to an “elective” section second time round. I was even told that I would been leaving DS1 motherless if I tried to have a natural birth at home. That was from a female consultant. The same one that then wanted to induce me when I went over (need a banging head emoticon here!) despite it being far more dangerous rupture wise to induce than to have a VB.
I do agree with medically nesseccary sections and that includes for mental health reasons, trauma, phobia etc but just because they “think it might hurt” (or whatever, didn’t want to raise my blood pressure as high as Merrys by reading the article!) no, never. If they were scared of losing their pelvic floor and so forth perhaps they aren’t the right people to be having babies, I think thats far more likely evolutionary path to cause a rise in sections than narrow hipped babies! I’m sure I could rant on forever on this subject but I’m sure you all get the gist!
merry says
I think mostly they think vbac after 1 is safe now, you have to look harder for someone completely against it (though that wasn’t the case when i had Maddy in 2000) and of course, they’d like they c/s rates to be lower if possible.
Try getting people to “agree” to a vbac after 2 or 3 though, even if all for different reasons.
Carlotta says
That’s interesting Sally, since your experience represents the opposite of mine! After necessary c section with my first child, the male consultant applied pretty intense pressure to get me to have a VBAC. So I guess it does all come down to individual practice and probably always will.