The natural conspiracy

Too posh to push. Unnatural. A failure. The modern back-to-nature birth movement has become so dominant that many women feel bad when they don't manage to go through labour without surgical intervention. Of course, if you can do it without drugs and caesarians, great. And it's good for mum and baby to try it (elective caesarians unless there is a good medical reason seem crazy - why put yourself through major abdominal surgery if you don't have to?). But the pendulum does seem to have swung too far the other way. Tiffanie Darke makes a persuasive case today for not persecuting caesarian mums - after all it's getting the baby safely through the astral portal that counts, not how it happens. And of course getting on with being a family after it arrives. What do you think? Were you brain-washed into homebirth/ no intervention and felt bad about your caesarian?

Comments

[karla]

I've had 2 emergency c-sections and am hoping for a natural birth with my third child. Apparently this is completely possible. I don't want to suffer another op if I don't have to. What seems to have come up time and again here is 'induction'. Does this ever work? It twice failed with me - hence 2 sections. This time I WILL NOT BE INDUCED. I will either go into a natural labour and see how it goes, or opt for a c-section. Cutting out that 'induction' gives me more choice and, as its my baby and my body, it should be MY choice. I have had other women hint that my c-sections were easy and, although emergency, elective. These same women brag about their lack of pain relief etc. Bully for them. They're lucky. Don't judge me - my boys and me survived!!

[Mrs Trellis]

How can any mother make an "informed choice" without a medical degree? It is impossible to know exactly what can and can't happen, or what the risks and benefits might be of each and every choice, without an in-depth knowledge of anatomy, endocrinology, anaesthesia and paediatrics. It may sound patriarchal, but I'd rather listen to the advice of an obstetrician than a non-medically qualified doula. Instead of squabbling and sharing war stories, we should focus on women in the developing world who simply do not have the luxury of deciding whether to have a caesarian, epidural, home birth or whatever.

[Sarah Johnson]

I despair of mums like Tiffany Darke, who have convinced themselves that there is some kind of conspiracy to make them feel guilty about C-section. She should try being in the shoes of a mother who wants a home birth; or of a mother who wants a natural delivery of a breech baby; or of a VBAC mother...then she would really know what guilt means. As a doula I have heard amazingly insensitive and cruel remarks made to mothers who dare to question their doctors' preference for a C-section. I have seen the pressure women come under in hospitals to accept interventions. The idea that in this country there is a "conspiracy" to prevent women from having whatever intervention or pain relief they want is a fantasy. The opposite is the truth: women are constantly coerced into accepting interventions and pain relief even when it means bringing in the "cascade" effect and increasing the likelihood of C/S or instrumental delivery.
Check out the www.homebirth.org.uk for a selection of absurd random reasons given "against" homebirth.

[Kate]

With a 2 year old & a 4 year old & a full time job, I've only just read Tiffanie Dark's article (OK I'm only 2 weeks late!).

I went into labour naturally & after 2 days of painful posterior labour had an emergency c-section for exactly the same reasons. Head too big, pelvis tilted. The pushing of Adam back up so that he could be delivered was incredibly strange!

Had an elective c-section with my daughter. The thought of doing the same thing all over again was too overwhelming.

[Shifra]

Noone ever tried to brainwash me into a homebirth, when I had my first 2 sons in the UK, and I put myself onto the NHS conveyor belt, and first had a c/sec and then subsequently a vbac at 36 weeks.

I wish someone had bullied me into a homebirth, as I had a traumatic 2nd c/sec in the Australian hospy system (which is worse than the uk!)and then finally I had a homebirth last year and I came to the realisation that trying to have a natural birth in a hospital is akin to trying out some extreme sport!

Natural birth is the hardest work I have ever done in my life, but having a c/sec makes the work I did after I had the baby extremely hard. There is NO easy way out when you have a baby to bring out of your body and into the world.

But we live in a fast-food materialistic society these days. We expect a baby and latte-to-go, and forget that some things have to be worked for.

my stories are here: http://www.myspace.com/hba2clady

[Lane]

The sheer number of posts on this subject illustrates how women tie themselves up in knots and welcome any excuse to get out the flagellation whip and beat themselves senseless with worry and guilt. In the scheme of life, birth is only a minute part and when push comes to shove surely it should never be a question of 'how' but 'how safely'. I am tired of hearing of how women are 'made to feel - soft, guilty etc'. One is only 'made to feel' if one has no spine or the luxury of time to wallow feeling guilty about these things.
The important thing is to get 'em out any which way you can and get on with the important job of raising human beings who will never be 'made to feel' anything that they don't want to.

[Di Collins]

On International Womens' Day let's celebrate the fact that C-Sections are possible. If I hadn't had a c-section 33 years ago neither my son nor I would be here today.

[natalie johnson]

I had an emergency c. section and feel i have not taken an 'easy way out' of birth, I was very overwhelmed at the concept but felt very safe in the hands of the doctor. I had gone into labour and hadn't asked for any drugs and was possibly going to have a natural birth, through shock more than choice, i was so mentally unprepared although I was lying in the hospital bed I really hadn't digested the fact that I was about to give birth, it all seemed so surreal.
My c. section went smoothly and I made a quick and good recovery with no complications, the doctor even said I was his first patient to laugh through my c. section.
I do not feel I cheated or took the easy option I do not think it matters whether you have a c. section or natural birth. Child birth can be a traumatic experience for a woman and if she feels her choice in method of childbirth will make her feel more at ease with the labour who are we to judge and condemn?

[SpoiltCow]

Gosh chaps, can't we all stop beating each other up? It's like the working/stay at home "mommy wars" - women really are each other's worst enemies.
Speaking personally I think the gold standard is a standard vaginal delivery with loads of drugs, but next time round if I need a C-section then thank God I'm in a country where I can have one without there being a very high risk of death/permanent disability. (hmmm... thinks of NHS hygiene standards and reconsiders last sentence)

[Liz Hughes]

Well done Tiffanie for speaking up for those of us who deliver by Csection! What we must not lose sight of is the plain fact that if it were not for this huge advance in medical technology mothers & babies would die. I include myself & my 2 sons, both Csections -1 emergency/1 elective. My first son was born 5 years ago, being 20 days late & therefore having to be induced.I had a drip inserted(painfully by a trainee midwife!) at 8.30 am & there followed a comedy of errors. A very slow labour with strong contractions, lots of bad language & blood loss, gas&air, 2 diamorphine jabs, 1 epidural plus top-up & finally the blessed relief of a general anaesthetic some 15 hours later. My son was on a scalp monitor throughout & I never dilated past 4cm. My husband still maintains that the most terrifying words he has ever heard are "theatre now I think or we lose both of them"!! My second son was born 6 months ago by elective section. My surgeon was perfectly happy for me to choose this route & actively recommended it following my last experience.
Recovery from the first was predictably slow following the shock, trauma & huge amounts of drugs inside me; from the second recovery was fast, up& about the next day, walking normally the next week.
I am fortunate that, on the Wirral, we have a large maternity unit with community teams & my wonderful midwife was there with me all through my second birth, even going so far as to schedule herself on duty for my delivery day.
I do not consider myself "too posh to push" but am absurdly grateful that I and my 2 sons are here today healthy & happy. If I became pregnant again (the immaculate conception my husband says it would have to be!!) I would without doubt have another csection.
To those of you waiting for one or who have just been through one, my best wishes for the good health of yourselves & your babies. Surely that is what we should be celebrating?

[annie]

I have never understood the fuss about natural childbirth - the ultimate aim is a healthy baby and a healthy mother. I too had to have a caesarean (after 2 days of labour) and have never felt a failure. I had no problems breast-feeding afterwards, and recovered far more quickly than another friend who insisted on a natural birth (and couldn't sit down without a cushion for 6 mths). People forget that many women and babies used to die in childbirth.

[Mary]

My first was an emergency c-section, premature and without it we would both certainly have died. The baby was in hospital for a couple of months and the whole thing was pretty traumatic. With the second I wanted to try for a VBAC. I want to the Active Birth Centre, did yoga and meditated. I went through labour with gas and air, everything went pretty smoothly. Right at the end there was some foetal distress and the baby popped out with a little help from a ventouse. We went home later that day. As you can imagine, I was elated. I called my Active Birth Centre teacher to tell her all about it. Bubbling with happiness and pride I related the story. I got to the end, there was a second's silence and then all she said was "Oh, what a pity they had to use the ventouse." God only knows what she would have said about a c-section.

[Sarah D]

I have just had a second baby in France. The experience was completely different to giving birth in the UK. All the women I spoke to had epidurals as a matter of course. No one complained, no one was in pain, everything seemed to go smoothly.

The Caesarian rate was 25%, a fact everyone accepted as necessary. When I described the stigma in Britain about drugs and caesarians, they were aghast. As one French doctor put it, "You wouldn't have a tooth taken out without anaesthetic, would you?"

[Claire]

I too am an NCT teacher - I don't think whether I have a hairy face or not is relevant (nor do I care if a midwife has facial hair). One of the first things I say to my classes is that the NCT started out as the NATURAL childbirth association but that we are now NATIONAL - and that this is vitally important as we are here to support pregnant parents whatever their choices. Yes, I talk about the risks of CS but I also say that it can be life saving and is a wonderful thing. I also point out that no-one has the right to accuse a woman of being too posh to push (a common reason given in classes for a Caesarean) - we cannot know all the factors that makes a woman decide on an apparently "unnecessary" CS. As for epidurals, again I point out the risks as well as the benefits and suggest that women who WOULD LIKE to avoid one should consider holding out for another 10 minutes or so to see if they find that the pain has eased. I also tell them that there are no prizes for giving birth without pain relief - of whatever type they choose.

[Fiona]

I am an NCT tutor (so not only work with couples giving them support & information, whatever their birth choice but also training NCT teachers) I am co-author of Caesarean Birth Your Questions Answered, a best selling NCT publication. Having given birth by caesarean, I have always been passionate that women should have information and support for caesarean birth, although this is balanced with other relevant information about birth. I think it sad when a woman feels she has failed becoming a mother, birth is a challenge however the baby is born and all mothers should be able to celebrate their personal achievement.

As a tutor for the NCT I have spent time writing articles and running training days ( 2 in the next month) about how to cover caesareans positively in antenatal classes, without undermining those women who choose to have a different birth whether at home or in hospital. NCT teachers are trained to Diploma level and we have a robust system for ongoing development. We always follow up complaints should they be made ( which is quite rare), equally we will always support any woman regardless of her birth or feeding choice. We do campaign for 'normal' as it would be a sad day if normal birth was lost.

It saddens me that some women feel so negative about their experience or feel so uncared for that the only place to debrief ( as all women need to do) is national newspapers. Where is 'good old midwifery support' that allowed women to discuss their experience in private, coming to terms with their own birth without the influence of others. Are stories like this really related to the national shortage of midwives and not the appearance of NCT teachers.

[Lynn]

I shared the same experience of childbirth with Tiffanie and many others who have commented - an induced labour as I was 2 weeks overdue , very slow to dilate , very strong contractions and finally my baby in distress and having to have oxygen samples taken from his scalp . The decision to do the Caesarean was such a relief as we were convinced by then that he would be brain damaged . All finally was well and I bonded with him immediately despite his traumatic arrival . As many have said it does not matter how they get into the world .
I went on to have 2 more Caesareans - the second was a late decision because our daughter seemed to be in the strange postition our son was in and I could not bear to go through the distress again . The third was automatic because the scars might not withstand a normal labour .I bonded with them all straight away despit only being awake for our middle baby but they were so wanted and cherished it was irrelevant how they had arrived .

[Wendy Hinds]

"The cesearean was a good call in the end as the baby was nearly 9 pounds, there wasn't much amniotic fluid and the placenta had already started to deteriorate, so labour would not have been the empowering, enlightening experience some fascistic "natural" birth advocates would have you believe." Plenty of women who have complications go on to have perfectly normal vaginal births, and women with no risk factors at all end up having c-sections. My second baby was also delivered late, weighed nearly eleven pounds, I had an excess of amniotic fluid and gestational diabetes. I had him at home, a normal birth over an intact perineum. If I'd been living in the US I would have most likely have had an elective section because it would have been assumed I couldn't have got a baby that size out vaginally (particularly in light of the fact that my first had been a forceps birth). You can't tell what your labour would have been like so maybe it's best not to make assumptions and then use those to beat the 'natural birth fascists' (ie those people who gave ME the confidence to go for a vaginal birth) around the head.

[Wendy Hinds]

Having read the article it's not clear that the author attended NCT classes at all. If she'd attended MY classes (I'm a trainee teacher), she would have had the opportunity to find out about what a c-section involves, why a woman might need one, and had a chance to discuss ways of coping with the physical and emotional fall-out that sometimes accompanies a difficult birth (whether that's an instrumental birth or assisted/unassisted vaginal birth). NCT teachers don't work in a natural childbirth 'bubble' - we see all our clients after their babies are born and spend a lot of time talking to women who've had c-sections and instrumental births. I'd consider it a deriliction of duty not to try to prepare couples emotionally and in practical and information terms for the full range of outcomes they may experience in childbirth. I feel really disappointed that the journalist has gone for such a cheap shot in sneering at the NCT, without even bothering to find out what our classes cover.

[Ruth]

Tom says that the NCT introduces worry and this might be the cause of the increased number of sections - if only the NCT reached enough mothers to make it's mark on national maternity statistics, it simply doesn't!

I've never known anyone "persecute" mums who have caesareans for whatever reason. Pointing out the benefits of vaginal birth does not mean that you are anti-caesareans. What movements such as the NCT are about is ensuring mums have informed choices, so that means giving research based information, which may not always be what people want to hear, but does that mean it should be ignored? Should the research that pointed out the dangers of smoking have been supressed 50 years ago in case it upset smokers?

Nobody has an informed choice in childbirth if they are not supported by adequate maternity provision to enable their choices to become reality. Women up and down the country are choosing unmedicated birth but then being left alone in labour rooms as they share their midwife with other labouring women due to staff shortages, so it's no wonder they end up terrified and in pain and beg for epidurals. So should we all forget about doing it the way nature intended and outlaw the NCT or should we be actually doing something to improve the standards in our maternity units so that all women have access to excellent care, so that they can have a good chance of a straightforward birth if that is what they want and know that if they end up with a section, it's because there was a good reason?

[Elaine]

I had to have an emergency c-section with my first baby as she was found (at the last minute) to be brow presentation and in terrible distress. I had been in labour for hours by the time this was discovered. I am just thankful that a surgical option was there to ensure my baby was delivered alive and safe. I am now pregant with my second child and will be having an elective c-section. The traumatic nature of my first birth experience has made me totally unwilling to try for a VBAC, despite considerable pressure from midwives. I and my husband are both happy with this decision but I am getting a little tired of other women (always women!) commenting on and judging me for this choice. What does it matter how a baby arrives? It's delivering them safely and what happens afterwards that really counts surely?
There are many reasons for c-sections, and these are often highly emotional and complicated, lets not punish anyone for their choice of safe delivery.

[MELISSA]

I wrote a piece years ago when I had been throught the NCT/NHS saga of childbirth. I had an epidural and a long birth and was harangued by some natural birth zealots who told me I'd be stronger next time and they'd be there to help me fight the meds off. "They" were a couple who were following Jean Liedloff's Continuum Concept (breastfeeding for 4 years minimum etc) . The next time, I didn't need as much pain relief ( lucky Me), but fell victim to all my middle class friends being too posh to push and left me feeling like a hag with an unecessarily droopy vagina, (according to them). Surely the point is no two births are the same and it's not up for discussion, let alone trying to map it out with a birth plan. I certainly don't relish tales of birth woe and feel uncomfortable going on about mine. My eldest daughter, now at boarding school, was even told she was "unlucky" by another girl, because she wasn't born in water! Our expectations really are so high, but a safe delivery and healthy baby now seem so fortunate because my children are older and there are so many other triumphs in our lives. The birth was just the beginning, a very short episode compared to the rest of the mothering adventure.

[Aukje]

This article is yet another one written by a journalist who uses her personal experience as evidence for a certain phenomenon, the rise in caesarian sections. As she says 1 in 4 women have a c-section these days, this rate is simply too high, the WHO states a rate higher than 15% cannot be clinically justified. Tiffanie, the truth is you wouldn't have written this article if you had had a straightforward birth(in fact you may have written one on the joys of a straightfoward birth and how easy it all really was.You still feel cheated by the fact that you ended up with a c-section which may not have happened if you hadn't been induced. Your references to hairy faced NCT types are unfair (and yes I am a trainee antenatal taecher with NCT), it is simply untrue to say that childbirth is hugely complicated and the only one who is making you feel quilty or persecuted about your C-Section is yourself. I think you need time to put your experience in perspective and come to terms with what happened. I have had 2 vaginal deliveries one induced and the other spontaneous, but still in hopspital. I know it hurts, I know what the system is like but as another post mentions you don't need to work your way through a large array of natural remedies etc or swot up before having a baby. Your body,which does not have a fixed pelvis- all women's bodies KNOW how to give birth- how else would we have survived all these million of years- and yes interventions have saved countless lives but childbirth is no more dangerous or risky than other bodily processes. It is a myth that we can control our lives in every aspect- just by being alive we are at risk of dying.

[kieransmum]

I had a Caesar, after 24 hours of non-successful induction.
Three days later, on the recovery ward, a midwife came to see me and demanded "why I had chosen a ~Caesarean."
I said that I had not, that it had been medically necessary and recommended by the doctor.
"Oh," she said, clearly disappointed that she had been deprived of the opportunity to harangue a 'too-posh-to-push.'
I am still mystified by the arrogance in her approach.

[Lisa Jolly]

Who demonises women? In Tiffanie Darkes' article, it was argued that we should stop demonising women for having caesarean sections. I don't think any sound person, man or woman would dare to argue that caesareans are not sometimes neccessary. The problem is, the UK has the highest c-section rate in Europe, and it is not because women in England are worse at giving birth than the rest of Europe. Holland manages to have a 33% home birth rate, compared to between 1 and 2% in this country, and home births are statistically proven to have fewer complications overall, higher apgar scores for the babies than a hospital birth and a faster recovery for the mother. I am one of the lucky women who did have a very happy and peaceful homebirth. My choice for having a home birth didn't happen because I'm a vegetarian who's got hairy armpits (I'm not, and I don't), but through my strong desire to give birth in water. St. George's hospital in Tooting where I was meant to give birth only has one pool! As a result, I mentioned home birth to my husband, did heaps of research about the subject, waited until my husband thought it had been his idea, and hired the pool. I had a brilliant midwife (paid for by the NHS), in my house. My husband made her tea while I vomited in a bucket in between my not so pleasant contractions. However, after several trips to the loo, my midwife's shock at my sewer mouth swearing, my refusal to get out of the pool even though my second midwife had not yet arrived (two have to be present at birth), and my husbands desperate attempt with a sive (use your own imagination), our son swam out like a fish, and I felt as high as a kite, declaring I could do that again!
Too few women are allowed to speak of their nice experiences. I'm the only one I know with a good birthing story, and I'm the only one I know who did it by myself, at home, with absolutely no intervention. My other friends suffered in hospital with multiple infections, interventions and big operations. Shouldn't the priority be to think of what's best for the mother and the babies longterm health, and improving the birthing experience overall, instead of who wins, the earth mothers or the ones with a scar? I'm convinced that if more mothers were given more confidence in their own ability to give birth, and the conditions in which they did so were cleaner, more calm and less power struggles between the professional groups, you would hear a lot more stories like mine, even in hospitals.

Dear Tiffanie. Hocus Pocus as you call acupuncture....
My son was breech at 8 months. The doctor told me he had to be turned manually in the hospital, which has potentially fatal consequences and a low success rate. I read that acupuncture, or more specifically moxa bustion statistically had a higher success rate. I saw a brilliant acupuncturist who specialises in pregnancy, and my son turned the next day. The obstetrician informed me two days later I could just forget about my home birth, and prepare myself for a caesarian. I insisted the baby had turned, he didn't believe me until he did an ultrasound, and his face turned red. Sometimes not relying on others to tell you what you need to know about pregnancy and birth is your best bet as a woman, beacuse as you'll soon find out, when it comes to birth, we all think we're right!

[MegsMum]

Best of luck to you, and congratulations, Sarah Kay!
I haven't had a c-section, for which I'm grateful - the medical necessity has not arisen. I try to make my own decisions carefully, and credit others with the same care. Therefore, I respect those decisions, and am often grateful I haven't had to face similar circumstances. I think care and respect could solve a lot of conflict in our society...

[Deirdre Johnston]

Thank you Tiffanie for your article. I too had an emergency caesarian with my daughter almost 8 years ago. The placenta was completely blocking her exit and without a wonderful obstetrician and advances in surgery we both could have died. Almost 6 years later at the age of 46 I elected to have a caesarian for my son's birth. It was marvellous.

Before I had my daughter I did a straw poll amongst family and friends who had had vaginal deliveries. All of them, 6 or 7, said if they'd had a choice they would have gone for caesarian. I have absolutely no regrets about having caesarian births. I was wide awake, in no pain, and held my babies straight away. My husband was there throughout. I was fully informed of the risks. In defence of the NCT which I joined when expecting my daughter, I did not get the impression that I would be a failure if I didn't push her out myself.

Since having my children I have come across so many younger Mums who have gone through hell having "natural" births. One in particular couldn't sit for a week because of stitches. It was not like that for me with caesarians. I walked a few hours after my son was born. Ok I didn't drive for a few weeks but I can honestly say that was the only drawback for me.

Informed choice is what its all about. Isn't that what our feminist sisters fought for in all walks of life.

[clare]

Thank you Tiffanie Darke for your article. I have had two C-sections, the first, 6 years ago, was elective because I had placenta previa so we are both thankfully alive due to the advances in obstetrics.
The second 8 months ago was also elective but for very different reasons. I had intended to go for a VBAC (vaginal birth after cesearean) until my supposedly loving partner of 8 years told me he was leaving me 5 weeks before my due date.Not for another woman but simply because he didn't fancy me anymore and wasn't going to consider any other option.Nice! I didn't want to go through what would have been a first labour with him as I would have probably insisted on ventousing his balls in the throes of painful labour. Nor could i bear the thought of a friend urging me to push when i was spending all hours of the day crying and facing life as a single mother. At no point was i co-erced into a decision. i was supported at all times by everyone from my midwife to the consultant and given detailed and clear instruction on the pros and cons of VBAC vs C-Section.
The cesearean was a good call in the end as the baby was nearly 9 pounds, there wasn't much amniotic fluid and the placenta had already started to deteriorate, so labour would not have been the empowering, enlightening experience some fascistic "natural" birth advocates would have you believe. I experienced very little pain after both C-sections and even though i had to be up and about sooner than i should have been with this baby (he did actually leave, 3 weeks after the baby was born) i have made a full physical recovery. i bonded both times with my babies and breastfed successfully.I certainly don't feel any less of a "woman" because i didn't give birth "naturally" and i ignore the "poor you" platitudes from other mums who seem to think i have missed out on a vital lesson in being a woman because of the C-sections. Isn't feminism all about freedom of choice? The guilt and un-neccessary pressure women put on themselves to compete in the perfect birth race seems to me to take up way too much energy and thought and the important thing is that the mother and baby are well and happy. So now i have my scar and no bloke, but two beautiful daughters in whom i will instill the virtues of choice and pragmatism and try to refrain from calling their father a poor excuse for a man and other phrases that involve expletives. Apparantly there are men out there who are into scars and the like so maybe in my search for a new husband i can turn my C-section scars into a pulling card! i don't think so....

[John D Eadie]

Another male contributor. So what qualification do I have for this missive? Only that my wife and I taught Tiffany and that our daughter, Rachel, who Tiffany will remember, was made to feel a complete failure as a mum by her 'friends' as she had to have C-sections for both of her children due to foetal distress. So, thank you, Tiffany, for putting the rarely heard side of the case.

[donmacnamara]

Women have domonated this blog. Are they entitled to the corner of the market in ant debate or are men just to.. shall we say emasculated to cometn.
I have some familiarity with the decision making process for section delivery> best clinical council is determined by the foetal state. Foetal disterss as meassured by its heartbeat is the commonest prognosticator and determines the urgency of delivery. It is almost indicated by foetal hypoxia . I ahve seen many cases of heroic mothers enduring 48 hrs of labour and I could not ever decide on whether their struggle was sacrificial or noble ( in the absence of any signs of foetal distress)
The too posh to push thingh is not a clinical decision at all ; it is rather the oppisite of a sound one and seems to me to be pandering in a misguided way to women absorbed with vanity or some absurdity they've read in a thrashy magazine .
And the obstetritcions who yield to this childish petulance are not practicing in accordance with proper clinical dictats .

[Janine]

Kate - please tell me what NCT literature makes women feel guilty? The NCT is getting a serious bashing when it isn't even clear that Tiffanie went to NCT classes. She certainly did hypnobirthing but NCT, I'm not so sure.
The NCT is about informed choice and supporting all parents, no matter whether they have a vaginal delivery or a c-section.

[Kate]

I work in operating theatres and have been present at many caesarian sections. When I gave birth to my baby I tried hard to do it naturally, but was unable to in the end - he was in the "brow presentation" position and we would probably have died without surgical intervention.

Because I have an intimate knowledge of life in the obstetric operating theatre I didn't feel like a failure, I know how often a C/S is the outcome of labour. Since then I have bonded with my son as completely as anyone could, and three years later he has a fantastic immune system and is rarely ill.

The birth is such a tiny part of motherhood - why do people feed women the myth that they won't bond with their child if it isn't a natural birth? As far as I can see the only reason you wouldn't bond after a C/S is because you're so indoctrinated into the "natural births are the only valid births" way of thinking that you choose to blame your child.

It upsets me when I see women coming into theatre crying because they perceive they've failed, and it upsets me when I read NCT literature that tries to make me feel like a failure. It's unecessary and wrong.

[Sarah Kay]

Well Done Tiffanie. I too am fed up with the phrase 'too posh to push' and feel that those of us who have cesarians are often made to feel inadequate and that the trauma of a major operation seems to be regarded as something trivial by the natural birth brigaide. It would be nice if we lived in a world where the natural reaction to the news that you had to have a major operation to deliver your baby was greated with a little sympathy for your suffering rather than dismissed.
If I hadn't had an emergency cesarian it is quite possible that my wonderful healthy son would not survived. The circumstances of the 'natural' part of my labour were distressing and the operation very traumatic. But as all that is insignificant compared with the distress and trauma of loosing a child, I feel fortunate that the operation was available. Due to complications in my current pregancy, as I type I am waiting (somewhat apprehensively) to have an elective cesarian tomorrow morning for my second child. It seems that a 'normal' child birth is just not going to happen for me and that does sadden me but the important thing is that my baby is healthy. As a result of medical advances childbirth is no longer the number one cause of death for women and children dying in childbirth is rare. We should celebrate this and be thankful that, however distressing and upsetting drastic options such as the cesarian may be in the short term, these medical interventions are available to us.

[Jane]

OK - I am a strange mixture - 1stly mum to 4 including twins, 2 labours in hospital with epidurals etc, 1 at home with nowt. Midwife for 13 years, NCT teacher for 3. Seen hundreds of babies born which I hope qualifies me to comment. I do tell women labour is painful, fear & stress are not helpful, so look at ways to reduce those however baby is born Regularly have women in my classes having elective caesareans - i think they're brave.
caesarean sections are associated with far more complications than straightforward birth and they're expensive that's why there's a move to reduce them. No woman should be made to feel guilty for any choice she makes in childbirth, unfortunately it is usually other women who make us guilt ridden - who should know better

[Tess]

As someone who gave birth to twin daughters by caesarian section last year it irks me that this is perceived as the soft option when it comes to birth. There appears to be a myth that this serious decision is reached on little more than a whim of vanity; as if we sit in our hospital beds idly weighing up ‘tummy scar’ versus ‘knackered pelvic floor’. It belittles the intelligence of women to assume that those of us faced with the option of a caesarian section do so imagining that it will be the easy way out. It is major abdominal surgery with the added bonus of a newborn to care for at the end of it. Hardly a breeze and, from experience, certainly a different take on the 'pain of childbirth'.

Vaginal delivery is the preferred option when the lives of mother and baby are not at risk and I agree that women should be encouraged and supported to reach this decision. But we should not forget that the majority of caesarian sections are performed as an emergency; at the onset of complications, when labour fails to progress, or as a result of pre-existing medical complications. We have caesarians to thank for the low infant/maternal mortality rate.

If you’ve ever had a caesarian you’d know that it isn’t the easy way out. The phsyical recovery is gruelling and made worse by the feeling that you have somehow failed in the stakes of motherhood. You aren’t a real woman if you haven’t given birth vaginally and this feeling of failure is reinforced across the so-called sisterhood. From health visitors and friends to strangers in the supermarket I know this to my cost. A twin pregnancy, placenta previa and recurrant bleeds and yet I still got “Never mind”, as if I hadn’t quite tried hard enough. And my friend, who gave birth to her baby four weeks after mine? She got“Well done” and the instant status of supermotherhood.

By all means support natural delivery but equally remember that caesarian is often more life-and-death than lifestyle choice.

[Laura]

It's unrealistic (and unfair) that women should be expected to argue the toss about intervention/c-sections with the health professionals looking after them, on the offchance that the health professionals might be being too interventionist. Not all of us have the confidence or presence of mind to force our vision of childbirth upon the health professionals looking after us.

I fully agree with Sarah's post.

[Janine]

I am an NCT Antenatal Teacher - my clients feel prepared for any event in labour and I get very positve feedback from couples who have ended up with an assisted delivery or a c-section because they were prepared for what it might involve.
I also teach a lot of 2nd time parents who didn't go to any classes the first time and had a traumatic experience - they have ALL said how much more prepared they were after the classes and had a more positive experience with the 2nd labour. I feel very strongly that good antenatal education can help couples make decisions about their care in labour and the feedback from my clients reinforces this.
And I don't have a hairy face - unless you include eyebrows!

[Anne]

Surely we can all agree that there are only two ways out for the baby, a vaginal birth or a caesarean. As so many new mothers report, it is hard work looking after a newborn, trying to get rest, trying to establish the all important breastfeeding. Why make this harder than it needs to be? In general, mothers who have straightforward vaginal births recover faster than women who have complicated births or caesaerans and therefore have greater success in the first few days and weeks at parenting. A successfully breastfed baby will have a stronger immune system resulting in fewer days off work for busy mums. In addition, the less intervention, the fewer problems in the future. A woman who has had a caesarean puts the next baby in a riskier situation than if she had birthed vaginally. Nobody could argue that these risks are not worth taking if the mother's or baby's health was at risk. However, all mothers deserve the opportunity to make an informed decision themselves rather than leave it to a junior doctor who thinks only of the immediate situation and doesn't take into account the future for the mother. Please don't vilify the people who support mothers in this.

[maria]

I read this article with personal interest as my labour was more or less exactly as Tiffanie wrote.
I too had only read about natural births whilst following information about "how to experience the best birth" etc.,
My son is 16 but after enduring 36 hours of labour, breaking of my waters, my body decided to stall.
Luckily, (in hindsight) I begged for an epidural. My son started showing distress after a further 5 hours and I was rushed into the theatre. I was just grateful that he was alive and that I hadn't been knocked out completely and missed his birth.
I had to contend with so many comments from friends about how much I had missed out on a vaginal delivery. They tried to make me feel inadequate and it was hard to deal with as I saw no problem with how he came into the world. When I read all the negative press I often think "there but for the grace of god go I".
My son is a beautiful strapping young man now. Did it make a difference to him how he came into this world?
I think not. I am forever thankful that medical technology gave us both the option!

[Sarah]

The article made a good case for caesarians in emergency situations. A woman should never by villified for choosing to have a ceasarian. Surely a succesful labour is simply one which produces a healthy mother and baby. However, a statistic of 1 in 4 labours ending in ceasarians was quoted and I find it hard to believe that this is a true reflection of complication rates. I believe it is right to question the current practices of obstetricians and midwives which is leading to this trend. Are they too quick to interfere with a natural process? Do staff shortages deprive women of the one to one care and support which can make all the difference and impose time pressures upon the process of giving birth?

But it is the medical profession who should be defending their decisions not the women who did the very best that they could for their children in the most physically and emotionally demanding of situations.

[Hilary]

I had a C section for my first baby as I went into emergency premature labour after 29 weeks with a problem pregnancy. Every chance of saving the baby was taken and getting her out immediately was essential. Healing was painful (no prior knowledge to compare), but the wounds held together for the next 3 vaginal deliveries 'better for the mother to do it naturally'.
20 years later, as a result of the damage vaginal deliveries made of my insides - the incontinence, the nerve and muscle damage, I now could say - in hindsight - I wish all my deliveries had been by C section.

[Nigel Hurst]

Conflict of interest? - As a male and a doctor should I be commenting?? I have nothing professionally to do with obstetrics, but I do have two daughters both of whom had difficult, damaging labours and an appalling standard of pain control.
Congratulations to Tiffanie on speaking out against the tyrrany of the system and in particular midwifery. The use of the term "too posh to push" is derogatory and demeaning and disguises the complexity of the issues. The only outcome that matters is a healthy mum and baby - and if it needs a Caesarean to achieve this, then do it. Health care workers should be providing accurate information and allowing mums to choose. The final decision is one which should be left to the mother with the advice and support of her medical advisors - and the final decision is noone else's business.
One example of misleading propaganda is the oft quoted "Caesareans are associated with a higher rate of complications". Of course they are, because most are still done in complicated deliveries when things go wrong. No one knows what the comparative health outcome of vaginal vs Caesarean is in uncomplicated deliveries because as far as I know the study has never been done.
So lets have less politics and prejudice and more and better science to help women choose what is best for them and their baby. And please stop using the term "too posh to push" - it is repugnant.

[Sarah]

I think that mothers have been brainwashed into believing that anything other than having a baby "naturally" is failing. I had my no 1 son 21 years ago - and could have taken a degree in having babies, I'd read so many books. So I held out against an epidural, and it was the worst and most painful experience of my life. No-one can quantify another's pain, but I do feel the NCT and similar have a lot to answer for - in any other sphere of surgery, analgesia is a fact of modern life for which we are all profoundly grateful.

[Lesley]

If I had not gone for a elected C-section, there would certainly have been a death in the family. I was guided by an x-ray, the comment on which was "That is not going to get through that!" Added to which I had a ex-midwife relative who kept pounding on about it was my body and I should take things naturally. When I added that I was going to have an epidural, well, I was told I wouldn't bond, I would be paralysed, etc. etc. I presume mums who adopt dont bond! I agree cosmetic c-sections ought to be taboo, but mums needing medically necessary ones should not be made to feel complete failures, which I can assure you they are.

[Rachel]

Of course if there are medical problems, a C-section should be given if both mother and baby are at risk.

But the trouble is today that doctors and women are far too ready to have C-sections and interventions. The importance of the beneficial effects of a natural birth on the baby and the mother cannot be underestimated.

I think all the sceptics are saying is let's not be too quick to operate/intervene.

[Elle]

Coming from a country where natural home births are the norm, I too resented a caesarean. As I was expecting twins however I was told that a natural birth was out of the question.

No matter how much I argued and showed statistics of natural multiple births in the UK versus everywhere else I lost the battle.

I always felt it was more convenient for the treating staff to 'do me' on a Monday afternoon rather than having to deal with it on Wednesday night or, God forbid, Sunday morning.

I now know that the maternity department where I was treated had an above average number of caesareans. It does make me think that more mothers have been 'bullied' into believing the caesarean as the best option, even against their wills.

Emergency situations excluded women should decide themselves how they want to give birth and they shouldn't be pressurised by anybody either way.

[Tom]

My impression - from the watching rather than doing side - is that worry introduced by NCT classses ntroduce an extra layer of stress during childbirth.
Why should any mum in labour be worrying 'I'm really in a lot of pain, but I'm selling out if I have an epidural, so I'll hold on a bit longer'? This is the worry that NCT classes introduce, and I wonder if that extra stress has caused unnecessary emergency caesarians itself.