caesarian on demand? a good thing?

After 39 hrs in labour my DD1 had a Cesarean with her first due to failure to progress and the baby being in distress. She also had problems post op...an infection and developed pre-eclampsia which is quite rare after baby is born (she had no problems with pre-eclampsia before baby was born, he was 2wks early) It was a very stressful time for all.

She has made the decision that she will be having a CS with her 2ND baby...she is a midwife...and has experienced in her career two ladies that have unfortunately had tears of their womb which is very rare..but still something to be considered when having a natural birth after CS. So it really is down to the individual and their own circumstances, their needs should be met and all options considered, and any questions the mother has should be answered to alleviate any anxieties.

The only trouble is that the rate now in Uk is very high.
I thought of a nice example of nature and childbirth - it is emerging that it is better for babies if they get placental blood. Anaemia is a problem in many countries in young babies. http://www.economist.com/node/21540226
But to try to guard against maternal haemorrhage the practice is to get the third stage over as quickly as possible. Clamp the cord and administer drug to make uterus contract. Tough call when you have also got a mother who is vulnerable to anaemia.

I had horrendous labours both ending in emergency ceasarian-the type when they are running you down to the theatre suddenly.
I am 4ft 11ins small boned etc.The main reason for the first was transverse lie in labour.DS1was passing meconium inside me and his Apgar was 1 meaning more dead than alive.Fortunatly he was successfully resusitated. With my second pregnancy I was told that I would have a trial of labour, as it was still a wait and see situation.I spent this pregnancy in fear.The trial of labour failed, as I did not dilate and my uterus was on the point of rupturing when DS2 was brought out of it.His head was stuck in my pelvis and the surgeon had to apply forceps to ease his head out after I was cut open.Only then was it proved I should have had ceasarian deliveries every time.I asked the reason why I was made to go through labour again and was told we have to give you a try.Well I made sure no one was going to try on me again so I had the tubal tie done.
This was 42 and 39 years ago.I am glad things are changing now.

I would always opt for CS over a high forceps delivery. The women in our family seem cursed always to have problem first births. My mother suffered horrendous injury giving birth to my brother (3 day labour, posterior presentation) that resulted in her bowels becoming adhered to her uterus and eventual dangerous prolapse as well. Required several operations. I had a high forceps for (two day labour, posterior presentation) for my first baby and suffered badly from serious tears that required several surgical repairs over months. Was months before I could sit down without pain. My daughter had an emergency CS (posterior presentation again) and recovered swiftly.

Maybe coincidence but I think the damage that can be done by high forceps is quite often underestimated. A fairly recent Lancet study showed that PTSD and PND were more common in women who had high forceps deliveries than in those who had a normal delivery or CS.

Yes - I do not subscribe to the natural = good school of thought. I am just reading a book by Bill Bryson that has researched so much about our history and nature is brutal and maternal and infant mortality the norm.

My D had a posterior presentation both times, thought to be partly due to the angle of her coccyx; how I wish they had heeded the warnings of her first brutal labour and gone for a CS. Those in attendance at home insisted that the degree of pain she was in was normal and she laboured on at home far too long - she should not have been there in the first place.

During the pregnancy I was dying to say that I thought she should not be having a home delivery, but it is hard to interfere, as it would have sounded as though I was being a doom-monger, and she was holding onto the idea that it mwould not be as dreadful second time round.

So true Mishap. We have been conned by advertising and marketing into thinking that natural=good. I for one would be long gone if nature had been allowed to take its course. Nature is brutal in culling the weak - and damaging mothers in order to get the baby out. Human babies have big heads and our curved biped pelvises are a tight fit at the best of times.

I suspect my DIL problems were partly down to the staff being overly keen on letting nature take its course, rather than identifying that here was a small boned woman with a posterior presentation. The only time i was on the ward they were drifting round dressed as earth mothers... Call me old fashioned but I would like a midwife to be dressed in a nice clean set of scrubs!

I think that one of the problems is that there is now a strong home delivery/natural birth lobby that sometimes leads to poor decisions, because the desire to encourage a "natural birth" skews professional judgement.

There is no doubt that my D's second baby should have been born by CS and that the prolonged agony she endured at home before being rushed in for a spinal and a forceps should never have been allowed to go ahead. The problems that arose were identical to her first labour and entirely predictable due to disproportion and a mis-shapen bone structure.

The problems that she has been left with will undoubtedly continue to trouble her for the rest of her life.

The idea that a natural birth is the ideal is misguided - a lot of natural things are extremely negative: cholera, arthritis, diptheria, puerperal fever - I could go on. We have the benefit of modern medical science - let's use it!

Knowledge is power. A natural birth is always the preferred option but there is so much interference which often creates problems at the least and can cause a painful birth. An expectant mother really should discuss what they want in their birthing plan with their doctor/midwife so they know exactly what that person thinks is the norm.

I found this link really interesting as it is talking about labour and birth interventions.
www.naturalbirthandbabycare.com/birth-interventions.html

Caesarian when necessary, natural birth when possible seems to be the right option.

BUT as far as I'm concerned, caesarian IS necessary when the baby is breech, when the Mum has a narrow pelvis, when labour is taking too long, and when any other dangers are present.

If a hospital is more concerned about budget than the patients, then I believe they might make a mother suffer unnecessarily, rather than go to the expense of surgery.

I've had the three main options: bearable, caesarian and unbearable.

I had a natural 'birth' when it was 3 months premature. The baby was stillborn; we already know this when I went into labour, but the 16 hours of pain and pushing was bearable - just.

Then I had an emergency caesarian when the baby was breech with prolapsed cord. It went well, no problems then or afterwards.

Then I had a so-called 'natural' birth. It involved 12 hours of unbearable pain followed by a forceps delivery, and a lifetime of back troubles. The midwife had not picked up the fact the cord was round the baby's shoulder, preventing me from pushing it out. Doctor's rounds and the discovery of the problem happened in time to save my sanity and the baby's life.

Then I said NEVER AGAIN.

We took permanent precautions.

A midwife friend said that a vaginal birth massages the spine of the children being born which is important stimulation and causes pain relief hormones-endorphines- for the baby to be released. In a CS, the baby is without these hormones and ideally the mother should have had at least several hours of contractions.
Never on demand but always available. That is what the NHS should aim for.

I agree there is a place for elective caesarians but the idea of "on demand" smacks of the "too posh to push" that does prevail in areas of private healthcare. Also... private doctors just possibly charge a higher fee...
But Littlemo my DIL had similar experience re posterior + botched up delivery. Like you I will not discuss these online, but if you would like we could PM? She is fine now. But it was definitely caesarian for the second one.
They are often not a walk in the park. The recovery period can be difficult.

Absolutely littlemo My D2's first baby was in a posterior position and she said the birth was absolute agony. Her baby was 9lb 2ozs and my daughter was depressed after the birth. She was frightened to get pregnant again and said she didn't want to go back for more torture. Three years later she got pregnant again and she had nightmares each night from the day she found out she was pregnant.

D2 asked an older experienced midwife who does home births to give her advice and this woman visited one afternoon to try and help D2 to settle her fears. Her advice was if you could push out a baby in a posterior position you must be very strong and you should be able to do it again. D2 also has a friend who is a nurse and very much into home births and she tried very hard to talk my daughter into a natural birth. The midwife also suggested that she visit a physiotherapist who is very experienced with pregnant women. My daughter went to see her intending that if the baby was in the correct position she would go for a natural birth. When my daughter found out that she has a twisted pelvis and her second baby was also in the posterior position, she decided that she was going to have a c-section.

D2's doctor (different doctor and hospital from the first pregnancy) had always been supportive and said he was happy to do a c-section. The outcome was a very happy relaxed mother and baby too. Six days after my GD was born we went to the monthly meeting for the Homebirth Group, my daughter likes to attend these meetings as she is interested later in becoming a midwife and she is also a member of Nursing Mothers. My daughter looked fit, happy and relaxed. I know there were women there that thought she should have had a natural birth and they were surprised that she was feeling so well.

D1 had a very different experience, her first baby was in a breech position and her c-section was not as good an outcome as D2s. The stitches became infected and she was in a lot of pain straight after the birth. I saw her immediately after and she was shaking she was in so much pain. She had her baby at the same hospital as D2's first birth. Not a very good hospital I think. D1 had a natural birth with her second baby.

D2 also found this link reassuring on which decision she should make if second baby was in a posterior position. midwiferytoday.com/articles/paininback.asp

Yes - with you all the way littlemo. The long term detrimental results of a traumatic labour can be dreadful and it would be far better to have a CS. They have become as safe as a normal birth now, so I think they should be used more for the purpose of enhancing long term health.
D has just had a very similar experience to the one you describe and I know that the problems she is experiencing now will be plague her for the rest of her life. The decision to try labour at home after a similar experience with first baby was in my opinion reckless and ill-judged.

My daughter, two days ago, gave birth to a beautiful, healthy little boy. We are all delighted to welcome him into the family. However my daughter had a horrendous birth experience which ended in a spinal block and forceps delivery. I know it is early days but she is experiencing some severe post natal physical problems ( I don't want to go into detail). If she was to give birth again I would strongly advise her to have a C section.

I had to have my three sons by caesarean section on health grounds. I would have loved the chance to have natural birth unfortunately I could not. So I think it is better if you are able to have a natural birth.

will do absentgrana

There's another thread in the Health topics on this. It's called Elective Caesarean sections. You might want to have a look at that.

olliesgran, Just as you say I don't think it is likely to happen because of the cost involved.

I am sure there are lots of arguments for and against. Personally, I think a vaginal birth is best.