What not to say to a c-section mum

[Bournefree]

Following a link from another thread I found this interesting article about what not to say to a c-section mum.

I have at times felt like asking some of these questions of c-section mums, or have harboured these feelings - so I am quite guilty of these thoughts (mostly in my own mind, as I wouldn't normally voice these feelings out loud - of course for the fear of upsetting other mums, which is something that I totally wouldn't want to do intentionally)

This article really made me think and evaluate what is it that I feel?! I think that my feelings are similar to one of the comments - that I wonder how many of c-section mums wouldn't have needed or required a c-section if different healthcare attitude/support was in place before it got to the emergency stage? Which is why I mostly feel empathy for the birth these women have lost in some way. I like to challange how I feel!

I have extracted its main points below. Full article and comment at https://www.themidwifenextdoor.com/?p=1328

* If you’d gone to my midwife, she could have gotten the baby out without a c-section. While it is true that midwives are very good at helping babies come out vaginally, that’s not the only goal. In the years before caesarean birth was available, there were occasions when a baby truly could not be born vaginally. Eventually, mother and baby would both die because of obstructed labour. Even if you are convinced your midwife could have gotten the baby out, respect the mother who has had a caesarean birth, and acknowledge that some babies cannot be born vaginally.
* Most “emergency” c-sections are not really emergencies. While I believe that many emergency c-sections are not really emergencies, I have also seen many c-sections that were emergencies. In those instances, I was very grateful for the option of a caesarean birth. Unless you were present and aware of the circumstances surrounding the decision to perform a c-section, this is a difficult judgment for anyone to make.
* Trust birth/your body won’t grow a baby too big to get out/your body was designed to give birth/birth is natural. Any and all of these mantras carry an important truth, but not an absolute truth. There are women whose bodies grow babies too big to be born vaginally. Birth is natural, and so is death. Should I tell the woman who arrived at the hospital 8 centimetres dilated, only to be told we could not find a fetal heartbeat, that she just didn’t trust birth enough? I believe we should trust the process of birth, unless there is a clear indication that the process is not working normally. In those cases, there are times when a caesarean birth is the best option.
* If your doctor had ______, you wouldn’t have needed a c-section. (Insert phrase of your choice: delivered your baby breech, done an external version, used forceps, not given you an epidural, let you get out of bed, etc.) Again, this is making a judgment on the c-section mother. At the time a woman consents to a c-section, she is usually tired, possibly in pain, and almost certainly scared for her baby’s safety and even her own. To judge her because she made the best decision she could under very stressful circumstances is simply heartless.

It must be so very hard at times to breastfeed and care for your baby with a major surgical wound to cope with too?

However birth happens; I was really shocked to find out that the most likely cause of death for mums (both expectant and post nataly) is suicide!! So we should really be looking out for the psychological effects pregnancy, labour, birth and post natal care is having on women in "developed" countries.

What do you think ladies - this has in someway conflicted how I feel? I will certainly be watching what I say or even write in future.. as I realise this could be very harmful.

------------------------------
Good link to an article by a lady fed up with being told be "be greatful" she had a healthy baby! Thank you Samatha

 

[chuck]

One thing that boils my blood is 'too posh to push'

I cannot stand it, I've been reported to mods for getting a bit ranty to people who throw that comment around. An elective for no medical reasons in the UK is very rare, most of us have no real choice when push (excuse the pun) comes to shove due to the situation we are in.

 

[Jenniflower]

I plan to be "too posh to push' but for completely different reasons, hahaha.

I love what you've posted here Bournefree. I think it's really important that every woman respect other women and their births. It's no place to judge whether it be a home birth judging a c-section or an Epi judging Gas and Air. I think that's one of the main reasons I don't get most of my friends backs up when I talk about having a home birth. I'm not saying it's the end all be all of birthing, but that it's merely what I'm hoping to achieve.

 

[urbanbumpkin]

I think that is a good list to remind yourself with if you find you are judging other people's situations, and want to catch yourself. It can be easy to forget that the truth of your own experience isn't necessarily universal.

--------------------------------------------

I was booked in for a homebirth with a very supportive and experienced team of dedicated homebirth midwives.

On their advice I transferred to hospital for continuous monitoring when I had heavy meconium staining in my waters. I trusted them, and their years of experience (and knew their commitment to home birth was very strong) so went in.

My c-section resulted from the lack of mobility due to the continuous monitoring that they had advised. The baby just wasn't able to get into a good position for birth, due to my lack of movement and not being able to get into the positions that I instinctively knew and felt were best. (The contacts on the monitor would fall off in most positions and with movement so I was stood still and upright for almost 12 hours).

Neither of us was in danger or distressed, I was fully dilated (with no pain relief apart from hypnobirthing techniques), but while being monitored nothing was progressing.

I do know that the resulting c-section was the end point in a chain that led directly back to me being monitored.

It isn't the way I would have wanted to birth, and it wasn't the way my fantastic homebirth midwives wanted me to birth (but they have said I am still a good home birth candidate for next time, which is great).

-------------------------

So from my own personal experience I feel it is particularly good to be open minded about how you approach thinking about other women's c-sections. You never know the full story.

However on a positive note the hypnobirthing enabled me to feel calm, in control and positive even when the situation was not what I wanted. And it has helped me get over it quite well, and helped me find peace with myself, even though I would do things differently next time if possible.

-------------

Thanks for the link to the article, Bournefree.

 

[Dragonfly]

I had an emergancy c section. I didnt want it but we where both in danger after hours of labour so had to be done. i felt I didnt have a proper birth and was upset over it for a long time. even induction pissed me off for ages, I wish i had of said to them to leave me a few more days like I did this time but I had high bp, swelling for weeks and was over due and knew less.
When i got pregnant with Alex I wanted a natural birth so much, I didnt want what happened last time I felt like I failed and didnt know what a real birth was till the end. They tried to induce me but refused and went further over due. I went naturally myself a day before my book induction I was 12 days over due and got a virginal birth. I felt so much better! i dont feel pissed off about any of it any more as i know what natural birth feels like and wish I had of had it for william but he is here and I am here both safe. My hospital dont do them willingly only on in emergencies. Alex got stuck and they tried to do one only I wouldn't have it.

It shocks me poeple can choose this though, I rather the natural way I was up and about hours later and walking out of the hospital and felt so much better.

 

[Mervs Mum]

I once heard a MW say of the other MW in the room - she took the easy route and he came out the sunroof.....now they knew each other VERY well so the laughed and it didnt seem an issue but I dont like anyone calling it the easy route. It's WAY more risky than a vaginal delivery and I can tell you from partnering my sister and seeing her after, that was NOT easy.

 

[Dragonfly]

no not easy, I couldnt well for a while and coughing near killed me. Scared me to that happening being cut open. And lucky I breastfed fine after.

 

[Mervs Mum]

I think BFing after and elective is more likely to be problematic than after an ECS. yes shock can effect things but at least the body and baby have had the hormonal signals and triggers if labour happened spontaneously.

 

[Dragonfly]

ah I see. But I was induced. Wish I knew more then instead of everyone thinking and telling me induction was so normal around me. Didnt feel right at all. I was 1cm when I got in for my induction I wish I had of just waited or said something. Lucky I didnt have pre eclempsia. Never would I choose that and dreaded it happening again last time. I read most inductions end of c sections somewhere.

 

[Mervs Mum]

Yes a high percentage do. I got away with just forceps with my induction.

 

[clarsair]

Thanks for posting that extract. I still have unresolved feelings about LO's birth - I had planned an active homebirth with nothing more than gas and air for pain relief and it was all going to plan but after about 16 hours of established labour things started slowing down, midwives thought baby had turned back to back and I was exhausted so they recommended an ambulance transfer to hospital. After another 3 hours and having every type of pain relief going the doctor recommended a c-section has her head was still only 3/5ths engaged and there was some variation in the heart rate. I have, and still do, beat myself up a bit with all of the statements you posted - could I have been more active (I was upright the whole time until going to hospital)? If I'd not had the epidural or let the midwives try to break my waters would things be different? Did the doctor intervene because of the length of time that had passed rather than 'needing' to perform a c-section thus robbing me of the normal delivery I so badly wanted? I've since heard a midwife say that the doctors at the hospital have no faith in women's abilities to give birth. Or was it my lack of postivie thinking? I truly believed in the statements that birth is natural etc and read lots of hypnobirthing/natural birthing books beforehand, Ina May Gaskin etc which I think made me feel like even more of a failure now. Even my midwife saying that if my case had happened 100 years ago we both would have died, didn't make me feel much better.

Anyway, it's definately made me think much harder about c-sections as I too was perhaps a bit guilty of thinking of it as the 'easy option' before it actually happened to me.

 

[Bournefree]

Thank you for sharing your thoughts, feelings and more importantly your experiences about this ladies.

This thread would be poorer without the input of women who have encountered the sharp-end (pun intended), of medical care.

How would I feel faced with your situations? I think I know that I would have done all of the things that you did do. (though, I do have strong feelings about constant monitoring)

I also have strong convictions about natural birth - but then I haven’t been through anything else.. so I'm not at all in a position to comment, but I have always had a strong sense of empathy.

I do however have some convictions about medical interventions.. mostly how I feel that mothers should be supported, encouraged and helped to relax as much possible by our heath carers... before reaching for/considering intervention. Interventions should be used as final options and reserved for those that require them. Those that do, I'm sure are grateful, as I would be.

However, one thing I can't resolve in my own head, is how anyone would want to do an elective c-section considering it is a major operation?? I think the one circumstance I would choose this option would be if I was so psychologically terrified of natural birth, that it would become a medical necessity for my mental health? I do find it very sad there are so many women who are genuinely frightened of giving birth*; I have found that most women who are frightened are first time mums, as they have no idea what to expect, and bring to their birth whatever cultural experiences of birth they have - another way of saying media influence really, as few lucky women get to see or participate in the brith of any of our family anymore. You only have to read some of the comments from each of the trimesters to confirm this. The realistic picture of birth is under/poorly-represented. (perhaps both on the natural and the EMCS side)
xXx


*In my experience, I haven't found many second, third or more mums who are fightened of repeating some of their less than satisfiying births. I have nothing but the upmost respect for an individual who decides next time it WILL be different, and comes back to birth with her faith and resolve in tact! You are inspirational!

 

[Dragonfly]

I was terrified second time around and I had emergancy c section first time. I didnt want that again and didnt know what vaginal felt like and everyone said c section was easier. Made me worse as c section didnt feel so great for me after so how much worse could natural be I thought. But I didnt want c section as I didnt feel I had a normal birth, As I explained before there (sorry if I repeat msyelf my heads mashed i need sleep lol)

I would have natural over c section any day. I felt better mentally after like I actually did achieve something. Now I aint saying all woman dont achieve that have even an emergancy c section but thats honestly how I felt and I was upset about it for a long time. I do think I needed it though but got what I wanted in the end and feel finished with labours and happier.

 

[xoxsarahxox]

i have read but dont fully understand everything in this post (im not the birghtest crayon in the box )i dont no anyone who has had a c-section, emergency or selective. i cant understand why anybody would choose to have one over a vaginal birth other than for medical reasons. and i think it is a huge shame for those mums who go into labour expecting a vaginal birth and end up having a c section. not so much because they didnt get the type of birth they wanted but because they havent been prepared for a c section. i have 2 children and i dont remember once during either of my pregnanys being told about c sections the risks/how they do it/ who does it/how long it takes/ who can be there/ recovery....the list is endless. during my first labour they were about ready to give me an emergency c section and i was so frightened, just because i didnt know what to expect. sorry if i have turned this into a mini rant, i understand not everyone is going to end up having an emergency c section but it still ends up being the way for some woman and i think it is terrible how poorly informed we are of c section births during our pregnancy x

 

[BabyBinns]

I am due for a c-section and although it is for medical reasons on my notes I am down as an elective C section.

This will be my second "Elective C-section" but the reason for this is that with my first pregnancy in labour I suffered a full term placenta abruption and had to give birth vaginally with the help of the drs, it was a long long birth and I lost 16 pints of blood and was too ill to have the baby born by c-section and twice they did bring in my family to say good bye, not that I can remember it but they did.

They cant tell me if labour caused the abruption or if the abruption caused labour and once this happens you cant physically get your mind back to having a healthy vaginal delivery again. I think my reasons are psychological but also maybe partly medical in my mind but also its very hard in the UK to get an elective c section you have to go and plead your case to a dr and then they decide if you can have one or not and on both occasions as soon as I sit they say I have read your notes and we wont be opposing a c section and fully recommend one.

Just wanted to give the other side of the coin so to speak.

 

[Dragonfly]

sounds like you had reasons medically.

 

[Celesse]

My section is a bit of a grey area with regards could it have been avoided or not. At 5cm she was found to have a high heart rate with decelerations so I was sent into hospital for continuous monitoring. Once in I opted for an epidural, mainly to avoid having a general anaesthetic if a crash section was needed. As the labour went on she had a massive deceleration which was followed by an even higher heart rate. I also had a high heart rate, high BP and high temperature.

The high heart rate and transfer where diagnosed at around 4pm (5cm and 13 hours into labour) and I was immobile from around 5pm. Decision for C-Section was around 11:45pm (8cm). The decision was made on the poor heart rate and the slowish labour which meant exposing the baby to an environment that was distressing her for longer than the consultant felt safe doing so. At the rate I was dilating it would potentially mean another 6 hours of labour, (4 hours to dilate the remaining 2 cm, an hour to allow baby to descend and another hour of pushing). If the high heart rate was caused by an infection that would mean another 6 hours of exposure for LO.

Monitoring responsible for the section? Possibly. If I had the same labour but without the fetal heart rate problems chances are I would have remained mobile and upright and delivered vaginally much earlier. But intermittent monitoring picked up a problem that they had to act on. The baby was distressed and this distress did get worse as labour went on. At the point at which I transferred to hospital and began monitoring there was a real risk of a poor outcome, which was reduced by knowing what the baby was doing.

 

[urbanbumpkin]

though, I do have strong feelings about constant monitoring

I did too, and knew that it could lead to further interventions.

But it was the course advised by my very supportive of natural birth midwives. The same midwives that would have been happy to deliver a breech baby naturally (if he had been breech), who were happy with going as far over term as I wanted (with monitoring), who had recently done a lotus birth, who were on board with hypnobirthing, who would happily deliver into water, etc

So I trusted their judgement in the situation I was in. I knew it placed me at risk for a further intervention, including a section though.

I do think if 'my' midwife had stayed with me it wouldn't have got to the section stage. It almost makes me wish he had been breech as then she would have stayed with me, rather than handing me over to the hospital team (due to her breech experience)!

 

[helen1234]

my mw upset me when i just had rhys, she was quite old school, but kept banging on about statistics of c sections, she looked at my notes and said "fetal distress and pre eclamp" shook her head and said we'll never get the statistics down in this hospital. if i hadnt been so distressed over just sorting rhys's tongue tie i think i would have jumped off the bed and punched, she made me feel like i'd had a c section for know reason, and that wasnt the case. the mw who sent me over to the consultant side did everything in her power to change my position etc, even got a second bp machine to double check my bp grrrr

 

[Smudgelicious]

This is something I posted in another place so it's not entirely relevant here, but a lot of it is. I liked the link though I have to admit I was surprised that people really are that judgemental about c sections.


Don't tar women who want a different birth or who worry about coping as 'naive' or uninformed. How do you know ? Where on earth do you get the idea that everyone has the same world view, or experience, let alone method/s of coping with birth ? Birth, which is so individually variable it can't be simplified into 'coping' or 'not' ?

I'm having my fourth baby and I'm having another c section. I'm not in a bubble, natural birth kills my babies because I am not 'designed' to give birth naturally - a common enough variable, unfortunately dismissed by believers in the 'we're all designed for this' cliche. Me and other women like me are the ones that used to die in childbirth. However, c sections exist so now we don't, we have wonderful lovely births of happy perfect babies. I can't imagine being disappointed in a surgical birth of a live healthy baby.

It often seems forgotten in the debate of who did it 'right' or not, that the aim of pregnancy is a healthy child of a healthy mother. If that outcome is achieved with every single technological intervention possible in a hospital, or at home with a midwife, WHO CARES ? One or the other is not a superior experience. And birth fades in the experience of actually raising children.