Safe is a Dangerous Word

I've been reading a blog post by Ricki Lake this morning, and while a great deal of what she writes is to be applauded - providing birth plan choices that reflect each individual woman's preference and caring about a woman's postnatal mental health for example - as with many voices on the subject of natural birth, her repeated use of the word "safe" concerns me.

Don't get me wrong - I have used the word safe to describe a planned cesarean too, but in the context of surgery in 2011 being 'comparatively safe' or 'statistically safer' in some respects, than other birth plans.

I would never categorically state that any birth plan is categorically safe.

NICE Stakeholder Caesarean Comments Submitted - Back to Blog

As always, I seem to have a backlog of stories and medical studies to report on here. On this occasion, my time has been largely consumed with reading around 600 pages of the NICE Caesarean Guideline Update Draft, and preparing detailed feedback for the Guideline Development Group before they agree the final text.

C-section Caps Cost Lives and Money

I was appalled to read this story in the Express this morning, "Op Cutbacks Put Mothers At Risk". 

In it, Lucy Johnston writes:  "The Sunday Express has learned a growing number of health authorities have said they will not cover the cost of caesareans if they exceed the national average of 23 per cent. They will instead pay only the rate for a normal delivery, which means hospitals could lose up to £1,300 each time."

And I couldn't agree more with some of the comments quoted in the report:

Breech Birth Choice or Pressure?

Many women have complained that when they wanted to try to deliver their breech babies vaginally (e.g. using ECV), they have been pressured into having a planned cesarean by their doctors.

Obviously, a percentage of these women would have been successful in their trial of labor, and therefore it's good that the SOGC has published guidelines that may help women like this in the future.

In an article that was originally published in 2009, but updated this year (C-section not best option for breech birth), André Lalonde, executive vice-president of the SOGC, said: “Our primary purpose is to offer choice to women”.

But let's hope that the pendulum hasn't swung too far the other way now, and that women who would be more confident having a planned cesarean for breech presentation (as I was) are not being denied this entirely legitimate choice.

Devastating story in BMJ today: 'Living with obstetric fistula'

This is why I often say that there are TOO FEW cesareans in many parts of the world. Published in the BMJ on 9th June, 2011, 'Living with obstetric fistula' is a must-read for anyone who doubts the need for more obstetric care in the developing world.

Maternal Request Children LEAST Likely to Develop Psychopathological Problems

"The likelihood of childhood psychopathological problems may be the lowest in children born by CDMR (cesarean delivery on maternal request), followed by those born by SVD (spontaneous vaginal delivery), whereas the highest probability was observed in those born by AVD (assisted vaginal delivery)."

School asks parents how child was born - cesarean or vaginal?

Yes - as part of its elementary school application process, Dry Creek School District in California is reported to have asked parents how their child was born.

You can read the story in full at CBS' School Application Criticized For Birth Questions, but as the reporter says, unfortunately there is no word yet from the school district.

Frederick Leboyer on Natural Birth - A Must Listen

BBC Radio 4's Woman's Hour: "The French obstretician, now aged 92, discusses the influence of his landmark 1975 book Birth Without Violence."

This is just a short interview that played on Woman's Hour on 31 May, 2011, and well worth a listen - just prepare for your mouth to drop open wide very early on and probably stay like that way right the way through to the end.

Why I Chose To Have An Elective C-Section

I just had to comment on this article by canadian author Rebecca Eckler. Here's what I wrote:

This is a great post, thank you.

May I just add that there are also women who choose to plan a cesarean birth because they've made an informed decision - and not just out of fear.