Wednesday, February 22, 2012

Call the Midwife but Celebrate the C-section too

The dedicated midwives depicted in this BBC drama undoubtedly deserve our praise.
But so far at least, there seems to have been a dearth of recognition (in reviews) for another praiseworthy life saver: the c-section.

The often untold stories of babies and mothers who died or were seriously injured during natural births in the 1950s are touched on in this series, and it's evident that the technology available to us today, including ultrasound and emergency or planned cesareans, would have prevented so much grief and heartache.

We marvel at how far we've come (e.g. contraception, IVF, pain relief and hygiene), and yet advances in the comparative safety of cesarean surgery can sometimes be overlooked, taken for granted or even maligned.

Let's celebrate the call to midwifery, yes, but we should celebrate the cesarean too; it's just as deserving.

11 comments:

Sensible Midwife said...

Hmmmm. In their place C/Sections are very useful.

And I mean in their place - as a life saving last resort and not as a lifestyle choice.

Sensible Midwife said...

Hmmmm. In their place C/Sections are very useful.

And I mean in their place - as a life saving last resort and not as a lifestyle choice.

cesarean debate said...

I find the phrase 'lifestyle choice' at best unhelpful and at worst, ill-informed.
Cesarean choice is usually a prophylactic choice, and the term lifestyle is only really relevant in the context of women wanting to avoid potential damage to their pelvic floors, and the devastating changes in lifestyle that this can mean for some.
As for cesareans being used as a 'last resort' only, this has its dangers too. Some women and babies with certain risk profiles would have better outcomes if a planned cesarean was carried out rather than waiting for or inducing a trial of labor.

Anonymous said...

Pelvic floors are damaged by pregnancy itself.

Sweeping generalisations are unhelpful.

Yes, some babies are best delivered by CS. But that's not what the banner in your blog says: you advocate them without medical or obstetric reason.

cesarean debate said...

I absolutely support informed cesarean choice where there is no medical or obstetrical reason, yes.

You say that sweeping generalisations are unhelpful having just stated that 'pelvic floors are damaged by pregnancy itself'. With respect, this demonstrates that you are not up to date with the medical evidence that exists on birth-type associated risks. The risk of pelvic floor damage IS greater with planned vaginal birth compared with planned cesarean birth.

Anonymous said...

If we are using sweeping generalisations Risk of death is higher with caesarean section (as with any surgery) compared to vaginal delivery.

Anonymous said...

If you want to start a slanging match and accusing me of being ill informed, feel free. I'm just a plodding old midwife who works at the coalface and therefore my opinions are worthless.

For the vast majority of women and babies, normal birth is the most apporopriate mode of delivery.

A tiny minority of women may suffer pelvic floor damage but with the right treatment this is not permanent. The biggest barrier to appropriate treatment is embarassment.

You made your choice. That's your lookout. Whatever your personal reasons were: am not criticising you for that. It's your pro CS stance for CS with no obstetric (not obstetrical, unless you are American) reason.

I find it so sad that you are going these lengths to justify your choices. You appear to have made your choice out of fear rather than anything else, and now you are trying your very best to put to project that same fear into other women, many who may not even be pregnant yet.

Unnecessarily. For as I said, the vast majority of women will deliver naturally with no problems at all and for the tiny minority who do experience problems, these can be be remedied.

Anecdotally I have had 4 beautiful big babies, with no damage whatsoever. I have never had such empowering experiences ever, and I don't think I will again.

As a midwife, I feel that every birth is special and every baby is unique, no matter what the mode of delivery. But spontaneous labours, where you can watch women move around freely, listening to their bodies, with supportive birth supporters culminating in a wee peep of a baby's head and a smooth birth - priceless.

Believe what you will, and justify your choices as you will, but please stop trying to scare women.

It's not nice.

cesarean debate said...

There is no point comparing risk of death with different birth outcomes only. Obviously, the group of healthy spontaneous vaginal birth outcomes will have a lower death rate than all cesarean surgeries grouped together.
But the point is that we need to look at PLANNED modes of birth -vaginal and cesarean - and then compare each of their actual outcomes.
Deaths that occur in emergency cesarean surgeries that originated as planned vaginal deliveries are unrelated to the planned cesarean group, but unfortunately, many medical studies in the past did not recognize this fact.

cesarean debate said...

This blog is a forum for debate, nothing else, and I don't believe that your opinions are worthless at all.
I use American spelling because the book I have co-authored is published in America, and this blog was started while I was living in America.
I think that on some points we must agree to disagree, and I think that it's important that we respect each other's choices.
I am not trying to project any fears on to other women, and I have no desire to encourage all women to have a cesarean. I simply believe that they deserve to be told the risks associated with a planned vaginal birth in addition to the risks associated with a planned cesarean birth.
Also, I am absolutely confident that it is not true that, 'with the right treatment', all pelvic floor damage can 'be remedied' or 'is not permanent'. And even where treatment is able to relieve some of the worse physical symptoms, there are a number of women for whom life is simply never the same again, and additionally, they may suffer long-term psychological trauma too.
I agree with you that this does not happen in the majority of cases, and women should understand this, but for too long now, too many women have suffered serious damage as a result of vaginal birth and said to their doctors, "No one ever told me this could happen".
I think sometimes that it is some natural birth advocates who are fearful - fearful of what birth choices women might make once they are fully informed of all the facts (not you necessarily, but I have certainly come across this fear in others in the past).

Awesome Mom said...

Don't let the trolls get you down, I think what you are doing here is awesome! Call me vain if you will but after hearing about my sister's vbac with a big headed baby I am so glad I did not choose that with my children and instead went to planned csections. My kids all had large heads and I am glad that I avoided being ripped up down there plus I did not need to worry about the possibility of uterine rupture.

Tim Reed said...

From where I live, most women would wish for planned vaginal birth for monetary reasons. No doubt CS works, but likely the last resort.