So the C-section debate has blown up again. With news reporting that NICE are now recommending women be given option of a CS if they request one under certain circumstances.
For reference the existing the existing NICE guidelines (http://www.nice.org.uk/nicemedia/live/10940/29334/29334.pdf) and the draft updated NICE guidance (http://www.nice.org.uk/nicemedia/live/12156/54552/54552.pdf) which also differentiates the risks of ELCS versus EmCS and vaginal birth.
The draft NICE guidelines (Published 23rd May, 2011- maybe a more uptodate version somewhere- too tired and grumpy to google) (http://www.nice.org.uk/newsroom/pressreleases/CSectionUpdateConsultation.jsp) state “when a woman requests a CS because of a fear of childbirth she should be offered a referral to a healthcare professional with expertise in providing perinatal mental health support to help her address her fears in a supportive manner. If, after providing support, a vaginal birth is still not an acceptable option to the woman, offer a planned CS.” http://www.nice.org.uk/nicemedia/live/12156/54552/54552.pdf)
I am happy with this. The latest update seems to indicate NICE maybe publishing guidance that may offer C-sections as a valid birth choice not necessarily dependent on medical need.
Given that I am now 9weeks away from a possible C-section after traumatic first birth (If I decide to ELCS and not VB not sure yet) think it safer for my mental health if I keep out of the current debate but there are some fascinating points being made here.
But I did want to ramble about a couple of things- firstly as a twitter pal pointed out yes ELCS is £800 more expensive than a vaginal birth but these don’t necessarily include the cost of subsequent vaginal repair operations or counselling or additional appointments. God knows how much extra my traumatic first birth has cost the NHS. I know if I have a traumatic second vaginal birth I will be costing them a lot more than £800!
Secondly I saw a tweet that said something along lines of if a woman had experienced a perfect vaginal birth there is no way she would ever have her stomach sliced open (and tweet rambled on quite graphically about how utterly ick sections are). That one struck a chord with me. It is possible true (but with unnecessary vitriol being directed towards CS’s which don’t serve to make women feel better who have experienced that option whether through choice or necessity). The debate kind of trundled on into birth preparation being the issue. But how can you guarantee a “perfect birth”? remember ONE in TEN women will suffer some form of PTSD after childbirth. Many others report feelings of loss, sadness, trauma or shock particularly around first births. I think it is an unreasonable expectation- this notion of women need to be prepared properly for birth- yes I agree to some extent but all the preparation in the world isn’t going to stop some of the things from happening and to suggest that it can and will just serves to make women who don’t manage a “perfect birth” feel more of a failure.
So in conclusion I need to stop reading tweets/blogs/newspaper articles about it because my brain can’t cope at the minute with it given where I am. But overall yes I welcome CS being made a valid birth option for women if they were to choose. Women shouldn’t have to fight for something they need and it’s not a choice women make lightly so giving them autonomy over their own bodies is important. I am so so lucky that my new hospital have not made me fight and have supported me so well.