Whatever we may think of the UK caesarean rate, the fact is a significant number of us will have a caesarean, planned or otherwise. My work over the last six years with practitioners and women preparing for birth and those who have already started their families has made it abundantly clear that this mode of birth is both feared and stigmatised by many. It is little wonder that thousands of us every year experience it as ‘disappointing’ or worse ‘highly traumatic’. So why prepare? I talk to Netmums…
Author: admin
Who are Lazy Daisy and why are they different
I recently came across a relatively new antenatal organisation – Lazy Daisy. They offer movement based pregnancy wellbeing and birth preparation classes. Â While they do not talk about interventions and more traditional modes of pain relief as I would advocate what is fantastic is that they focus on
“helping mum eliminate worry or fear before the birth…encouraging her to look forward to her birthing day, however the journey pans outâ€.
Of course a caesarean may be the outcome but in viewing birth as a positive journey and focusing on the end goal Lazy Daisy’s founder Julie Long reports that
“even when birth has taken a different path to what they hoped, [women] continue to feel in control and so feel 100% positive about the journey. Many of our mums forget to even mention how the journey finishes [vaginal or caesarean] because they are so enthusiastic about describing how they were riding their waves.”
These classes do not claim to be a one stop shop for antenatal preparation but they do seem to encourage women to have more realistic expectations of birth. The classes provide a safe, open and honest environment in which to discuss all aspects of birth. No topic is out of bounds. Lazy Daisy recognise that while natural birth and breastfeeding are desirable goals they also acknowledge that for some women bottle feeding and medical forms of pain relief may be preferrable. They point out that there should be no shame attached to this and they encourage discussion on all topics.
Anja a mother who recently attended Lazy Daisy classes before her home based VBAC said
“We practised techniques to help keep us calm and once in labour I went into a kind of automatic, I could hear the teachers voice from the relaxation sessions and it really worked, my homebirth was a wonderful, calm experience.”
The organisation is growing fast and there are now classes all over the country.
Thinking about a VBAC?
What should you consider if you have previously had a c-section and are now expecting another baby?
“Decision-making following a caesarean is naturally coloured by previous experience, but if possible the key thing to focus on when making your decision for your next birth is a balanced assessment of risk in your specific circumstances, this time round. It should not simply be a question of ‘This is nature, I am made to do it this way’ or ‘This is my right’. It is the specific circumstances of your previous births, your current condition and the progress of your pregnancy this time that should carry most weight.” More
Media reports on NICE caesarean debate quite balanced
Media debate over one of the key changes to the NICE caesarean guideline has been very thorough throughout the day. Focus has primarily been on the recommendation that women should have the right to request a caesarean even when they do not have a medical indication for one, (assuming that request follows detailed discussion about the benefits and risks of both modes of birth).
What is particularly impressive about the media coverage is the balance and accuracy achieved in so many of the interviews and reports.
NICE guidelines published
Today NICE released the 2011 version of their guidelines for Caesarean Section.
There are a number of significant updates. In particular:
- women wanting to request a caesarean on the grounds of fear should be offered perinatal mental health support and if, following this, they continue to want a caesarean, this should be granted
- women wanting to request a caesarean where there is no medical need should engage in a detailed discussion with their practitioners. All the risks and benefits of both vaginal and caesarean birth should be fully discuss but if, after this, the woman still prefers a caesarean this should be granted
- not all women with HIV should be automatically offered a caesarean, they should be informed that “the risk of HIV transmission is the same for a CS and a vaginal birth” in specific circumstances – read the guideline (page 6) to get a summary of the specific circumstances where this is the case
There are also new recommendations regarding: timing of antibiotic administration, the use of colour-flow Doppler ultrasound scans etc.
The important thing to note is that this is a guideline, not a directive and some hospitals may still choose to ignore some of the recommendations.