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Antenatal advice may ‘perpetuate C-section myths’

With over half of UK births involving intervention, I believe women need to know more about their options so they can assess the risks for themselves and play an active role in the direction of their labour. Unfortunately some antenatal education classes shy away from this difficult subject leaving women in the dark about these important interventions. I highlighted this point for a BBC article.

“All too often the risks of vaginal birth are significantly downplayed while caesareans are portrayed as an intervention to avoid wherever possible, with those planning a Caesarean labelled selfish or “too posh to push”.”

“Unfortunately the majority of women still understand so little about C-sections that it should come as no surprise to find that many find their experience, if they have one, extremely traumatic, so severe in fact that some go on to develop post-traumatic stress disorder, while those who want or need to plan a Caesarean are left totally unaware of the opportunities for making their birth feel special and personal.”

While not all classes have such glaring omissions it remains the case that the quality of antenatal education is quite variable and “Unfortunately the toxic combination of out of date or inadequate information and biased advice means that women will continue to face their birth with huge gaps in their knowledge leading to unnecessary trauma.”

Check out your hospital using Patient Opinion

Founded in 2005 Patient Opinion is a UK non-profit feedback platform for health services. It enables patients to share their experiences and opinions of the health services they have used.

It is a quick and useful way to find out about the hospital you plan to use for your birth. Through reading the experience of others it can give you an insight into the sorts of questions you might want to ask your carers before you decide where to give birth.

Maternal requests should be supported within the NHS

NICE have issued (subject to typo corrections) the new version of the Caesarean Section Guideline. There have been a number of significant steps forward in this version. In particular the following:

  • “Recommendation 38: For all women requesting a CS, if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS.” pg 12
  • “Recommendation 39: An obstetrican has the right to decline a woman’s request for a CS. If this happens, they should refer the woman to an NHS obstetrician in the same unit who will carry out the CS.” pg 12
  • NICE “agreed that it is important that women are presented with evidence based information in order that they are able to make an informed decision. The reported benefits and harms can then be discussed with each individual woman to help her make decisions based on the relative trade off between the two modes of birth interpreted in light of her own circumstances.” pg 63
  • NICE “agreed that when discussing the risks and benefits outlined in the table, the healthcare professional and woman also need to consider the woman‟s individual circumstances which affect the risks associated with vaginal birth and CS such as previous abdominal or pelvic surgery, impaired mobility from pelvic girdle pain, or care of other children. It is also important to discuss the number of future babies that the woman and her partner are planning as some risks such as placenta praevia increase with an increasing number of CS.” pg 63

Birth Trauma Association review ‘Caesarean Birth: A positive…’

“This is one of the most balanced books on caesarean section that I have ever read. It is practical, evidence based and unique in that it looks at the caesarean issue from all the perspectives; those who want a caesarean; those who want to avoid one and those who have had one or will need one. It examines the physical and emotional dimensions and provides invaluable and detailed information on the risks of caesarean versus vaginal birth and how to recover quickly.

An absolute must read because as Leigh East, the author, points out in Chapter 2 ‘a caesarean is the possible outcome of every birth’.”

Caesarean book recommended by Maureen Treadwell of the BTA

csectionsupport.co.uk review of ‘Caesarean Birth: A positive…’

csectionsupport.co.uk have reviewed the book “At last, a book that has turned a c-section into a positive birthing experience!  It is so important for women and their families that a c-section is no longer seen as a negative or a dreaded last resort. This book has turned those opinions on their heads.

Leigh writes in a straight forward, easy to understand manner and has taken a much needed positive approach to caesareans.  She has a refreshingly ‘real’ and honest approach to preparing yourself for the procedure and the recovery.  There are also some excellent chapters on how the surgery can affect partners, and also how to make the surgery itself a more special and fulfilling birthing process.

This book empowers women to feel in control of their birth experience, and the importance of that is vital.  I cannot recommend this book more highly and wish I had read it myself during my own pregnancy.  This book should be read by all expectant mothers, and also healthcare professionals who can unfortunately skirt around the issue, leaving women mentally and emotionally unprepared for such an event.” Alison Palmer (Editor csectionsupport.co.uk)