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NICE change afoot, C-Sections available to all

1/11/2011

4 Comments

 
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Cameron telling us where to stick it
I recall in the late nineties and early 2000s as the Spice girls began to spawn, plop, plop, plop the phrase ‘Too posh to push’ doing the rounds. Suspicions of Posh Spice (as she was then) et al electing to give birth by the blade in order to sneak in an immediate post natal tummy tuck were rife. Mothers who had given birth naturally wrote about the experience and some healthcare professionals (I have a feeling this is a new phrase, perhaps in the 90s we were still allowed to say nurses?) anonymously touted the advantages of giving birth naturally. 

As I always understood it caesareans were a last resort procedure, my mother gave birth to me via an emergency caesarean under general anaesthetic when I got a bit too flummoxed at the whole idea of life (from what I can gather the birth canal totally grossed me out and I started to heave my way out the oesophagus/head, Athena style). Another member of my family who is svelte of hip gave birth via caesarean twice. I am taking you down anecdote lane so it is clear I realise there’s a place for scheduled and emergency C-sections.  I also realise that pregnant women should be able to make their own decisions having spent 9 months being told what to do by the papers and general public. I am irked by the ‘Too posh to push’ slogan being bandied about by newspapers who have no idea the circumstances of a particular birth.

I do however have a problem with the NHS now making . Giving birth is dangerous; sadly no pregnancy is guaranteed to end in a healthy baby. A C-section however is major abdominal surgery after which the mother has a long recovery period and is unable to pick up heavy objects, such as a baby. Which could delay the mother-baby bonding process. If the woman does not have a supportive partner, family or friends it might encourage her to ignore the healing time required in order to care for the new baby. 

Caesareans are seen as a more sterile and easy way to give birth, we’ve sanitised the female genitalia so much we no longer recall what they can do. Beyond being something to douche. I believe this is partially why 10% of women have a fear of giving birth and the main reason women might request a caesarean.  It’s easier for society if we all act as though beneath our pants are smooth Barbie and Ken style mounds.
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NICE report on Caesareans
You probably want more stats, here are some stats from NICE. Women who have given birth via C-section increase their risk of having a hysterectomy, 0.03% compared to 0.01%. The NICE report suggests women having a caesarean are offered prophylactic antibiotics to reduce the risk of post-op infections. Infections such as endometritis, urinary tract and wound infections, which occur in 8% of women who have caesareans. On the whole there is no proof either way if one method of giving birth is safer than the other. There is, however, proof that one method costs the NHS significantly more. A normal delivery for a woman costs £1236. A caesarean, with no complications, costs £2,378. This is not including the cost of the length of stay and if you have a caesarean, the likelihood is that you will require a hospital stay.

Pregnancy is not an illness; unless there are complications therefore it is not something that should require surgery. It makes me incandescent with rage to think of women on a maternity ward going without the full support of a midwife because of all the staff required for an elected C-section. It irks me to think that those women who do elect to have a caesarean will be cast as silly women who are too squeamish about their bits (which is stupid because you have to have a vaginal catheter, JUST SAYING) instead of the ill-informed result of birth being kept as such a mystery over the years. The Guardian’s Doctor Dillner suggests such women might think about this; “As a default, I would say that nature gave us a channel for childbirth and it wasn't a zip on our bikini line”.


Squeamish Kate

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4 Comments
Nic
1/11/2011 08:49:37 am

I'm totally against them offering it to everyone. I really think major surgery should be a last resort option, I think it makes it look like natural birth and C-sections are equal when they just aren't. Natural birth works, it's not that you have to do it to be a better mother or to experience birth, it's just the best process unless there is some kind of emergency.

Reply
Squeamish Kate
1/11/2011 09:04:54 am

Yes, I can see the debate going the way of Breast is Best and pitting new mothers against each other...

Reply
Em
2/11/2011 02:05:03 am

Midwives, newly qualified midwives and student midwives were the first to go when the first massive cost saving schemes were implemented at the NHS trust I used to work in. In 2008.

They recinded the job offers of all newly qualified midwives and shut down the training courses for student midwives.

Services & jobs for women are generally the first to go when it comes to making cost savings in a hospital enviroment.

Offering every pregnant woman the chance to deliver by elective c-section is a political point rather than a workable or fundable solution.

What I can't get my head around is why the government would consider this as a policy change and spend that kind of money. Surely it would make more sense to invest in midwives to improve the experiences of most women who give birth naturally, instead.

Unless, of course, the long term plan is to sell off maternity services to a PFI. That way, you have written into the guidelines that c-sections should be offered and more money can be made.

Reply
Squeamish Kate
2/11/2011 02:12:22 am

Yes, it's very sad midwives aren't valued nearly as much as they should be.

I suspect/fear you might be right regarding selling off maternity services.

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