Tuesday, 1 November 2011

The right to choose a caesarean section

Pregnancy is an exciting time but childbirth can be a very worrying and troublesome time for many expectant parents. Many common fears of childbirth include; Episiotomy, stillbirth, the pain, loss of sexual enjoyment after tearing, accidental bowl movements, medical intervention, the cord around the child’s neck, meconium problems and so many more. Fears are natural, some would say normal, so do these fears warrant a caesarean section?

            New government guidelines (to be published next month) will give all mothers to be the right to a caesarean section even if it is not medically needed and at the cost of the NHS. My question is this, should the NHS pay for women to have a caesarean section because they ‘don’t want’ to push or because of cosmetic reasons? A caesarean section cost around £800 more than a vaginal birth; in the current financial state of the UK should this option be available? If the UK reduced the caesarean rate by 1% the NHS could save a massive 5.6 million pound a year.

            A caesarean section is certainly not a decision to be made lightly; it is major surgery that can take months and months to recover from. I have three children; all born by caesarean sections and if I’m honest none of the births were a positive experience for me. My first C section was in October 2005, our eldest daughter weighed a whopping 10lb 4oz; with me having childhood hip and pelvis problems the doctors decided it was the best way for her to arrive. Due to complications and the weight of our first child the doctors thought another c section was best, in October 2008 my second daughter arrived. When I fell pregnant with our third child I had lengthy discussions with the doctors about trying a vaginal birth but he ruled it out again on medical grounds; our third daughter arrived in august 2010. Each experience (for me) was worse than the one before it and the recovery time longer.

 I understand there are a lot of reasons women might choose a c section and I’m all for choice but surely every case should be looked at on an individual basis; I totally disagree with a woman choosing this form of delivery because its ‘quicker’ or ‘easier’. As a generation, are we becoming more and more removed from the ways our ancestors did things? If I could have delivered my girls vaginally then I would have. I would have loved to be able to hold my daughter straight away and be able to look after her without the help of others.

Hospitals already struggle with the amount of patients they have, they like to have you in and out as quickly as possible to avoid bed shortages. Caesarean sections usually require a three day stay in hospital and I’m not sure our hospitals could manage with the intake of patients they could have because of these guidelines, and I also think a bed shortage is inevitable. A lot of doctors will only perform a caesarean if it is absolutely necessary, under the new guidelines these doctors can refer their patients to another doctor; some doctors will inevitably have more patents than others.

 One of the main things to concern me over the new guidelines is theatre space and lack of midwives. During a caesarean there are approximately seven or eight doctors/nurses/midwifes in the operating room; if caesareans birth rates dramatically increase where will the extra staff come from? In my local hospital they have two theaters on the maternity unit, one for emergencies and the other for necessary planned c sections, around 6 planned sections are preformed a day;  how will the maternity unit manage if that number doubles?, what standard of care can really be offered in such a busy environment?

I’m not a big fan of the new guidelines and I think they raise questions that have no answers.

Thanks for reading. Please follow me on twitter http://twitter.com/#!/hayleythompson1


  1. Interesting reading. My better half wrote something about the subject a few days ago herself:


  2. Great post on an interesting topic which has certainly got me fired up!

  3. Well this is an interesting question!

    I think there's several grey areas here though. Can a hospital refuse an operation to a footballer who broke his ankle because he chose to play football and this avoidable injury would cost the NHS £1200? Can the hospital refuse to treat a smoker because they chose to smoke and their treatment will cost the hospital £2000? (I'm making numbers up, btw!). I deliberately chose two very different examples there because the point is 'choice'. Just because a woman chooses to not push, or chooses to not face a pain she is terrified of, or chooses to avoid the very real chance she will rip and have several ops to correct the rip problem...should the hospital refuse a section because her choice is not about a pre-existing health risk?

    I had a vaginal delivery and was very 'happy' to do so (you know, as happy as you can be during labour!) but I would question the NHS's moral right to question a person's choice.

    Interesting post!!

  4. thank you very much for your comments, i think this topic is a hard one to judge at the best of time.