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Pregnancy bump
Oct 31

Every mother-to-be, in England and Wales, will soon be given the right to have her baby by caesarean section on the NHS, even if there is no medical need.

Under new guidelines recommended by the National Institute for Health and Clinical Excellence (NICE), women will be given the right to choose whether they would prefer a natural birth or caesarean section. Previously, they were expected to give birth naturally unless there was a medical reason not to.

About a quarter of all births in the UK are currently caesarean deliveries. It is estimated that a caesarean section costs the NHS £800 more than a natural delivery. Health economists have calculated that reducing the caesarean section rate by one percentage point could save the NHS £5.6 million a year.

Speaking to the Daily Mail, Dr Bryan Beattie, a consultant obstetrician who helped to draw up the existing NICE guidelines, said: “It is a huge development.

“Ten or 15 years ago there may have been a better argument for saying no, but caesarean sections have become much safer. We have closed the gap to the extent that you really do have to bring in maternal choice as part of the decision-making process.”

The guidelines are undoubtedly controversial. Independent midwife, Virginia Howes, debating the subject on the BBC, said: “What message are we giving our daughters and the women of tomorrow? That our bodies fail us; that we don’t need to go through this process? Women are amazing and you cannot judge and measure this feeling of empowerment that women [feel] when they give birth naturally. That cannot be measured by any statistician.”

For me, these new guidelines are a good thing. I have been advised that if I go onto have a second child, I should elect for a caesarean section – so this should hopefully mean that I can make that choice more easily, if and when the time comes. However, if I had have been offered this choice with my first pregnancy, I’m pretty sure that it would have confused matters for me – I am a firm believer in natural childbirth unless medical circumstances dictate, and so I would have been questioning why I was being given such a choice. I think it would have unnerved me.

In my opinion, it’s crucial that any mother-to-be is armed with all of the facts and truths behind childbirth, before being able to make an informed choice between a caesarean section and natural birth. Speaking from personal experience, and that of my friends’, it’s often the case that women entering their first experience of childbirth are very rarely prepared for everything that could happen. It is nature’s way of protecting us (and keeping the human race going!). So I seriously question whether any first-time mum could be capable of making such an immense choice, unless medical circumstances dictate otherwise and the decision is effectively made for them.

I would love to hear your views on the subject. If you have any thoughts to share, please feel free to do so in the comments section below.

Image by Richard Barry Photography.

About the Author

Wendy McAuliffe

Social media & online PR consultant and trainer, and ex-journalist. Founder and Director of Populate Digital and Mum of two. Living by the sea in Bournemouth. @wendymcauliffe.

  • Sean Hargrave

    I think the £800 extra cost would be seriously reduced if they took in to account the urinary and faecal incontinence natural child birth brings about, particularly through forceps etc…. only these happen normally later on in life and so aren’t always immediately considered.

  • wendymcauliffe

    You make a really valid point Sean, and that ties in with the line of argument about caesarean sections being a much safer option nowadays, and in some cases the safest option for the mother-to-be when weighed up against the possible longer term consequences of a natural birth.

  • Catriona Regan

    I had my son abroad and when discussing my birth plan I said that I didn’t want forceps to be used, my Indian Doctor was horrified. “Forceps”, we don’t use forceps they belong in a Museum of Torture! I have to say I was relieved as I had heard horror stories about the long term damage forceps can leave women with. During this same conversation I was offered an elective c-section which I declined as I wanted to have a natural birth.
    However, Mother Nature had other plans and after 19 hours I was offered a c-section which I jumped at! And it was just as well as the cord was swapped around Isaac’s neck twice.

    We are lucky that if needed a c-section is performed – as we all know women die in childbirth every day – but I don’t think we should be given the choice of one at the outset. I think the labour process is a crucial step on the long road to becoming a mum. I agree that we should have all the info to hand. However, even the most diligent mum-to-be can’t be fully prepared for birth, as it’s not a straight forward process and sometimes things happen unexpectedly. Of course labour is a petrifying and daunting prospect and the reality isn’t much better – but I think it’s that way for a reason. A human being is leaving our body!

    I worry that it will be those who are not well informed opting for a c-section and for all the wrong reasons – i.e. its easier and not as painful. A C-section is not an easy option. It’s painful for one and you can’t drive or pick anything heavy up for at least six weeks. It’s considered to be major stomach surgery and having one can mean complications for subsequent pregnancies and childbirth.

    I have no medical training but I feel that mothers-to-be would be better served if instead of using forceps or a knife a c-section is offered earlier.

  • wendymcauliffe

    Thank you Catriona for sharing your experience. Your comment has reminded me of something that my midwife said to me after the birth of my daughter, which was that labour is nature’s way of preparing us for the patience and endurance that we need to learn as parents! I agree these new guidelines might result in women choosing a caesarean section for non-medical or non-psychological reasons. I’m no doctor either but I know that natural labour is generally better for the baby and mother, if there are no complications and no need for invasive steps such as forceps. If only there was a crystal ball for this sort of thing!

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  • Melissa Beaty

    I planned my son’s birth. I am a very shy person when it comes to things, well, down there. I would have had the worst anxiety and that would not have been very good on my son. Plus, come to find out, I would have had to have an emergency Csec bc come to find out, his head was too big and never would have came through. I think it is your choice, period. It is YOUR body and YOUR baby. YOUR decision!

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