The aims of csections.org
In the UK at present, 1 in 4 women will give birth by Caesarean Section. We believe it is essential that women are able to participate in discussions about their births prior to and during their labour. In order to do this effectively we believe women need more information about caesareans. We hope that this in turn may help to reduce the trauma and negativity experienced by those women who have a caesarean when they would rather have had a vaginal birth.
There are still women having caesareans when they do not want them and in some cases when they do not really need them. And for those who do want a caesarean they are often unfairly judged as simply being "too posh to push" when the reality is often far more complex. We hope this website will provide women with some of the information they need about caesareans in order to feel more in control of their births.
To quote Jeannie Douche, from the New Zealand College Of Midwives Journal, "Caesarean birth has evolved in just over a decade from a major abdominal operation with profound negative consequences for women, to become an increasingly acceptable choice of birth method" 89.
csections.org aims to provide:
- Information about women's rights when requesting and refusing a caesarean
- Information about the procedure and recovery
- Some real birth experiences
- Ultimately a more balanced perspective on caesarean delivery
A
Previous and current history do not, in fact, alter your right to try to have a home delivery, though if there are medical indications such as multiple births, breech presentation etc. it is likely that you will be strongly encouraged to deliver in hospital.
Arguably if you really want a home delivery and you are brought into hospital, your labour is less likely to proceed as you would wish. According to the National Childbirth Trust (NCT) "CFM [Continuous Fetal Monitoring] has been shown by many research studies not to improve the outcomes for either babies or mothers, that is to say no benefits to life or health have been shown, but it has been shown to increase caesarean rates. That is caesareans are thought to be advisable when they aren't needed." 60 So if you really want a vaginal delivery it is a good idea to think about having most if not all of your labour at home. Some hospitals (inc. Guy's and St Thomas' in London) do admit that if you try for a vaginal birth following a previous caesarean and it transpires during your labour that you may need a caesarean, it is likely to be "done earlier than in the first labour, [they] do not try so long with a scar" 74. Health authorities have a legal obligation to provide a competent midwife at your home. Your GP and midwife are obliged to provide obstetric services in the event of an emergency. A home booking does not prevent you from transferring to hospital at any time during your labour should you need or wish to do so.
Vaginal Birth After Caesarean (VBAC) organisations can provide a lot more information about the possibilities of a vaginal delivery after a caesarean. The concern often described to women in this situation is that there is an increased risk of the previous caesarean scar tearing during labour. A reporter writing in the the National Childbirth Trust magazine - New Generation Digest quoted that "The risk of rupture of a transverse [horizontal] lower segment scar is generally considered to be around 0.5% (which is one in 200 women). The majority of these cases result in minimal adverse effects on either mother or baby. The occurrence of poor outcome is considerably lower. In a review of all the VBAC studies carried out worldwide and documented in the International Childbirth Education Association (ICEA) Review published in August 1990 it was found that "in over 21,000 planned labours after caesarean only five babies were reported to have died in association with scar rupture". This is less than one in 4,200 (0.02%). In the same sample "twelve mothers lost their uterus due to scar rupture (0.06%)." 9