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I would demand another Caesarean in a heartbeat – when a hospital refuses an elective C-section, that’s patriarchy in action

Seventy-five per cent of maternity units across the UK are denying women access to elective C-sections, even though it's actually the safest type of birth there is

Josie Cox
Tuesday 21 August 2018 15:07 BST
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I consider my birth to have been just as natural as anyone else's
I consider my birth to have been just as natural as anyone else's (Getty/iStockphoto)

It’s well-known and widely accepted that madness has, historically, been feminised. The term “hysterical” comes from the Latin word hystericus, or “of the womb”, and “lunacy” is derived from a regular monthly period of insanity tied to the moon’s phases.

We’d all like to discuss these instances as ridiculous anachronisms with no credence – but new research shows that the medical profession probably still has reams of work to do when it comes to treating women as the rational, reasonable creatures we are. Yes, even when in the hormonal throes of pregnancy and childbirth.

According to figures published by the charity Birthrights this week on the back of an FOI, women at 75 per cent of maternity units across the country are being denied the right to choose a Caesarean birth even though guidelines from The National Institute for Health and Care Excellence (NICE) state that women should be allowed to opt for one, even if it’s not considered a medical necessity. It seems that women’s anxieties around having a vaginal birth are, in too many cases, being underestimated – even dismissed – and the consequences of this can easily be even more grave than having to endure the utter exhaustion of a painful but successful 40-hour labour.

Psychology, in fact, plays a huge part in how harrowing, or (believe it or not) pleasant a birth ends up being. Look no further than the many advocates of hypnobirthing for proof of that. And equally, being fully informed and psychologically prepared for a safe, planned Caesarean birth can be extremely positive for a woman and her child. But to allow that, you have to trust that a woman knows her own body and mind – and then give her the agency to carry out her wishes.

Apart from a Red Cross babysitting certificate obtained at the age of 14, I have no medical qualifications, but as an incessant late-night Googler during my own pregnancy, I learned that if a women has a phobia of giving birth – known as tokophobia – or even a level of fear that’s not as acute as a full-blown phobia, the adrenaline that builds up in her body when labour sets in may indeed inhibit her ability to deliver in a safe way. Studies cited in the BMJ confirm this: women who suffer from a fear of childbirth during pregnancy have an increased risk of being forced to have an emergency C-section. Needless to say, a planned C-section is preferable to an emergency one – and not just for the expectant mother.

The British Trauma Association has found that mortality rates are lowest for women who have elective Caesareans as compared to all other types of birth, including vaginal (bear in mind that often when Caesareans are described as “more risky” or more likely to lead to a baby in neonatal intensive care, that’s because they’re lumping in the stats of women who had elective sections with those who were rushed into emergency procedures when their labour went wrong.) Research also shows that women who opt for a planned C-section after a first Caesarean delivery have lower rates of serious bleeding and womb rupture, and their babies are less likely to be stillborn.

YouTuber Sarah Schmid gives birth on camera

Yes, a woman who wants to have a C-section should be offered guidance and advice from medical professionals so she has all the information at hand. She may change her mind, perhaps more than once. But that choice, whatever it ends up being, is still hers to make, even if there are no clinical indications. And that pertains to all fields of medicine (we still have a big problem accepting that women should be able to have abortions when they say they want them, without having to demonstrate psychological or physical trauma to two separate doctors). If she has a solid reason to believe that a C-section is the best and safest option for her, why would we not grant her that fundamental, basic right?

I delivered a healthy baby girl 12 weeks ago by C-section. She was breech – with her head up, rather than down in the womb – and my amniotic fluid levels were precariously low during the final trimester, meaning that her chances of turning, I was told, were practically zero.

Some hospitals will allow mothers to attempt a vaginal delivery of a breech baby, but considering all the circumstances my doctor strongly advised against it and I wasn’t about to argue. I was terrified, had nightmares featuring ghoulish images of bleeding to death on the operating table or losing an organ, but in the end I had a wholly positive birth experience. Fewer than 15 minutes passed between being given the spinal anaesthetic and holding my daughter in my arms. The delivery was bizarre but completely pain-free. She came out kicking and screaming, pink and alert, at a healthy weight.

Granted, my recovery was much slower and perhaps more painful than that of many women who have vaginal births – I still can’t run or do any other high-impact exercise – but, should I decide to have another child in a few years’ time I would demand another Caesarean in a heartbeat, whether there’s a medical reason for one or not.

Aside from this week’s distressing research, social stigma around not having a “natural birth” also need to be tackled immediately. I may not have gone into labour or pushed my daughter out of my body unaided, but I nonetheless consider her birth to have been natural. Perhaps the most natural thing in the world. So let’s stop with the slyly derogatory misnomers.

Yes, Caesareans cost an already stressed healthcare system several hundred pounds more than alternate delivery methods, but this is not an area where budgets can afford to be cut. We need to start practicing what our national guidelines already preach.

Women who want C-sections are not “too posh to push” or “unreasonably hysterical”. We’re not lunatics or scaredycats. We’re not lesser mothers if we haven’t endured the indignity of broken water on the tube during rush hour, or the full force of agonising contractions in the back of a cab at 2am, or incontinence or an episiotomy caused by a difficult final few pushes. How can anyone even argue that having your abdomen cut open and organs rearranged is an easy or, God forbid, lazy way out? If men were doing it, they certainly wouldn’t say so. And if we’ve really moved on from patriarchal medicine, we need to prove it.

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