Tuesday 6 September 2011

C-Section - Customer's Right to Choose?

In what has to be one of the more bizarre stories I have come across lately I understand that the NHS watchdog is looking at giving women the option to have a Caesarean regardless of whether or not medical need exists. At last all women will have the opportunity to undergo major surgery so that they might keep their nether regions tight and their diaries managed!

This will apparently appear in new guidelines to be published by NICE (National Institute for Clinical Excellence - the same people who refuse drugs to terminally and seriously ill people on the grounds of cost). This is what I find to be the cherry (if you'll excuse the expression in this context) on the cake when you consider that a 'normal' birth costs around £1,500 and an elective C-section costs around £2.500 - so how comes terminally ill patients can be denied drugs that would extend life and money can be wasted on consumer baby deliveries?

One of the reasons appears to be because it will legitimise (sorry, they use the word 'formalise') those hospitals that offer C-Section on demand and this is, as I understand it, consumerism gone mad!

Listening to a radio programme for women (essential listening to and from the Crem') a couple of year's back I found myself railing at the radio as some high-powered executive woman explained that she had decided on a C-section to enable her to fit the birth in between meetings and social events. The baby's birth date (and time) was set to fit her work and social calendar with the added benefits that she'd still be 'like a teenager' (as long as she didn't look in the mirror at her face I guess) down below and could return to work within a 'matter of days'.

The fact is that all surgery is dangerous (even the 'safe' stuff) and a C-section is (unless things have changed recently) regarded as major surgery which therefore ramps up the risk. Not just that but when we take into account the fact that the current C-section rate is about 25% of all births in the UK (the World Health Organisation's recommendation is that it should be less than 15%) this is a totally off the wall move.

I understand that for some people there is a medical (physical or psychological) reason and necessity for such a procedure but this doesn't seem to be the situation generally with regard to this issue when it is billed as a matter of choice. It is just another part of the consumer 'our right to choose' culture (just like the social engineering that is abortion perhaps - the other side of the marketplace?). Oddly, I've not met many women who wanted an emergency C-section (but were truly grateful for it) - what a strange world but; Hey Ho - the world takes another step towards madness I guess.

Pax

6 comments:

Emma said...

I totally agree that opting for a c-section out of convenience is totally unnecessary and potentially dangerous, who would want to be cut open and have the other potential risks associated with any surgery, including something going wrong with the spinal anaesthetic, just so that you can schedule things. It is also wrong for many women to assume that their 'lady bits' (nether regions as you put it) will remain tight, obviously with a caesarian there isn't the risk of tearing or needing stitching but the effects of pregnancy hormones on muscle function means that the muscles are relaxed anyway and the pressure and weight of the baby will have also affected the pelvic floor, so even with a c-section there will be 'slackness' and the need for pelvic floor exercises. I am not sure if all this from me is TMI, so apologise if it is!

Wendy said...

Likewise, I have never been able to understand choosing to have major surgery unnecessarily. These women seem to think that they will be cut open, sewed up and back to 'normal' the next day, without the need for their body to heal the massive trauma inflicted on it. Surely it should count as self-harm?

Andrew said...

OTOH, if you have had a bad 24-hr labor with an earlier baby, perhaps you might think that the option of a c-section is preferable!

Vic Van Den Bergh said...

I would have thought that if you'd previously had a really bad labour that the medico's would have taken this into consideration with the management of the next pregnancy anyway?

C-section is a drastic move (more so than pethedine and some of the other upscale stuff they inject) and needs to have medical (physical and psychological) indications to bring it about not convenience and surely if things were as bad as you say they were Andrew this would fit the medical criteria and so this is perhaps a non-issue.

Thanks for comments people,

V

Andrew said...

Indeed if it was as bad as I suggested it probably would indicate a caesarian, but I was giving an extreme case. There are gradations where the mother (or indeed father!) might not want a repeat of the previous example but the medics don't think it was bad enough to warrant a section. This was really what I was getting at. It might not JUST be a question of convenience for the mother.

OTOH, basically I do agree with your main thrust, that it is ridiculous to have it as an 'on demand' option, and most people would (I think) not opt for one - at least if properly advised of the dangers.

Cettis Warbler said...

I've done both - "proper" birth first time and c-section for twins subsequently and I can assure all you chaps that only a lunatic would go for major surgery unnecessarily. Bear in mind also that I had a 17 hour labour the first time without pain relief (I wanted to see how bad it could be!)Major surgery is just that - it takes a long time to heal and you're never the same again.