“A topic that is frequently discussed in our group is the choice between a vaginal birth or scheduled caesarean section for subsequent pregnancies. There are many factors to take into consideration, physical and emotional, and the advice from doctors can vary greatly. Half of the women in our support group choose to have a caesarean for their next birth. Many of us suffer from ongoing problems such as incontinence, pain, sexual dysfunction and pelvic organ prolapse. Choosing to have a cesarean is a valid attempt at not worsening those issues. But we do not just suffer physical complications. Many of us have suffered birth trauma and/or PTSD, and could not emotionally go through another vaginal delivery.”
Professor Michael Keighley says:
“The MASIC Foundation, concerned about preventing obstetric anal sphincter injury in childbirth, endorses the right of every pregnant woman to receive evidence-based, unbiased and personalised information when discussing a planned mode of birth with her care provider. The potential associated risks and benefits of all care choices, both for the mother and her baby, should always be explained in a way that is understandable, relevant and sensitive. Respect for each woman’s autonomy and individuality must be the cornerstone of maternity care.”
“I chose to have a c-section because I previously had a 4th degree tear.
My c-section was absolutely amazing and my recovery was super easy and quick in comparison to my 4th degree.”
“A c-section was absolutely the right decision for us after a previous 4th degree tear, but not an easy one to make.
I got my healing birth after a previous birth trauma with a 4th degree tear.”
The Australasian Birth Trauma Association’s Amy Dawes was injured while giving birth to her first child, and she says:
“We are so conditioned to believe that a vaginal birth is the ‘right’ way to give birth, instead of recognising that cesarean sections are usually necessary interventions that not only save lives, but also help preserve quality of life for both mothers and babies. We need to look at evidence-based research and acknowledge that, for some women, a cesarean section may be the safest and least traumatic birth method for her and her baby, or it may simply be her choice. We must encourage maternity policies to focus on positive psychological AND physical outcomes for both mother and baby. One way to start this is by providing a supportive, unbiased and informed decision making process that considers the risk-factors, values and desires unique to each woman, rather than a one-size-fits-all approach to birth.”
We know that not every woman will need or want a caesarean birth, and there needs to be a better understanding that all birth choices are valid, with both the first and subsequent births. We also know that many women, whose pelvic floor is damaged during a vaginal birth, say that they were not informed about this risk, and simply didn’t know.
This needs to change.
What’s most important is that balanced information is offered, and each woman’s final decision is respected and supported.
- Produced by author and journalist Pauline Hull