It’s not very often something makes me as cross as reading this article did this morning.
Apparently, NICE guidelines (one of the governing bodies of the UK’s National Health Service) have been changed to allow women to choose caesarean section to give birth, even if there is no medical indication.
NICE insist that this does not mean that caesareans will be dished out willy-nilly. Rather, this will make caesareans available for women who are suffering from psychological distress surrounding birth; women who may have been turned down previously by an unsympathetic doctor.
Let me just make one thing clear – I support women’s rights to give birth however and wherever they choose, and that includes caesareans. I think that a woman’s emotional distress is just as valid as a physical problem, and women who are suffering from emotional distress surrounding the birth of their baby should absolutely be able to opt for a caesarean if they so wish.
Caesareans are one of the miracles of modern medicine, and have saved the lives of millions of babies and mothers. I am eternally grateful that they exist, and that they are available to those who need them.
What I am NOT happy about is footing the bill for expensive unnecessary surgeries for women who are NOT in emotional distress and who do NOT have any physical medical need for surgery.
In the current economic climate, where benefits for the needy and public service budgets are being cut left right and centre, how can changes such as these be implemented? How can the NHS spend their meagre budget on unnecessary surgeries? As a taxpayer, I will happily foot the bill if your surgery is necessary – for physical or emotional reasons – but I will not pay for surgery because you want to fit your birth into your busy schedule.
My husband needs an operation. His condition isn’t life threatening, but it is incredibly uncomfortable and impacts on his life on a daily basis. When he visited his doctor (and when he sought a second opinion), he was denied even a referral to a specialist, let alone an operation. His only options are an appeal (which would most likely get denied), or to simply wait until his condition worsens enough for them to give a crap. Only then will he get a referral to a specialist, and only then will he have a hope in hell of ending up on a waiting list for an operation.
And yet, women who have no physical or psychological need for surgery will be able to request it, and doctors will not be able to refuse?
Now, I am aware that most women would prefer to give birth vaginally. Even those of us who would have chosen a caesarean had we been given a choice often change our minds when we learn about the implications of the procedure in comparison to vaginal birth. But, when you consider that the cost of an uncomplicated caesarean to the NHS is £2500, in comparison to around £1500 for an uncomplicated vaginal birth, the cost will quickly add up even if only a small percentage of the population opt for their babies making their entrance via the sunroof.
Also, it’s worth taking into consideration that maternity services here in the UK are stretched to breaking point as it is. Although the caesarean rate rising isn’t necessarily a problem in and of itself, how are the maternity services going to cope with the extra workload? We already hear stories every day of women in postnatal wards across the UK who are left to their own devices following their caesareans because there simply aren’t enough nurses and midwives to go round. There are women everywhere who have felt abandoned after their caesarean births, laying in their beds unable to even lift their babies up by themselves. What happens when the caesarean rates inevitably rise, putting more women in postnatal wards for longer periods of time, and requiring more care? How do NICE intend to ensure the NHS can provide enough staff to care for them? It wasn’t long ago that myself and some other local mothers were campaigning to keep overnight stays available at our local NHS birth centre, and now the NHS are taking steps that will likely end up with MORE women needing overnight care for an extended period of time? It doesn’t make any sense.
And what about the human cost? What about the fact that caesarean section is four times more likely to lead to fatalities (according to a report in the British Medical Journal)? What about the fact that studies have suggested that babies born by caesarean are more likely to suffer respiratory distress? What about the fact that mothers who give birth by caesarean are statistically less likely to breastfeed, which could cause further health problems later down the line for baby and mum? What about the fact that women who have caesareans are more likely to suffer complications with healing after giving birth? Of course, these points are vastly outweighed by the benefit of a necessary caesarean section – but one with absolutely no medical indication, physically or otherwise? Seriously? Am I the only one here saying WTF?
Again, I support women’s rights to give birth however they choose. I just think that if women want to choose an expensive and unnecessary procedure with no medical indication, they should have to pay for it themselves. Give birth however you like – just don’t expect me to pay for your unnecessary surgery when there are people out there who are being denied treatment through lack of funding.
NICE should be focusing on improving support for pregnant families, and on developing a better system for the counselling offered to women who have suffered a birth trauma, or who have a phobia of giving birth. These women should absolutely be able to choose to have a caesarean if they want to, but they deserve to have their issues addressed properly – throwing a caesarean at those issues is not good enough, not by a long shot. Women deserve better.
EDIT: I just want to clarify something again, as a few people have misunderstood my stance on this: I have nothing against caesareans or the women that choose them. I would feel the same way about this if it were a case of, say, NICE saying that doctors could no longer refuse patients drugs they wanted, regardless of whether or not they are necessary. Patients should not be denied access to drugs they need, but they certainly shoudn’t be dished out in accordance to the patients whim. Same goes for serious surgery like caesarean section.