The Right to Choose

This week it was confirmed that women will be given the right to choose a Caesarean section birth on the NHS.

The National Institute for Clinical Excellence (NICE) guidelines state that pregnant women can now opt for a section, even if they don’t need one medically. After being told of the risks involved and offered counselling, any woman who still wants to give birth by section will be able to (although if her doctor does not agree with a section for non-medical reasons, she will be referred to a doctor who is willing to support her decision).

For too long, mums-to-be to electing to have a section for non-medical reasons have been mocked as being "too posh to push", mainly due to the media obsession with celebrities such as Victoria Beckham, Liz Hurley and Catherine Zeta Jones who opted to give birth this way. It should be noted, of course, that these mums paid for their sections themselves, thus not draining the NHS of any of its meagre resources - so why the inordinate level of press attention in the first place? Whether these celeb mums are, in fact "too posh to push", nobody really knows, and if they are footing the bill, who has the right to judge?

I certainly pushed Little J out, after an incredibly intense induction and around nine hours of contractions. It was, it seemed, a relatively straightforward birth. I had a few stitches, but I was home and functioning as normal after a couple of days. It was several weeks before I realised that things weren't quite right. I won't go into too much graphic detail, but it became clear that I wasn't healing down below as I should be (things didn't seem to be - ahem - in the "right place"). I ended up going back in for a corrective surgical procedure around 5 months after Little J was born. At this time, I was also diagnosed with post-natal depression. I had suffered from depression on and off since my early 20s, but this time it hit me like a brick in the face. I hope to blog about this when I feel that I can. I'm mentioning it now because it's relevant to my decision to give birth to my second child by section.

I wouldn't describe my first birth as "traumatic" (if I'm honest, I believe that all births, natural or otherwise, are fairly traumatic, but here I use the word in the way that the NICE, the medical profession and people in general do when talking about childbirth e.g a ventouse delivery, massive blood loss, serious injuries to the baby, etc). However in my case, the months following the birth certainly were.

It actually didn't occur to me that a section would be an option when I found out I was pregnant again, two years later. But from the very moment I saw "pregnant" on that little white stick, I was filled with anxiety. It was only a matter of days before that familiar black cloud invaded my world again. I was diagnosed with pre-natal depression and the next few months were horrific.

When my midwife suggested a section birth at around 18 weeks, I felt an immediate sense of relief. Mr J and I discussed it, and I thought about it for several weeks, weighing up the pros and cons. I was aware of the risks, and my biggest concern was not being able to pick up my two year old son. The physical problem I had after Little J's birth (in a nutshell, I wasn't stitched up properly) didn't mean I couldn't have another natural birth. For me, it was the fact that I associated my first experience of childbirth with a horrible recovery period, further surgery and severe depression. I knew that having a section would in no way rule out a further bout of depression, but that wasn't the point. I wanted a completely different birth experience, and when I finally made the decision (with the support of my midwife and doctor, due to my mental health issues) my state of mind improved dramatically. I felt like I was in control of something. After I had Little J, I felt wildly out of control.

It's interesting that NICE actually hopes fewer women will give birth by section (the current rate is one in four) despite the new guidelines. This all comes down to giving women the right information, advice and support, to help them make an informed decision. The right decision for them, their bodies and their minds.

Electing to have a section was not simply a case of telling the doctor what I wanted and ticking a box on a form. Oh there were forms - several of them. I had to have two separate consultations with my doctor, and meet with a psychiatrist in the maternity unit...an interesting but ultimately useless experience, which I may blog about one day...

Did I make the right choice? I think so. Having a section was very strange after my first lengthy, surreal, incredibly painful natural birth (although the section was pretty surreal too). It was over so quickly. It was very weird not being able to feel my legs. I cried all the way through it. I couldn't hold Littlest J right away, but her daddy did, and the first thing the surgeon did was hold her up over the sheet for me to see that she was, in fact, a girl. I was still crying. I was so happy that my baby girl was here, and that she had arrived on the anniversary of her late, great Nana's birthday (something else that told me I had made the right choice. And no, I didn't get to choose the date of my section!)

If I ever have another child, I'm not sure what I would want to do. My mental health is, and always will be, a huge factor. I'm certainly not "too posh to push", but I do intend to exercise my right to choose. As all pregnant women should.