Kirsty Allsopp whips up a storm
In the weekend section of The Times on February 26th, Kirsty Allsopp confesses to the enormous upset she has caused amongst the so-called ‘natural-birth brigade’ by coming out publicly and saying that she has had two caesarean-sections and does not think that women should feel guilty when a caesarean-section is called for to deliver a healthy baby. Her main beef is the lack of information women are given about caesarean-sections in antenatal classes. The Chief Executive of the NCT, Belinda Phipps responded by saying that most women do not want to know about caesarean-sections and so most classes do not cover them.
Women, empower yourselves!
I think there are a few fundamental holes in both arguments here. With the age of the internet there is no reason why every woman who can turn on a computer (that is, surely, everyone of birthing age these days) cannot do their own research on caesarean-sections or any issue related to birth. There is a reasonable argument here that if women want to know about a subject, particularly one not covered in a class if they are attending classes, then they can do their own research.
The other issue is that ‘you don’t know what you don’t know’. What is it that women say they don’t know about caesarean-sections? Is it that they did not know a caesarean-section meant an operation that would cut open their abdomen and remove the baby or is it that they did not know the months of side-effects and additional post-partum pain and inconvenience?
What do classes teach?
Here, there is a conspiracy of silence certainly in NHS classes which predominantly down play the side effects of caesarean-sections knowing full well vast numbers of women have them. In the NCT classes I suspect the conspiracy of silence is to do with trying to convince people not to have them – but without explaining the full pros and cons of both sides of the argument, you have not won people over to your (evidence-based) way of thinking that natural births are better for babies but you have simply failed to paint the full picture offering the option of informed choice for the individual.
Then there is the philosophy of HypnoBirthing which does not discuss in detail any serious problems (called special circumstances) but instead focus’ on the woman’s ability to make everything go well but feel calm and in control if ‘special circumstances’ require medical intervention, which is a life-saving intervention if required. A truly useful antenatal education equips women to avoid what is known as ‘the cascade of intervention’ rather than pitching a ‘them and us’ battle amongst new parents.
When is life-threatening, life-threatening?
Allsopp, like all other women who have caesarean-sections claim that it is a life saving operation and we are lucky to live in an age with such amazing medical knowledge. This is of course completely correct. The problem is that caesarean-sections are used when the situation is not life threatening and then the side effects of caesarean-sections can be bad for mother and are known to be bad for baby. Mothers who have had caesarean-sections do not want to hear this but I would direct them to continue their research, for example at Michel Odent’s Primal Health Databank. Allsopp is right that there is no point making women who have had caesarean-sections feel guilty – after birth every mother should be given total support to parent as best she can. However, women should be encouraged to carry out their own research before birth to ensure she is best prepared to ensure a natural birth, if that is what she wants.
Education, not guilt should be the debate
Guilt is not a constructive emotion to feel or wish upon any new parent. Improved antenatal education to develop informed choice and promote an individual’s ability to take control of their own birth experience should be the crux of this debate.