An Open Letter to Kirstie Allsopp

Kirstie, I cannot quietly sit and continue to read the completely unbalanced view which has been put forward via Twitter last week, and the Telegraph article today.

Kirstie, I understand your experience of birth has been of C Section birth. I understand that you did not feel prepared or supported before or after this. I think this is appalling, and that you were terribly and unforgivably let down. You are correct, NO woman should suffer a stigma for having had a C-Section. C Section is definitely NOT an easy way out. Women who are facing having a C Section should have access to appropriate support, both to prepare and recover, both physically and emotionally.

HOWEVER, Kirstie just because this was YOUR experience, does not mean that the answer to women having better birth experiences, is implementing across the board, surgical birth education. I guarantee, if antenatal education took that direction, that our C Section rate would climb even higher.

Your standpoint is that because approximately 25% of births are now C -Sections, we should accept this statistic and start preparing and teaching parents antenatally about surgical birth, as there is a 1 in 4 chance they will have one.

Sorry Kirstie, on this you are just wrong, and doing expectant parents a huge disservice.

WHY do you not want to challenge this 1 in 4 C-Section rate? WHY are we not looking for a way to lower this, rather than accepting it & educating our expectant parents to just accept it too?! This isn’t about stigma Kirstie, this is where your arguments have gotten confused, its about safety, its about education and its about informed choice.

C-Sections SHOULD absolutely 100% be used when needed – they are an amazing medical advance which undoubtedly saves lives. That is what they are there for, and there should be absolutely no guilt, stigma or failure ever attached to this.

A C-Section should be (which even you, yourself referred to it as on Twitter) – a “life saving operation”. So, if we agree that this is the role of a C-Section, do we therefore really think that 1 in 4 of all births are so dangerous that they require a life-saving procedure?

Your comment that “Not talking C-sections during a childbirth course is like not talking Shakespeare during an English literature course” is so unbelievably misinformed. Unlike you, I believe in the ability of most women to safely birth their own baby. I believe that the majority of traditional NHS and some other antenatal classes do not teach women how to do this, therefore leading to this high rate in interventions and C-Sections. That’s right, I don’t simply blame the NHS for poor care, but I blame the quality of our antenatal education, which has a crucial role to play in the UK’s high ratio of C-Sections.

I was reading with interest some of the tweets which you received during your debate. Proud parents tweeting to say that they agreed with you that it was important they had done the full C-Section role play in class, because in their class “5 out of 9 couples ended up with C-Sections”.

So, this class which had educated and prepared its parents for C-Section, had a C Section rate of around 65%! More than twice the national average… alarm bells ringing for anyone else here??

Compare this to the classes I teach, where my average C-Section rate is around 12% – HALF the national average, and four times lower than this class. Why is this?? Maybe because I am empowering women, educating them to understand their body, understand how it works, and preparing that body to get ready for birth. These are things which are not currently adequately covered in all NHS classes or traditional classes. Perhaps Kirstie, you should attend a private natural birth class, see some of the really great practice out there and the difference it makes, and promote the good… Rather than putting us all in the same boat, and slagging us off across the board with little understanding of what we do.

I am PRO women having the most positive, easy and enjoyable birth experience they can. I am anti unnecessary medical procedures which are risky and can be highly traumatic to the whole family unit. Yes, I support woman to have natural births. By your definition Kirstie, this makes me anti C-Sections. Not the case. I teach all my ladies, that in an emergency, you trust your care provider and their medical expertise, as that is what it is there for, to back you up.

However, I work with women to make INFORMED choices. Kirstie, if I had worked with you for the birth of your second baby; I would have supported you to consider all your options, and then 100% supported whichever decision you felt was RIGHT for you. Considering all the options is not about stigma attached to any particular choice – but about the fact that decisions should be about INFORMED choice. This approach is relevant whether we are talking about C Sections, or which house we decide to buy.

I am working with two perfectly healthy pregnant women at the moment, with perfectly healthy babies, who in the last week who have been told by their medical provider, that no-one should have a water birth because “it will kill their baby”. Not all advice, just because it is offered by someone in a medical role, is unbiased, accurate or informed.

There is a reason some of us are trying to support more women to have natural births, and bring down that overall C-Section percentage, and it is nothing to do with thinking women who have C-Sections are ‘lesser than’. For a start, a vaginal birth is much safer. C Sections carry much higher risk than natural birth, to both the mum and baby. The risk of a woman dying following a C-Section is 4 times higher than following a natural birth. We are talking about major abdominal surgery here. Other reasons include the impact on the mother following the birth, which is also something clearly close to your heart too. The increase in rates of postnatal depression in C-Section mothers is not just about stigma, but also is rooted in physiological factors that are absent when baby is not born vaginally.

The women I work with who have been faced with an emergency C Section during their labour, have been able to utilise the coping and breathing techniques I teach to stay calm and involved in the decision making process. I don’t ostracise, make an example of or highlight as ‘different’ any woman who while attending my classes decides to opt for an elective section. All women learn the same coping techniques which are applicable in a variety of situations.

For those women I have worked with who have had been faced with emergency sections, do I honestly think that having ‘role played’ a C Section in advance with some playmobile will make that moment when their baby’s heart stopped beating, and they got whipped into theatre, with dad chewing his nails in the corridor, any less frightening ? No, this is probably one of the most traumatic, terrifying moments of your life. It is scary, and sometimes there are things in life which we can never be truly prepared for.

Kirstie, you absolutely deserved more support, both antenatally and postnatally, than you received.
C-Section birth should not have any stigma attached to it.
But that’s as far as I can agree with you.

The answer to addressing stigma and support is NOT adding specific surgical birth education to childbirth courses. Women do deserve better education, support and birthing experiences. I already have too many women who come to my classes who have been terrified by descriptions of epidurals or demonstrations of forceps, but no real idea of how to empower themselves to have a better birth. Let’s start to support this generation of ladies who are not “too posh to push” but rather ‘too scared to push’.

Steph
Birth & Postnatal Doula & Antenatal Educator
Bump, Birth and Beyond www.bumpbirthandbeyond.co.uk