Belfast Telegraph

Thursday 23 October 2014

What do money men know about the best way of bringing a child into the world?

To push or not to push, that is the question. But is it really a question for a man in a suit to be considering on behalf of thousands of women and babies across Northern Ireland?

The prospect of a long labour and excruciating birth is daunting for every expectant mum, particularly the first-timers, so you can hardly blame any woman for making what may seem like an easier choice. Or at least wanting to explore those options in an informed way that isn't dictated by a faceless penny-pincher.

The decision of whether to have a natural birth or a Caesarean section is one that should be discussed between mothers, doctors and midwives.

It's a medical decision in a maternity setting. It's not the natural home of the Auditor General and nor should it be. What Kieran Donnelly does is boil an emotive and emotional experience down to cold, hard cash. It's all about figures, budgets and regional comparisons – not the best way to bring a child into the world. And that's wrong.

Tell a woman in the final huffs and puffs of a difficult labour that she couldn't have a Caesarean because of a trust official saving cash and see what sort of reaction you get.

The fact remains that pregnant woman do not have the option of having a Caesarean in Northern Ireland simply because they want to. We are not a region of women too posh to push, and the Auditor General's own figures bear that out. The 28.4 per cent of babies born here via Caesarean is only slightly higher than the UK average of 26.7%, showing that we don't have an unusually high rate.

I've never met a woman who had to opt for delivery via surgery simply because she didn't want to. They have all been emergency interventions or for a good medical reason.

Personally, I pushed. I wasn't offered the choice of a Caesarean; I didn't ask for it and I didn't need one.

I tried to do it in the luxury of a warm birthing pool, but an infection and subsequent bed shortages got in the way.

Instead, I ended up in a random bed in an operating theatre where my canister of gas and air ran out in time for the final – and most painful – contractions.

If someone had offered me a Caesarean in that last hour of a 38-hour labour I would have ripped their arm off. I don't remember much, but my husband still likes to remind me about my colourful pleas for mercy.

With hospital cash under extreme pressure, of course their accountants have to keep on top of how maternity budgets are spent. But outside attention from the likes of the Auditor General sets up unnecessary pressure.

I have two friends who both endured extremely difficult labours that were allowed to go too far before a decision to operate was finally made. They both believe intervention was slow for cost-saving reasons. That's the danger of making decisions based on black and white numbers.

So, my advice to any money man taking an interest in what happens on a maternity ward is to experience what it's like to have your feet up in stirrups first.

Until then, he should keep his nose out of the labour room.

Two views: From the Sharon Brown who had a C-section and the Sharon Brown who opted for a natural birth

Sharon Brown (40), from Belfast, has three children: Eoin (21), Eilish (8) and Daniel (6). She had one natural child birth and two emergency C-sections.

"With my second child, my daughter, I was overdue by two weeks. They brought me in to start the labour and nothing was happening so I had to have a section.

"The first time I really didn't know what was going on. I think I was in shock. I didn't like the time it took for recovery – you can't drive for a while and your movement is really restricted because of the scar.

"But the second time I knew what was going to be ahead of me. But they still wanted me to try and deliver naturally. I thought nothing of it.

"I would have preferred just to have been booked in to have had the section during my second and third pregancy, but they had told me because I had given birth naturally once you can do it again. But I faced the same problems and had the section.

"My sister was the same as me; she had a section with her first baby and was in hospital for a day-an-a-half. She was in labour and they ended up giving her a section.

"But every woman has a different experience. I would have preferred to have given birth naturally for all three babies but medically I couldn't."

 

Sharon Brown (29), also from Belfast, gave birth to Kayla in December 2013 after undergoing fertility treatment. She had a natural birth.

"I'm so glad, I don't regret for a second not having even considered a section. I remember different people saying to me: 'You should book in for a section, it is over and done with'.

"But I remember just thinking no, it's supposed to be a natural thing. I had already gone through the fertility part of it, so I wanted to try and have the birth naturally.

"So I'm really, really glad that I did get that. And to be honest, it happened quite quickly.

"My two sisters-in-law had difficult pregnancies and they had to have emergency sections.

"And in those circumstances, where maybe someone is in danger, I can completely respect that it is the best thing for that situation. In my personal opinion, I don't see why anyone would pay to get one.

"I know some people maybe pay or want a section because they want it on a certain date or don't want to go through labour. In my opinion, it's not normal. If God intended for the baby to come out a certain way then that's the way it should come.

"I wouldn't judge for their own decision. It just wouldn't be my choice."

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