The contractions that heralded the birth of my first baby began on a Monday morning. I calmly packed my hospital bag - folding tiny clothes and choosing a CD. I even made sandwiches. Thirty painful hours later I gave birth - of sorts - in a surgery surrounded by masked medics. After some rummaging around in my abdomen my son was produced, whisked away for an injection, then placed in the hands of my partner. Unable to move from the surgery, it was an hour before I could hold my baby. It was as far removed from my birth plan as it was possible to be.
My first efforts at breastfeeding were a disaster. I couldn't position the baby properly because of the pain of the caesarean. In fact, I never established proper feeding and gave up soon after. I spent the first weeks of my son's life feeling a failure - a feeling that persists, despite two subsequent natural births.
Mine was an emergency caesarean, the most risky type of birth because surgery is carried out while the muscles are contracting. My son had been suffering foetal distress, it may have saved his life, so what is my problem? It is this: that childbirth is the most powerful, important thing I will ever do. It may not be pleasant or pretty, it may hurt like bloody hell, but for its sheer raw humanity and as a rite of passage you can't beat it.
In last week's Observer, Jo Revill argued that women should not only be allowed to choose planned caesareans where there is no medical necessity, but that this should be encouraged. Natural childbirth, it was argued, can go wrong, leading to complications ending in an emergency caesarean. Women also, it seems, do not like the idea of the pain associated with giving birth normally.
But a caesarean is not a soft option. A surgical birth is a major abdominal operation. The pain is acute for around a week after surgery and the wound is still tender up to six weeks later. The main consequence is one of practicality - breastfeeding is more difficult and women are advised not to drive or lift anything heavier than the baby. There is also an increased risk of infection and haemorrhage for the mother.
The secret of a positive natural-birth experience is in the care you receive. In my first pregnancy I was lucky if I saw the same midwife twice. During labour, different midwives drifted in and out, and by the time it came to making a decision I felt too exhausted and out of control to care. I was determined that next time it would be different - and it was.
I gave birth naturally to my daughter an hour after arriving in hospital. I recall not so much the pain as the huge physical and emotional relief. But what I remember most is the sweetness of that first skin-on-skin contact, the immediacy of feeding her - topped by a feeling of being very pleased with myself. It was the most profound moment of my life.
Choice versus risk: your opinions
The call by Jo Revill for all expectant mothers to be offered caesarean births is consumerism at its worst: 'I want it therefore it is my right to have it.' We enjoy an NHS that is free at the point of need but women who choose caesareans for social reasons do not have a legitimate need. Normal, pregnant women are not ill. They have chosen to bear children. They need to consider the realities of childbirth before they become pregnant, rather than assume we will foot the bill for a birth to fit their day-to-day plans.
E Joyce
Some of the anti-Jo Revill comments posted smack of the hysteria that arises when anyone suggests giving women more choice about birth. The author isn't campaigning for forced caesareans - I wasn't frogmarched into an operating theatre when I had one. And I doubt that this campaign for choice will bring more than a small increase in the number of women who choose caesareans. During pregnancy, I was amazed at how many other expectant mothers were psyched up for natural childbirth.
How will giving mothers a degree more choice cut the throat of the NHS? It won't, but it might immeasurably help a minority of women and babies who suffer permanent injury through the current system.
Carrie Bennet
As a specialist registrar in obstetrics and gynaecology, I find the idea that a caesarean should be the encouraged form of delivery deeply distasteful. Caesareans are apparently safer for mother and baby, so would Jo Revill like to explain why women who have them are at greater risk of haemorrhage, emergency hysterectomy, wound infection, endometritis (infection of the lining of the uterus), chest infection, deep vein thrombosis, future scar separation if attempting a later vaginal delivery and adhesion formation, to name but a few potential complications, than mothers who deliver vaginally?
Unnecessary operations expose a woman to risks, however small, that in my opinion are not justifiable. If pain is the issue, women can opt for an epidural, as 95% of those delivering vaginally in the US do.
Tarek S. Arab
I wanted a natural birth, but my baby was delivered by emergency caesarean after a four-day labour. When the doctor was finally called, he felt he should have been summoned far earlier. My child's heartbeat dropped suddenly. When my baby was finally wrenched from his position wedged in my pelvis, he needed to be resuscitated. The staff, looking at the clock above my head, sounded increasingly desperate as they urged: 'Wake up, baby'.
My son is now eight months and in rude health. Perhaps 100 years ago, we would have both been dead. Yet I feel angry that the pendulum seems to have swung so far in favour of non-medicalised births that senior medical advice is only sought as a last resort. In our case, it was nearly too late.
'Jenny'
Jo Revill's claim that healthy women were being denied caesareans for 'political reasons' is absolutely not the case. The Department of Health is committed to these only where there is a clinical need.
The inference that pre-planned, well timed, so-called 'elective' caesareans are entirely risk free and without possible long-term complications is extremely misleading. Although such risks are minimal, they are clearly shown by independent evidence.
Dr Gwyneth Lewis, National Clinical Lead for Maternity Services
Liam Byrne, Minister for Social Care
London SW1
I worked in the legal section of a health trust and found that compensation is paid to many women after 'natural' childbirth. It goes to those whose babies are born with brain damage because of a badly managed labour and lack of oxygen; or because the baby swallowed meconium [mucoid material] or was damaged by forceps; and to those who became incontinent; and those who were given more than one episiotomy [an incision made to widen the vaginal opening] because of midwives' changing shift.
Don't forget to factor in the cost of all this when claiming that 'natural' deliveries are cheaper. Caesareans should not be forced on people, but they should be available to those who want one.
'Pepper'
