The Healthy Post Natal Body Podcast
The Healthy Post Natal Body Podcast
C-Section Stigma and Diastasis Recti: What Every Mother Needs to Know
This week it's just little old me again as I talk about the weird, frankly insane, stigma surrounding c-sections.
A lot of chat on my social media feed was about c-section this week so I thought I'd spend a bit of time going over the numbers;
What % of women give birth via c-section in various countries?
What is the reason for most c-sections? (hint, it's not "too posh to push!!")
Why do doctors recommend c-sections for certain women? (hint; it's not "to make money"!)
What % of c-sections is elective? (it's a LOT lower than most people think..and even then there are usually very good reasons for it)
I also talk about the "diastasis recti is an adaptation" argument a bit and compare it to Wolverine's claws. Very useful in a fight, not so much when you want to open a jar of peanutbutter.
As always; HPNB still only has 5 billing cycles.
So this means that you not only get 3 months FREE access, no obligation!
BUT, if you decide you want to do the rest of the program, after only 5 months of paying $10/£8 a month you now get FREE LIFE TIME ACCESS! That's $50 max spend, in case you were wondering.
Though I'm not terribly active on Instagram and Facebook you can follow us there. I am however active on Threads so find me there!
And, of course, you can always find us on our YouTube channel if you like your podcast in video form :)
Visit healthypostnatalbody.com and get 3 months completely FREE access. No sales, no commitment, no BS.
Email peter@healthypostnatalbody.com if you have any questions, comments or want to suggest a guest/topic
If you could rate the podcast on your favourite platform that would be a big help.
Playing us out this week; "Es El Comienzo" by REMEDEE
Hey, welcome to the Healthy Postnatal Body Podcast with your postnatal expert, peter Lap. That, as always, would be me Today. It's just little me, so you're going to have to listen to my dulcet tones for 20-25 minutes or so. And I am talking about C-sections because I had a lot of conversations around C-sections this week and we're talking mainly about numbers today. So a little bit C-section recovery and all that type of stuff, but I'm not going to go in too much depth about C-sections the actual procedure again. I've done an episode on that before and I'm talking about is diastasis recti really an adaptation and, if so, is it a useful one? What purpose does it actually have? This is something that's currently really has taken off the last few years. Diastasis isn't a big thing, it's just an adaptation and therefore, you know we shouldn't worry about it at all. It's not actually true, right? So without further ado, here we go. Hey, welcome to the Healthy Postnatal Buddy Podcast.
Peter:This is an episode for the 6th of April 2025. On the UK school holidays just ran a corner as Lola drinks some water in the background, because why would you not do that? As I just start recording this take for about the fourth or fifth time, the puppies are not. They're not cooperating with me today, so I'm afraid you're just going to have to listen to it because I'm giving up. They're unmanageable it is. You know what it's like Pretend that they're children and you understand just how much of a pain in the bum bum it really is. It's a beautifully sunny day out there. You'll be pleased to know. At least in Edinburgh it is. I hope you're well. What are we doing? Peter at HealthyPostnatalBodycom I keep forgetting to put that at the start or reasonably early on in the episode. Peter at HealthyPostnatalBodycom, send us an email If you have any questions or comments or whatever. I know you can do the text thing as well. That's in the podcast description and all that sort of thing.
Peter:You'll find me on threads the Healthy Postnatal Body account on threads and yes, I do discuss a lot of politics on there because you know fundamentally and a lot of the Palestine stuff and fundamentally. The reason for that is because when you look like me, when you're six foot something and you're bald and you're white and you're middle-aged, you have to make sure you speak up about these things, otherwise people 10 years from now are going to assume you are on the wrong side. I cannot stay quiet about this stuff because I look like I'm on the wrong side of this particular debate, so I don't. Yeah, and I know it upsets some people, and I get it. I get it, it's upsetting stuff, but we can't stay quiet about the things that are happening in Gaza. We can't stay quiet about what's happening with disability cuts in the UK and all that sort of stuff. You don't speak up about that stuff. You know that is not a good place to be. Why are you quiet? Do you know what I mean? Anyways, peterhealthystaysofbodycom and you'll find me on threads C-sections have been at the forefront of my social media feed this week and there's been a lot of conversation about this.
Peter:And you know it started off with somebody comparing the NHS, the British healthcare system, to the Dutch healthcare system and the American one, and they stated and they were making some good points, but they were stating that in America the percentage of C-sections is higher than it is in the UK because they make more money from them. And that was an interesting point, because that's what they were making and I have no experience with the American healthcare system, but it sounds wrong. Do you know what I mean? Sometimes someone says something and you're like, yeah, it sounds right, but it could be right, but it also sounds kind of incorrect and I wouldn't say this is like a bullshit meter. It's a sniffer, because it really wasn't intended as such. It just didn't come across as quite correct. They were not intentionally trying to deceive, is what I'm saying.
Peter:So I looked it up Because I know, for instance, that in America it's about a third of all births are done via C-section. I think it's 31%, 32%, something like that. I will link to some articles with the numbers and I was wondering is that really higher than it is in the UK? And, if so, is that significantly higher than in the UK? Because you know how close are we and in the UK it used. So it's significantly higher than in the UK because you know how close are we and in the UK it used to, much to my surprise. In the UK we used to hover around the 29, 30% mark. So I would argue that 30 to 32% is statistically quite a small. It's within the margin of error, so to speak, especially if you have a decent sample size, and the UK is, you know, it's still a large country, not as large as America, but it's still large enough to say, you know, it's fairly similar. Right, it's ballpark similar for sure.
Peter:But then I looked at recent figures and according to an article and again I'll link to this, it shot up in the UK, in England at least, because we had figures for England to 40% and that's obviously significantly higher. It's up by a third right from 30% to 40% is a third increase and I'm teaching you to suck eggs, but other people might say it's 10, but it's gone up by a third um, and that's a significant increase. So so what causes that? Right? Is that? Because that kind of now puts england at least way ahead of of of the us, and I know other health care systems are available.
Peter:But for the purpose of this particular discussion it was a cost implication, right? The doctors make more money from C-sections. That's why they do more. That's obviously not the case in the UK, right? Because doctors don't get paid more for doing C-sections in the UK. They just don't. If you get the same amount of money, you show up, you get your £14 an hour or whatever the claim is Right, you get your barista-level wage. I'm sorry, I know I'm a jackass, but it's so.
Peter:Then it becomes a thing of why is it a bit higher, and I'm not going to go too much into the nitty-gritty of what the article mentioned, simply because there was very little actual reasoning behind why it's higher. But the interesting thing from it is it's still only that the number of selective procedures, c-sections, stayed at roughly 10% to 15%. So even though the number of C-sections went up by a third, the number of elective I think I said selective apologies, I'm not going to edit that out Selective I think I said selective earlier, apologies, I'm not going to edit that out the number of electives, so people who choose, who plan to have a C-section, stayed at 10 to 15%. It's always been around 10 to 15%, even when it was 29%. It's 10 to 15% in America as well, by the way. It's not much higher than that. So that means that out of all the people giving birth, means that out of all the people giving birth, the 100% of people giving birth 40% in England at least are now having C-sections and 10% to 15% of that is elective. So that means that out of 100% you're looking at 6, 7, 8% ballpark figure maths in my head type thing. That is actually like, say, at the high end it's 1 in 10.
Peter:So the too posh to push thing doesn't even come in into it anymore, right, and if you, once you realize that most c-sections are medically necessary, as in, doctors decide that that is the best way to deliver a healthy baby, that is like I said. There is no, there is no pay incentive here. So it must be, it must be a health decision that they make. And you know I, I crap on the NHS a lot, I have a lot of issues with it, same with the American healthcare system. But the one thing I do not doubt ever is the intention of people, of doctors, to make the right decision for their patient, right?
Peter:I argue a lot that GPs don't know certain things and that you need to see different specialists and at certain times, sometimes, uh, the people that you, you come across in in hospitals are not necessarily the best skilled at certain things, but they always, always, always, always seem to have almost always, because you have the Harold Shipman's in this world, but you have, they tend to be the doctors, at least tend to be making decisions based around the welfare of the mother and child. The best way to deliver a healthy baby for a mother, to keep mother and baby as healthy as we can, is c-section in the vast majority of cases, right? Um, like I said, I have lots of issues with the nhs, but that is beyond dispute. Most of my issues within the nhs is due to, uh, management, right, pencil pushers and the way it's structured that type the NHS is due to management, pencil pushers and the way it's structured that type of thing. It's nothing to do with the medical professionals. Anyways, that was a point I was trying to make. So that has shot up a lot. That has gone up a lot for whatever reasons. It's not actually that, like I said, there's no clear indicator as to why this has gone up, but it's not cost and that is important to remember that the vast majority of C-sections are medically just the right decision to make, right decision to make um, and therefore we really need to move away from this idea that c-sections are less than right. We need to even stop having this discussion with regards to that, because if we know that the vast majority of c-sections are medically necessary, there is no point in telling people that, well, the best way to give birth is a natural birth, because that's better for the baby. Doctors are aware of this. All you're doing when you push that point.
Peter:A lot is saying to women that need to have a C-section because it's medically necessary, right, for whatever reason, you're saying, well, wow, this isn't the best for the baby, as if these people have some sort of choice in this. So if these women have some sort of choice in in the action of the, the level of requirement for a c-section, you're only talking to about seven, eight percent of the people that choose to have a c-section, 7-8% of the people that choose to have a C-section, Again, for whatever reason. There could be many, many reasons. I'm not quite sure how that elective C-section section is actually counted, because that could well include women that have had a C-section before the twins, or they had a traumatic first birth experience and therefore a vaginal birth experience first time around that say no, say no, I'm gonna have c-section second time because first time was so bad, right. So again, we need to remove that judgment. Now.
Peter:One of the reasons this topic came up is because, you know, I know somebody who's who's going to give birth this week and they haven't told their mother because their mother is such a judgmental person with regards to c-section that you know I want my, my grandchild, to be born the natural way. Now imagine if, if you have how toxic and I'm saying that person is toxic, I'm just saying that how toxic she is in this particular case. That's next level, right that that you force somebody or try to guilt somebody into giving birth a certain way because you want it that way, not because it's what's best for baby and mother and how what they want, it's because you want it as someone who's not actually involved in in that or shouldn't be involved in that decision making process. But we need to move away from that stigma around C-sections because it really is complete and utter nonsense. It is fine to give birth via C-section, so, all right, the kid is healthy. Is vaginal birth healthy, better for the baby, long-time immune system and all sorts of? Yeah, sure, I'll buy that Right. Of course it doesn't matter, because the vast majority of women who give birth via C-section it's not their choice.
Peter:I mean in the same way that if people live in what's called the food desert, as in, there is no store available. Look, I kind of, if I, if I were disabled and I couldn't, I couldn't get out and about. I live in the sticks. Right, there isn't a supermarket within a three mile two and a half mile radius of my house. There isn't. If I didn't drive, then sometimes I would get a lot more takeaways delivered. Right, it is really. If all you have around you are difficult are convenience stores and all that type of stuff and takeaways, then you'll likely eat more of that type of food. Right, we need to move away from the judgment around that without realizing what people's circumstances actually are, because it really isn't doing anyone any good whatsoever. So, you know, if we can move away from that guilt-tripping people about things that they have very little control over, that would probably be a good thing.
Peter:Speaking of things I have very little control over, let's talk Diocese of Recta a little bit as. Uh see, it was a beautiful, beautiful segment, a beautiful segue, even um, when right. So this this. A while ago I had anthony lowan um, as you as you you might have caught that episode Antonello the physio detective, and he speaks about diastasis recta as an adaptation. Right, and this is quite common thinking now within the physio world and all that sort of stuff, and it's fine. There's nothing fundamentally wrong with that, because it's true, right, diastasis recta during pregnancy is an adaptation.
Peter:The thinking is that you have to have separation of the stomach muscles, otherwise that pressure is going to go somewhere else and that tends to lead to prolapse. So, as anthony was quite rightly uh, quite rightly pointing out the if, in the cases where diastasis is less, there's an increased chance of prolapse, right, the pressure builds up somewhere else and that, you know, um, and that then tends to be in in the pelvic floor region, uh, so vaginal prolapse and all that type of stuff is more common in in women that have less diastasis. So less separation of the stomach muscle. The pressure went a different way and there's some research that backs that up. So let's assume that that is correct, right, because it fundamentally is. Also, this is one of those it makes complete sense sort of things and therefore we don't need to overthink it, right? Baby needs to grow, stuff needs to expand. If it doesn't go one way, it'll go another way, right? That is fundamental science, right?
Peter:What is an issue is with the diastasis and adaptation thing is that you know how to put this. It is not a. Adaptations are useful when they're useful. So in the case of diastasis, that is, during the pregnancy, postpartum, diastasis isn't useful anymore. Let me put it this way Wolverine doesn't always have his claws out, right, because it's difficult to open jars Useful in a fight situation to have those claws out but it's really difficult if you're trying to make a sandwich, and that is the same with diastasis. So the diastasis is an adaptation, so therefore don't worry about it. It makes no sense Because it is not like there aren't complications from having diastasis and I don't mean serious complications, I mean there aren't consequences, that's a better word.
Peter:There are associated things with diastasis, such as postpartum back pain and that link. I don't care what they say, that link is solid. That link is solid as anything. I know there are some people saying that actually it's not proven. I have linked to so many studies about this in previous podcasts that you know solid as anything. I know there's some people saying that actually it's not proven, that I have linked to so many studies about this in previous podcasts that you know you can say causation, correlation and all that type of thing. But at some stage we have to say that hey, wait a minute. There's so much postpartum back pain in women with diastasis that, even though we can't say that it is not directly caused by the core not functioning properly, as soon as we fix that core bit. All of a sudden the back pain goes right. So you know, yeah, anyways, there we are. So there is a link between pelvic floor dysfunction and diastasis. We know there is because that's what pelvic floor specialists do.
Peter:Right, we have to address the issue of diastasis postpartum. We have to do it Because if the adaptation isn't useful anymore, then we need to deal with that. Wolverine can retract his claws, to stick to that stupid analogy. Right, for you superhero lovers. Right, you can retract the claws so you can make a sandwich. Right, it's not fighting anymore, the claws are cracked and you can make a sandwich, open a jar of peanut butter and all that type of stuff and slather that on with a knife. Right, and that is important. So diastasis is an adaptation.
Peter:Yes, during the pregnancy, postpartum, it is not a useful adaptation to have anymore and therefore we need to address it and we can address it. This is the beauty. So you know, all this stuff is fairly easy to manage, unless you have severe, severe diastasis and complications. Right, then you seek a medical professional, so to speak, and maybe get surgery, whatever. But fundamentally, yeah, we need to move away from that a little bit, as in from that second bit of the sentence Diastasis is an adaptation. Therefore, don't worry about it. No, diastasis is an adaptation that will need to be addressed postpartum, but you don't need to worry about it because it's eminently treatable. That is what that whole section should say.
Peter:So you know, if we could start doing that, that would be greatly appreciated, if we could move away from the eh there, it's fine sort of thing, don't worry about it. This is the price you pay. We just came from that, from that where women were told yeah, you have a mom tom as and I hate that term, you know, I hate that term. If you listen to this podcast regularly, I I despise that term as much as, maybe more than I do, baby blues, because mom time is a ridiculous term. Well, you have mom time, but you know, don't worry about it. This is the price you pay for being postpartum. That is, then, the same as saying you have postpartum back pain. That's just the price you have for having kids, the price you pay for having kids, and it's not true.
Peter:This stuff can be fixed and it should be. It should be free, don't get me wrong. I think everybody should get enough physio appointments until this stuff is free, or personal training, appointments, uh, and all this sort of stuff and I've spoken about this before it wouldn't even be that expensive to to do it. I think in the long run it would save money. But, as with all these things things to do, at least in preventative stuff the politicians don't like to spend money on prevention for anything, especially not if it's something that doesn't pay off for another five or ten years. Right, if ten years postpartum you're going to have back pain that is severe enough for you to need NHS intervention, then that's ten years away. Nobody cares, right? It's a difficult sell to a politician that, hey, if you spend I don't know five million pounds now, you'll save 50 million ten years from now. They'll never do it because all they hear is I need to spend money now, and they hate that, especially at a time when they're cutting monies for disabled people. Anyways, right, they're not spending money on anything that the public wants. So it's my, my. You know I was going to say that's my left wing ideology coming up. You know, I'm not even left wing in Holland, no, I'm center. In Holland, in the UK, in the US, I'm left wing, which again shows you how far to the right we are. Anyways, that's my waffling done for a week.
Peter:Before I go into too much of a rant on this stuff, here's a new bit of music. You take care of yourself. I've no idea what I'm doing next week yet you know. Tune in next week to find out more. Right, take care of yourself. Bye now, thank you. Ese comienzo, ese comienzo, ese comienzo. Quiero verte en mi corazón, quiero que me ames Dejé. Eres el comienzo. Eres el comienzo. Eres el comienzo. Is it a new start? Is it a new start? Is it a new start?