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A bit of a spinoff: When is a C-sec essential? - Page 2

post #21 of 99
Yes, also MDC member gossamer had an emergency c/s for HELLP syndrome
post #22 of 99
Yes, i remembered her story about HELLP and her dd. She was heavy on my thoughts last week when my friend had her baby.

warmly~

Lisa:bf
post #23 of 99
Well, I know this example is really really rare, but Heather Mills (Paul McCartney's wife) had a cesarean at 37 weeks, and I thought she was just another idiot celebrity who wanted to schedule her birth and be done with it. I didn't realize she had metal plates and pins in her pelvis, and she had to have reconstructive surgery a few months after the birth.

I felt like an a$$ for assuming the worst about her.
post #24 of 99
I know that paralysis is not an absolute indication for a c/sec. I know a woman that had a vaginal birth after she was paralysed, ironically enough, from an epidural in labor (she had a undiagnosed bleeding disorder and developed a clot at the site which caused nerve damage). She went on to deliver her next child vaginally despite being paralysed from the waist down.
post #25 of 99
because for some time i suspected i might have herpes, (i dont... i had an allergic reaction to iodine used in a rape kit in the ER...long story) i can tell you the herpes is usually not a good reason for a cesarean. If you have your average OB, he or she will likely push a cesarean whether you have lesions or not Some practitioners will push acyclovir (antiviral med) on you in the last weeks if you want to deliver vaginally.

However herpes is most fearsome when it is your very first outbreak while you are in labor, something that cannot be predicted and is quite rare in monogamous pregnancies, as you can imagine. Subsequent outbreaks do not present the same danger, and babies can be born vaginally in most cases as herpes doesnt always occur inside the vagina or on the cervix, it is often external.

in addition, there is some research showing that many babies born to women with recurring outbreaks (not the mother's first) have immunity to this disease! there is a weath of alternative treatments to prevent outbreaks, and so on and so forth.

I am quite glad it is no longer a concern for me (no on to bigger scarier worries :LOL) but I dont think herpes belongs on a list of "definite" reasons for cesarean.

tabitha
post #26 of 99
T
When a c-sec is planned, why is it so often planned for 38 weeks? Why can't they let the mother go 40 weeks, and just have her come in earlier if labor starts before then?
post #27 of 99
Tabitha, if a MW in CA who is licensed and has backup doesn't refer a client with herpes to an OB who will ultimately want to do a c/s, she will lose her backup if the baby gets sick. I agree it may not be a definite reason for c/s depending on the location and state of the lesions, but it is a big indicator. I think many practitioners are also doing the liquid banddaid stuff now where it is sealed off. I agree, it is definitely not an absolute, I should have said that in my post, thanks for correcting me.
post #28 of 99
I had a c-section due to genital herpes. I actually had to beg my OB's (I had two, since I moved halfway through my PG) to let me have a c-section. IME, most of them say it isn't usually necessary.

The reason I asked for one is b/c I had a history of asymptomatic outbreaks, a drastic increase in outbreak frequency during pregnancy, and I refused to go on acyclovir while pregnant (there's more but this is the short version, lol). I researched the issue for weeks on end and was very comfortable with my decision.

I had a wonderful birth and recovered very fast. Of course, I'll be having another one this time. However, I don't consider myself to be an "advocate" of CS and, in fact, I am definitely of the opinion that prenatal care and birthing needs to be taken out of the hospital/medical setting as the "norm". I could go on about that but I'm preaching to the choir here, lol.

Oh, and greaseball, the reason they schedule the sections a week early (for me, at least, it was 39 weeks, not 38) is because they prefer it if you don't go into labour first. First and foremost, because if for some reason you went through labour fast and/or weren't able to get to the hospital in time you risk an emergency c-section (general anaesthesia) which is something nobody wants! Also, it is much easier to recover from a section if you haven't laboured for long beforehand, not to mention I can't imagine dealing with getting the spinal/epidural and dealing with labour pains at the same time! Finally, a small reason but..you risk having a "partner" perform the C/S rather than the OB whose been your primary care person throughout your PG. However, I'm pretty sure that if I asked to wait until I started labour that they would be okay with that (I live 1.5 blocks from the hospital, lol).
post #29 of 99
Quote:
Originally posted by Greaseball
T
When a c-sec is planned, why is it so often planned for 38 weeks? Why can't they let the mother go 40 weeks, and just have her come in earlier if labor starts before then?
Ny OBs malpractice insurance would not let her due a csection prior to 39 weeks unless it was an emergency or their was a documented health concern, like pre-eclampsia or GD. In fact she actually gave me an article from the ACOG that recommends waiting until the 39th week. I read where a lot of people are having csections at 38 weeks, and I figure their doctors are lying on paper or dont give a rats behind.
I had a csection at 38 weeks, it was planned, and had medical reasons however my doctor made sure all her i's were dotted and I had to sign something knowing the risks.
post #30 of 99
I don't know that a thread like this, asking this question, is educational or helpful at all. Each woman's situation is so very different - and there are so many variances to so many different complications that arise in labor and birth.

I just think that it will do nothing but create a huge division and arguments.

Just my opinion, though.
post #31 of 99
Quote:
Originally posted by pamamidwife
I don't know that a thread like this, asking this question, is educational or helpful at all. Each woman's situation is so very different - and there are so many variances to so many different complications that arise in labor and birth.

I just think that it will do nothing but create a huge division and arguments.

Just my opinion, though.
I disagree...for now. I think so far it has been very civilized and some healthy non-judgemental (on either side) is a good thing. I think there are a lot of things that are assumed. I've had 2 c/bs and I didn't know "all" the reasons for a c/b. I've only known my own. And for the record most of us feel there is a division (not sure about huge) and that we are not heard.

This issue is so close to the heart it is bound to get ppl riled up but that doesn't mean it should be taboo. Life is about educating ourselves. I find this type of conversation helpful as long as it stays helpful and not judgmental. I also believe that if you know you are the type of person to be that way and to start "arguments" then you should avoid "conversations" like this. Not because you aren't to be heard but it is the "nice" thing to do.

About scheduling a c/b prior to 40 weeks or before labor starts... I'm not sure about statistical info but in my opinion if it is scheduled as a repeat I see no problem with waiting unless there are reasons not to. But if it were to be for footling breech where prolapsed cord is a concern then I agree having it before labor is good idea.

I had one c/b at 38 weeks after a failed indcution (a super long failed induction) and the recovery was long and hard. But baby was super fine. I had my second c/b planned (I planned it at 39 weeks so it was at 40 weeks...long story but most of you were here for it ) without labor. It was a much easier recovery and a much better experience. Bryce was in special care for 30 hours but that was due to low O2 sat levels. If I were to ever have another babe (which we arne't planning on) I'd see how I felt about everything again and if we did decide to go the way of a repeat we would again wait till 40 weeks unless there was a reason not to.
post #32 of 99
T sorta
Has anyone read Ina May's new book? She talks about a midwife in the Netherlands who practiced from 1693-1745 named Schrader. Of the just over 3000 births she attended 10 were placenta previa and in 8 of those cases she was able to deliver a live baby to a live mother. It's astonishing really!

I am not advocating attempting vaginal birth with a previa, just noting this amazing accomplishment.
post #33 of 99
T ?? In Schrader's time were they able to diagnose many "problems" or potential ones?? It IS amazing the things they CAN do
post #34 of 99
Well, if I am reading it correctly the diagnosis occured at the onset of labor when the woman would start bleeding profusely. The first time it happened to a woman she was tending she had no idea what was happening and the woman died. But she thought about it a lot and realised the only hope was to deliver as fast as possible. So she would watch closely and as soon as it was possible she would deliver the placenta, swiftly perform an internal version and pull the baby out by his/her feet. I have no doubt it was highly unpleasant for the mother but still, better than dying.
post #35 of 99
Quote:
Originally posted by pamamidwife
I don't know that a thread like this, asking this question, is educational or helpful at all. Each woman's situation is so very different - and there are so many variances to so many different complications that arise in labor and birth.

I just think that it will do nothing but create a huge division and arguments.

Just my opinion, though.
I totally agree. This thread kept me up all night thinking about it.

I think what bothers me the most is the language used.
Saying that a c-section, in retrospect, was or was not necessary does absolutely no good. What I think we should be discussing is whether or not c-sections are avoidable instead.

I honestly believe that for most women who have had a c-section, it was indeed necessary, given the particular situation, the particular circumstances, at that particular place and time.
Whether it could have been avoided is an entirely different sort of discussion, and one I think would be quite informative and beneficial for everyone.
post #36 of 99
i find it very helpful to discuss situations that warrant the need for cesarean birth. i have, of course, my own list (comfort level) and it will differ from anyone elses. but sharing our thoughts and info is never a bad thing.

i think, if i were made uncomfortable by this civil sharing of information, i would ask first what i was projecting into it? no harsh words have been shared here, but a lot of very useful info has beeen shared.

mamas need to know the what and why of cesarean necessity. they need to tools and info to find their own comfort level- for instance, i wouldnt have a cesarean for herpes, but others would. the important thing is that people are empowered to make a choice for themselves, not just told by someone they "have to". that is what i like about these sort of discussions. they challenge us to really dig into our hearts and discover where we stand. there is no judgement here. there is no wrong answer.

by discussing what would and would not guide me to choose a surgical birth, i am not judging a mother who has other reasons. there are some here, i know, who would choose sooner, some who would choose later than i.

Lauren, i think i was speaking about whether it should be a reason a Mama should feel cesarean was absolutely neccesary, not whether her practitioner would force her to have a surgical birth. It is true, many things will risk you out of normal attended birth... you just wont be able to find an OB or midwife, yk? (unless you travel, and a lot of mamas do...) In my case,though, if i felt educated and very strongly about my situation and did not feel it warranted a cesarean, i would birth unassisted if need be. of course, if i felt a strong need for a cesarean i would choose one. ( i havent given much thought to a situation where i wanted a cesarean but couldnt get one ... i imagine i could find an OB here easily who would give me one. who knows?)

i agree, stafl, that a discussion about avoiding cesarean is a great one. but if no one talks about the medical situations that lead to cesarean, who will know how to make their choice? if mamas are not talking about it, that leaves the OBs and midwives. i dont want to just listen to their recommendation and comply- i want to be informed and to have given it a good soul search in advance, so that i can fashion my own choice out of a wealth of knowledge. i am simply not comfortable with the thought that my midwife would tell me something, and i not give it any thought, as much as i trust her. frankly, i dont think she would be comfortable with that either. she makes sure when we talk that i am active and aware in the conversation... she doesnt make decisions for me, she is just my companion. she wants to know my comfort level, and she lets me know her emotional and legal comfort level. we have discussed all manner of situations... and the reason i am babbling on and on is that i think this thread and ones like it are useful, at least to me, because i plan to discuss all of these things with her.

tabitha
post #37 of 99
Thread Starter 
'Necessary' or 'Avoidable' are just words. In this discussion I think they mean essentially the same thing. It's not nomenclature or terminology that is the point of the discussion. That said, it *IS* important that we choose our words carefully esp when discussing a subject that so many find so provoking, and so a very valid point.

I have to say that I feel this has been an eye opening discussion for me and everyone has been respectful and polite.

Above all, as Mama's, we are responsible for informing ourselves and then making the best descisions for ourselves and our children based on this info. As Tabitha said, how will we be able to make informed choices if no one is willing to discuss these situations?

I've found the responses here to be VERY informative! I've even discovered that I don't really feel as 'afraid' of cesarean birth as I once was having read some of the Mama's stories here.

It's nice to know that we have the *choice* to have a c/s if we or our birth care providers deem it is unavoidable and/or necessary. It's also nice to know that there are alternative choices or alternative pathways to avoidance of a surgical birth, if you will.


I think this is a valuable and civil discussion and I want to thank everyone who has contributed stories or information! I'm learning LOTS!
post #38 of 99
tabitha [/B][/QUOTE] but if no one talks about the medical situations that lead to cesarean, who will know how to make their choice? if mamas are not talking about it, that leaves the OBs and midwives. i dont want to just listen to their recommendation and comply- i want to be informed and to have given it a good soul search in advance, so that i can fashion my own choice out of a wealth of knowledge.

AWESOME that you say this tabitha, I so AGREE! (no one pass out)

Before I had my daughter I never entertained the thought of a csection. I wasnt going to be one of "those" women. Even if my baby was breech I was going to have a vaginal delivery -- and my OB would have done it. The thing is my baby was a in a transverse breech position due to a uternine deformity -- something I didnt know I had. If I knew then what I know now about first time mothers and breeches, ECV, etc. I would have never done all the things I did to turn my baby or the ECV and would have planned a csection. As you said, each person is going to have their own comfort level -- and this would be mine, now. However I really didnt know enough and just was of the belief, it will not happen to me. Of course, no one ever discussed it either. None of my homebirthing friends, my doctor really didnt, the books I read barely touched on the subject and focussed on why not to have one, the dangers of it, etc.
post #39 of 99
Quote:
I don't understand why some midwives won't deliver breeches, even frank breeches. What's the point of having a midwife if they are just going to have the same rules doctors do?
I have read and re-read this and I feel like I have to reply. I want to point out a few of the reasons why a midwife may choose not to attend breeches.


1)Honoring your abilites. In my trainingas a midwife I attended 1 breech birth. It was a wonderful experince from which I learned a lot. Does that make me qualified to attend breeches? I would attend a woman at home for a planned breech (depending on the woman) and certainly with help from more experinced hands. Not all midwives have the training or experience to attend breeches- which is unfortunate- however, I feel it would be a disservice to a family to do something I don't know how to do.

2) The legal situation. While it is extremely frustrating to both midwives and parents when midwives are limited by legal rules/standards, most midwives cannot completely remove the law as a variable when she makes a decision. I could give so any examples; it comes down to each midwife weighing the choice in front of her. If it meant for me that I would not be able to practice if I attended a breech birth I don't think I could do it (I keep thinking of all the other families who I could attend if htat happened).

And finally, what is the point o fhaving a midwife? To have the opportunity to be a part of decsions that are made about you and your baby and to be cared for in a personal, loving way. I could list more reasons, but I think I think this is the heart of midwifery.

Again, I would love it if all midwives feltl they could and legally could attend breeches. Hopefully that day is coming.
post #40 of 99
Quote:
Originally posted by Carmel


And finally, what is the point o fhaving a midwife? To have the opportunity to be a part of decsions that are made about you and your baby and to be cared for in a personal, loving way.
I WISH the mws I went to were like this!! The ob I switched to was but my mws were far from what you describe. This is the reason I looked for a mw though
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