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What IF C-Section Was Proven Safer Than Natural Birth? - Page 2

post #21 of 143
Thread Starter 
Quote:
Originally Posted by LLQ1011 View Post

 I think over the years lots of stuff is deemed safe and unsafe and resafe and then black boxed. I would not trust that statement at all.
 

 

I'm not sure which statement you are referring to?

post #22 of 143
Thread Starter 
Quote:
Originally Posted by monkeyscience View Post

 

I think that is because, whether you are scientifically or religiously minded, we were evolved/created to give birth through our vaginas. That is how the system is set up to work. Like all systems, it doesn't have a 100% success rate, and it can go catastrophically wrong. We are not at all evolved/created to undergo c-sections. How well we withstand that is entirely dependent on how good the technology is. I think a lot of us have a hard time believing that just a few hundred years of surgical experimentation could surpass the millions of years of evolution and/or the work of an all-knowing God in terms of outcomes.

I agree that it is hard to believe that a few hundred years of medical/surgical experimentation can surpass hundreds of millions of years of evolution-or even better-intelligent design.  But it very clearly has in many cases.  Otherwise the vast majority of people wouldn't go to the doctor when their health is at risk and there wouldn't be life saving surgeries that we use when mother nature fails to keep us alive and feeling good.  I don't think that means life should be created in petri dishes going forward, but hopefully I am making some sense.

 

It again goes back to what seems like an ideological argument.  

post #23 of 143
How about an economic argument? Expectant management of birth AND miscarriage saves me money in the short AND long term. Which improves my quality of life. In a country with the highest medical costs in the world without the corresponding best outcomes, that is worth considering. Especially because I value & want to preserve my fertility, my uterine integrity, my hormonal function, keep my abdominal cavity adhesion free, etc.

At the base of the Section vs. Vaginal debate is a maternal safety vs. fetal safety debate. That is @ the very origin of Cesarean (before that they used to do a D&X in obstructed labor). Now it is deeply preferable to have a Cesarean & a live baby vs. a D&X, obviously. But I do NOT accept that in a country where I can end my pregnancy for any or a gender/diasability reason, to viability & beyond, that I have to patently increase my health costs & risks in a non-emergent situation for a statistical calculation of intrapartum safety!

Any difference on a population level would be super tiny. Even choosing a HomeBirth with any type of Midwife only increases intrapartum mortality from 0.07/100 to 0.243/100. And those are Dr. Amy's numbers. So any increase NEONATAL safety would be totally WAY too fractional for 39 weeks to ever become public health policy in any universe.

Dr. Amy has a great post on the concept of 'diminishing returns' that is worth reading on this topic.

As far as the idea that Pelvic Floor injuries would ever compete with actual abdominal intrusion, no. And I find the notion that vaginal birth irreprably damages the Yoni to be very unfeminist & less than accurate. My second birth IMPROVED my Yoni.

Just like you can't get a true rate of 'necessary Circ' in a culture that forcibly retracts & refuses to understand the foreskin, you can't get a true rate of injury in expectantly managed birth in an active management culture.
post #24 of 143
Quote:
Originally Posted by demeter888 View Post

I agree that it is hard to believe that a few hundred years of medical/surgical experimentation can surpass hundreds of millions of years of evolution-or even better-intelligent design.  But it very clearly has in many cases.  Otherwise the vast majority of people wouldn't go to the doctor when their health is at risk and there wouldn't be life saving surgeries that we use when mother nature fails to keep us alive and feeling good.  I don't think that means life should be created in petri dishes going forward, but hopefully I am making some sense.

 

It again goes back to what seems like an ideological argument.  

I go to the doctor when something's wrong. I go to the doctor to make sure nothing's wrong, and if something's wrong enough- I get medical treatment to fix it. But you do not get major surgery when everything's hunky dory!

 

By this argument- shouldn't we be hooking everyone up to feeding tubes?  We could ensure proper nutrition, eliminate unhealthy things, eliminate allergy concerns, etc. Given the rate of things like diabetes and people dying from allergic reactions- eating is horribly dangerous! But we don't. I've never even see anyone suggest that I should go to the doctor because they know better than me how to eat to the degree that I can't be trusted to eat myself.

 

"When their health is at risk" is not "When your body is functioning as it should and everything is going fine"- most births are the latter. Some births are the former, which is why we have c-sections and medical interventions. The problem is, we've gotten it into our head that- to go back to the food metaphor- healthy people with healthy bodies can't be trusted to eat dinner on their own just because some people have problems that prevent them from doing so without severe risk (and, yes, sometimes healthy people choke or get food poisoning or whatever else- so there's wisdom in having a medical professional around when giving birth, but having a medical professional around doesn't mean getting sliced open).

 

If there's a sign that natural birth will seriously put myself and/or my baby at risk- hell yeah I'm getting a c-section. I don't know a rational, responsible person who would refuse to get a c-section even when it's clear  But simply being pregnant is not a sign that my baby or me is at serious risk!

post #25 of 143

dinahx-do you have Dr Amy link?  I'd like to read her stuff.  

 

This is turning into an interesting conversation.  I may have missed some things.  What about mortality rate and csec?  I'm sure the numbers could be wrong, but in states with increased csec, mortality went up.  So how is that safer?  Finding a breakdown on how many of those were inductions, not elective, may be hard.  Maybe comparing US cesarean/mortality rates with a country with low cesarean/mortality rates would give some clear information.  Or even just high % vs low % among states.

 

 The US has a big problem with not education women on childbirth practices.  (on a lot of things imo)  No one ever told me csec risks. Nor breastfeeding info, or vaginal birth info.  The birthing class went over labor stages.  Not much else. 

 

Going back to natural, someone brought up bp problems-wouldn't the higher percent be nutritional problems and perhaps stress related,  not genetic?  When did eclapmsia/preclampsia start becoming a common problem?  Information tell us the higher percent is in many first time moms.  First time moms are stressed out and afraid-they have no idea what to expect.  And the diet in the US is horrible, for the most part.

 

My thoughts on birth, are that perhaps former delivery problems can be overcome, though not for everyone.  With guidance/counselling etc.  My 2 births were very different.  I had a lot of fear the second time of a repeat of the first, and the women surrounding me were very strong and helpful.  I read some empowering books on trusting the body during birth.  It was a different outlook than the first time.  

post #26 of 143
Quote:
Originally Posted by demeter888 View Post

Quote:
Originally Posted by monkeyscience View Post

 

I think that is because, whether you are scientifically or religiously minded, we were evolved/created to give birth through our vaginas. That is how the system is set up to work. Like all systems, it doesn't have a 100% success rate, and it can go catastrophically wrong. We are not at all evolved/created to undergo c-sections. How well we withstand that is entirely dependent on how good the technology is. I think a lot of us have a hard time believing that just a few hundred years of surgical experimentation could surpass the millions of years of evolution and/or the work of an all-knowing God in terms of outcomes.

I agree that it is hard to believe that a few hundred years of medical/surgical experimentation can surpass hundreds of millions of years of evolution-or even better-intelligent design.  But it very clearly has in many cases.  Otherwise the vast majority of people wouldn't go to the doctor when their health is at risk and there wouldn't be life saving surgeries that we use when mother nature fails to keep us alive and feeling good.  I don't think that means life should be created in petri dishes going forward, but hopefully I am making some sense.

 

Talking about medical treatment/surgery for an illness or abnormality isn't what you referred to in your original post, though. I thoroughly agree that a c-section is a much better option than a natural delivery for a mother with a complete previa, for example. What you appear to be saying is that because c-section is better in that case, it's better in all cases. That doesn't make sense. Dialysis is also an awesome modern medical innovation. But it's only for people with kidney problems. There is no reason for someone with healthy kidneys to opt to have their kidneys removed and be on dialysis for the rest of their life. I absolutely agree that modern medicine does wonderful things. But I have a hard time believing that modern medical intervention in a process that would otherwise occur naturally is a good idea, absent of specific problems or indications of risk.

post #27 of 143
Quote:

Originally Posted by demeter888 View Post

 

I understand and agree with all your points until this very last paragraph.  Obviously my exposure to information on c-sections is quite different from yours.  If I google c-section, the first ten articles coming up mostly do outline the risks of the surgery.  Maybe they aren't ideal, but it's a start.  Women who educate themselves find this information quite easily in comparison to the risks of natural birth.  I have heard numerous reports in major news broadcasts that hospitals are being accused of performing too many c-sections.  I know several mothers who underwent the procedure and have expressed doubts as to the necessity of it.  Anyone who digs in the very least will have been exposed to the natural childbirth movement. NBC is major one news source that has reported on it extensively over the years.   http://www.nbcnews.com/health/c-section-rate-stable-third-year-new-report-shows-6C10459239

 

I see a lot of supression of data. My mom worked for the CDC and the reports published on this kind of topic seem entirely politically motivated. And often inaccurate. The questions we have on this topic rarely even get asked in the first place. I am asking why. All the great points you brought up in your first paragraph and the many unknowns, are knowable and publishable.  The public just generally doesn't  want to hear it right now.  

 

As to not being told the risks of c-section, in my state we have to sign a waiver to consent to a c-section in which we are informed of the risks of c-section.  No such information is provided for in the consideration of a natural birth or the vast number of interventions and injuries that might take place during one.  More to the point:  google natural childbirth and compare the number of times the word "risk" appears in the headings.  It doesn't come up for me even once.

 

It's my own impression that there is a bias at work which implies that something is OK if it's natural and less than ideal if medicalized.  Birth is inherently dangerous and many women like myself often start out very naive as to its risks either way.  This creates a missing piece of the puzzle in educating women about childbirth.  

 

Being made to sign a consent form and actually having the risks thoroughly explained to you, in an unhurried manner, where you feel comfortable asking questions, are two completely different things. You don't have to sign a consent form for a natural birth for the same reason you don't have to sign a consent form for eating a meal or having a bowel movement. It's not a medical event. That doesn't mean there are no risks, or that you can't injure yourself.

 

I would also argue that if doctors felt natural birth were particularly risky, they would tell mothers about it. And some doctors do, in fact, tell mothers what they perceive as the negatives of a vaginal birth. (I think we're muddling 'natural' vs 'vaginal' birth in this thread, but that's a different point.) The fact that many doctors do not, to me, is a testimony that they do not consider it to be particularly risky.

 

I do agree that some NCB educators and advocates gloss over the risks of some birth choices, and that does bother me. However, (and I may be way off base here), it seems from your posts that you had a particularly physically traumatizing vaginal birth, and are generalizing your experience to all vaginal births, as if most mothers have the same outcome as you did, which I don't think is true. I would be interested to see some actual numbers as far as what you perceive the risks of vaginal birth to be, and what your sources are for those perceptions. And I mean that with respect. I feel like we are having a somewhat vague conversation that could be helped by being more concrete.

post #28 of 143
Thread Starter 
Quote:
Originally Posted by monkeyscience View Post

 

Being made to sign a consent form and actually having the risks thoroughly explained to you, in an unhurried manner, where you feel comfortable asking questions, are two completely different things. You don't have to sign a consent form for a natural birth for the same reason you don't have to sign a consent form for eating a meal or having a bowel movement. It's not a medical event. That doesn't mean there are no risks, or that you can't injure yourself.

 

I would also argue that if doctors felt natural birth were particularly risky, they would tell mothers about it. And some doctors do, in fact, tell mothers what they perceive as the negatives of a vaginal birth. (I think we're muddling 'natural' vs 'vaginal' birth in this thread, but that's a different point.) The fact that many doctors do not, to me, is a testimony that they do not consider it to be particularly risky.

 

I do agree that some NCB educators and advocates gloss over the risks of some birth choices, and that does bother me. However, (and I may be way off base here), it seems from your posts that you had a particularly physically traumatizing vaginal birth, and are generalizing your experience to all vaginal births, as if most mothers have the same outcome as you did, which I don't think is true. I would be interested to see some actual numbers as far as what you perceive the risks of vaginal birth to be, and what your sources are for those perceptions. And I mean that with respect. I feel like we are having a somewhat vague conversation that could be helped by being more concrete.

 

I didn't say the consent form was ideal, but it does outline some major risks.  Whether or not doctors should be held responsible for more is a matter of debate I won't argue; they should on all levels infomr us more and they should on some levels be far more informed themselves.

 

However, giving birth is much different than eating a meal or having a bowel movement and this is my point: for many women and babies birth is dangerous and that is why they need medical intervention.  The way that births take place in hospitals is a HIGHLY medical event but we all seem to still want to remain in denial of that fact or hope it won't happen to us when the fact is birth is a medical event for the majority of women.  Whether it should be is beside the point.  

 

You are not making any sense whatsoever by saying doctors don't consider vaginal birth particularly risky.  If they didn't, there would be vast numbers of them approving home births and supporting it as a whole.  The vast majority of doctors perceive birth as a medical event with inherent risks.  

 

My intention with the thread is not to argue over statistics and sources nor have my personal experience and how I perceive it to be analyzed.   The goal is to understand why so many people are disiniterested in or uncomfortable with the ideas presented on a deeper level.  And in turn, I mean that with all due respect and appreciate your replies:-) 

post #29 of 143
Thread Starter 
Quote:
Originally Posted by monkeyscience View Post

 

Talking about medical treatment/surgery for an illness or abnormality isn't what you referred to in your original post, though. I thoroughly agree that a c-section is a much better option than a natural delivery for a mother with a complete previa, for example. What you appear to be saying is that because c-section is better in that case, it's better in all cases. That doesn't make sense. Dialysis is also an awesome modern medical innovation. But it's only for people with kidney problems. There is no reason for someone with healthy kidneys to opt to have their kidneys removed and be on dialysis for the rest of their life. I absolutely agree that modern medicine does wonderful things. But I have a hard time believing that modern medical intervention in a process that would otherwise occur naturally is a good idea, absent of specific problems or indications of risk.

   

You haven't explained why, though.  A process that occurs naturally is not always the best process for the people involved.  It seems like this argument is not really based on something concrete, because you and others keep talking about belief.  

 

The bottom line is science and medicine step in where mother nature fails.  As there are inherent risks in human beings giving birth, to suppose that medicine has or could in fact become advanced enough to do a better job is not even remotely far-fetched.  I was using the point of other medical interventions that have shown effective; whether or not the original issue was intended for one of disease or perfectly natural occurence is really beside the point.  Maybe you don't think it should, but that is quite different from acknowledging that it could or maybe even does in some instances.  And all I wanted was to ask but what if it did?

post #30 of 143
You can't practice medicine on a 'best for everyone' basis. Isn't that your beef with Natural Birth ideology?

Birth also has benefits for a woman's body, we can't just write off those. Cesarean is a LOT closer to safe for every baby than it is to being safe or without seqelae for every mother. And that simply can never be enough justification for a policy of routine cesarean @ 39 weeks. It would have to be safer in the short AND long term for the *mother* & it would also have to be low in morbidity.

It all again comes down to 'a good mama throws her body under the bus for any microscopic increase in neonatal safety!' I don't accept I can't have both. Statistics show that setting & provider is a larger predictor of Cesaean rate than any single health indication. With the reveloution in microbiological understanding & cesaean's inevitable need for antibiotics (not to mention opiates!) the microbiome has to be considered too.
post #31 of 143
Quote:
Originally Posted by demeter888 View Post

   

You haven't explained why, though.  A process that occurs naturally is not always the best process for the people involved.  It seems like this argument is not really based on something concrete, because you and others keep talking about belief.  

 

The bottom line is science and medicine step in where mother nature fails.  As there are inherent risks in human beings giving birth, to suppose that medicine has or could in fact become advanced enough to do a better job is not even remotely far-fetched.  I was using the point of other medical interventions that have shown effective; whether or not the original issue was intended for one of disease or perfectly natural occurence is really beside the point.  Maybe you don't think it should, but that is quite different from acknowledging that it could or maybe even does in some instances.  And all I wanted was to ask but what if it did?

"Not always" is not "never" or even "under most circumstances", and we're talking about major surgery that has serious health risks and lifelong repercussions (including risks to future pregnancies) as well.

 

List one circumstance- with references- where invasive medical intervention is, the MAJORITY of the time, better than letting nature take it's course when your body is functioning as it is designed to. The only thing I could possibly think is vaccinations- and even then, vaccinations can do harm and there are people who have never gotten them and been fine.

 

As I said- medicine has found a better way to get humans nutrients. There are inherent risks in eating, some people have medical conditions that make eating without medical intervention impossible, some people have died from eating (choking, allergies, etc). Yet we still don't hook up feeding tubes to healthy humans.

post #32 of 143
Thread Starter 
Quote:
Originally Posted by dinahx View Post

How about an economic argument? Expectant management of birth AND miscarriage saves me money in the short AND long term. Which improves my quality of life. In a country with the highest medical costs in the world without the corresponding best outcomes, that is worth considering. Especially because I value & want to preserve my fertility, my uterine integrity, my hormonal function, keep my abdominal cavity adhesion free, etc.

At the base of the Section vs. Vaginal debate is a maternal safety vs. fetal safety debate. That is @ the very origin of Cesarean (before that they used to do a D&X in obstructed labor). Now it is deeply preferable to have a Cesarean & a live baby vs. a D&X, obviously. But I do NOT accept that in a country where I can end my pregnancy for any or a gender/diasability reason, to viability & beyond, that I have to patently increase my health costs & risks in a non-emergent situation for a statistical calculation of intrapartum safety!

Any difference on a population level would be super tiny. Even choosing a HomeBirth with any type of Midwife only increases intrapartum mortality from 0.07/100 to 0.243/100. And those are Dr. Amy's numbers. So any increase NEONATAL safety would be totally WAY too fractional for 39 weeks to ever become public health policy in any universe.

Dr. Amy has a great post on the concept of 'diminishing returns' that is worth reading on this topic.

As far as the idea that Pelvic Floor injuries would ever compete with actual abdominal intrusion, no. And I find the notion that vaginal birth irreprably damages the Yoni to be very unfeminist & less than accurate. My second birth IMPROVED my Yoni.

Just like you can't get a true rate of 'necessary Circ' in a culture that forcibly retracts & refuses to understand the foreskin, you can't get a true rate of injury in expectantly managed birth in an active management culture.

 

I think you are veering off the topic and making several points about your value system vs the values of others.  First of all, elective cesarians are not necessarily more expensive.  In fact, they would be cheaper than the system we currently have, which is roughly 30% of women in emergency surgeries.  There are risks with vaginal surgery that others might value just as much as you value your  fertility, uterine integrity,  hormonal function, abdominal cavity adhesion free, etc. 

 

 

All valid points for concern, just not exactly what I was asking about.  It would be more accurate to say that the risks of natural birth are more acceptable to you.  Despite the point of my question.

 

Furthermore, I care what is in my best interest, not what is cheaper for taxpayers.  Last time I checked we paid taxes too.  This is really getting into another ideological debate.  

post #33 of 143
Thread Starter 
Quote:
Originally Posted by sillysapling View Post

I go to the doctor when something's wrong. I go to the doctor to make sure nothing's wrong, and if something's wrong enough- I get medical treatment to fix it. But you do not get major surgery when everything's hunky dory!

 

 

I see your point and it's an ideological one.  I have already replied to one of your other posts.

post #34 of 143
Your POV expressed here is fundamentally idealogical. Are you asserting that you are alone in pursuing this question logically? I pay my own medical bills, so a cesarean is more expensive to me. Like enough to buy a used minivan more expensive. Everyone can now just 'charge it' to the taxpayer? Is there no responsibility as a society to act reasonably to minimize costs & steward resources?

Plus an increase in my lifetime medical costs, up to & including hysterectomy, which is more likely post several cesarean. That is a real risk & the prospect of diminished hormonal functioning in my wisdom years is a real & relevant risk.

I can't bet on being insured now or in the future, so I would be unwise to complicate my future medical care.

Are you asserting if we did it to everyone the price would magically come down? Via goodwill of surgeons & hospitals?

http://www.skepticalob.com/2009/12/cesarean-mortality-and-law-of.html
post #35 of 143

Honestly, I am more confused now as to what you are trying to get at. Assuming a totally hypothetical study proved beyond a reasonable doubt that caesarian birth was absolutely safer for all mothers/babies, would some of us still birth naturally and why? That was the question you asked, right? And many of us are saying no  we would not necessarily have surgery, based on our beliefs about who/how we were created/evolved, etc. Why is it wrong to make decisions based on our beliefs? Science can't have all the answers and we don't make decisions in vacuums where our beliefs don't color those decisions.

post #36 of 143

There not absolutes.   Context matters. A good doctor is treating the patient and not a disease. Yes, sometime c-section is the safest choice.

post #37 of 143
Quote:
Originally Posted by monkeyscience View Post

Quote:
Originally Posted by demeter888 View Post

I understand and agree with all your points until this very last paragraph.  Obviously my exposure to information on c-sections is quite different from yours.  If I google c-section, the first ten articles coming up mostly do outline the risks of the surgery.  Maybe they aren't ideal, but it's a start.  Women who educate themselves find this information quite easily in comparison to the risks of natural birth.  I have heard numerous reports in major news broadcasts that hospitals are being accused of performing too many c-sections.  I know several mothers who underwent the procedure and have expressed doubts as to the necessity of it.  Anyone who digs in the very least will have been exposed to the natural childbirth movement. NBC is major one news source that has reported on it extensively over the years.   http://www.nbcnews.com/health/c-section-rate-stable-third-year-new-report-shows-6C10459239


I see a lot of supression of data. My mom worked for the CDC and the reports published on this kind of topic seem entirely politically motivated. And often inaccurate. The questions we have on this topic rarely even get asked in the first place. I am asking why. All the great points you brought up in your first paragraph and the many unknowns, are knowable and publishable.  The public just generally doesn't  want to hear it right now.  

As to not being told the risks of c-section, in my state we have to sign a waiver to consent to a c-section in which we are informed of the risks of c-section.  No such information is provided for in the consideration of a natural birth or the vast number of interventions and injuries that might take place during one.  More to the point:  google natural childbirth and compare the number of times the word "risk" appears in the headings.  It doesn't come up for me even once.

It's my own impression that there is a bias at work which implies that something is OK if it's natural and less than ideal if medicalized.  Birth is inherently dangerous and many women like myself often start out very naive as to its risks either way.  This creates a missing piece of the puzzle in educating women about childbirth.  

Being made to sign a consent form and actually having the risks thoroughly explained to you, in an unhurried manner, where you feel comfortable asking questions, are two completely different things. You don't have to sign a consent form for a natural birth for the same reason you don't have to sign a consent form for eating a meal or having a bowel movement. It's not a medical event. That doesn't mean there are no risks, or that you can't injure yourself.

I would also argue that if doctors felt natural birth were particularly risky, they would tell mothers about it. And some doctors do, in fact, tell mothers what they perceive as the negatives of a vaginal birth. (I think we're muddling 'natural' vs 'vaginal' birth in this thread, but that's a different point.) The fact that many doctors do not, to me, is a testimony that they do not consider it to be particularly risky.

I do agree that some NCB educators and advocates gloss over the risks of some birth choices, and that does bother me. However, (and I may be way off base here), it seems from your posts that you had a particularly physically traumatizing vaginal birth, and are generalizing your experience to all vaginal births, as if most mothers have the same outcome as you did, which I don't think is true. I would be interested to see some actual numbers as far as what you perceive the risks of vaginal birth to be, and what your sources are for those perceptions. And I mean that with respect. I feel like we are having a somewhat vague conversation that could be helped by being more concrete.


It is true that the information on c-section risk is available to women to make an effort to educate themselves. However, unlike in the Mothering community, the vast majority of women make no efffort to educate themselves. If they do it is anecdotal advice from other women who had managed births, pop culture, Parenting magazine, What to Expect When You're Expecting, babycenter.com, or other outlets that simply parrot the medical worlds propoganda, and mainly they take the advice of their doctor, with very little questioning.

If these women do learn about the risk of csections and routinely managed birth, they may still dismiss it as not applicable in their particular case since it does not match what they were told by their doctor. So for most women, the risks of c-sections/interventions ARE downplayed. Doctors still give very biased information.

Consent is not needed for a natural birth in a hospital because by chosing to be there, you are acknowledging it is not without risk. The consent given for csections and other interventions in most facilities is laughable at best. Informed in no way describes it. For my hospital births, everything I declined was met with shocked lecturing and dire warnings, but interventions were done without ANY explanation, and when a consent form was required, it was presented during hard contractions during which I had no capability of reading the pages of warnings. In fact, I was told it was all 'just standard' and I would not be treated if I did not sign it without reading.

I would dare say most women I talk to who are not part of the natural birth community can barely even tell me why their C-section or induction was needed, other than generally that the baby 'would have died!' Each person is convinced that they were a special case. Which is not to say thay they made the wrong choice or are somehow at fault, just that there was obviously no education and informed consent provided to them.
Edited by myra1 - 8/12/13 at 2:12pm
post #38 of 143

The question was about safety, not cost. And in a hypothetical medical system that's made surgery as safe or safer than vaginal birth, perhaps it's also made it less expensive than it is now. It's a thought experiment, not grounded in the reality of our current medical system. 

 

It seems to me fairly clear that the question is whether or not our choices are purely statistic-based or if we have an a priori bias towards non-intervention or in favor of natural birth, and if so, how far? It isn't always wrong to be biased in favor of expectant management, but it's a bias that has to be recognized as much as any bias in favor of surgery. As a thought experiment, arguments about the reality of medical care today don't seem very relevant. Yes, now there is a lifetime risk to repeated surgery; we can't say this will always be true or to what extent, because we do not know what advances in surgical technique will be made. 

 

As for information sources, my experience--over 2 high risk pregnancies--is that while OBs may minimize risks, a large percentage of consumer level literature, childbirth education, etc does not come from OBs: it is written by groups or people trained by groups involved in natural childbirth. The prevalence of natural childbirth ideas in the literature is disproportionately large compared to the number of American women who actually have or plan one. (Even the hospital childbirth education that many people complain is geared towards getting you to have an epidural is often provided by Lamaze-trained CBEs.) I did not have antenatal education in the US--my first was in the UK--but I can tell you, the sources I was given were not biased in favor of interventive birth and in fact I was left unprepared for my emergency C. The reason many women are ignorant of risk isn't that they did not have access to the information, or in some cases even that they were not told by their OB: many never cared enough to read it. 

post #39 of 143
Quote:
Originally Posted by demeter888 View Post

Quote:
Originally Posted by sillysapling View Post

I go to the doctor when something's wrong. I go to the doctor to make sure nothing's wrong, and if something's wrong enough- I get medical treatment to fix it. But you do not get major surgery when everything's hunky dory!

 

 

I see your point and it's an ideological one.  I have already replied to one of your other posts.

 

How is this an ideological point? I see "if it ain't broke, don't fix it" as a logical point, not an ideological one.

post #40 of 143

(That said, I still dislike the image that women who do not seek out information are uninformed, uncaring sheeple. Many do not seek out information, or care, because they place no intrinsic value on the outcome other than getting out of it in a reasonable state. They place no value on process. If it is of no matter to you whether you have surgery or a vaginal birth, and you regard it as a simple medical question, the odds are you're going to say, "The OB can answer this better than I can, so I'll let him/her tell me what to do." There is another bias at work here: that an actively made, informed decision is always better. It frequently is--if you get the outcome you wanted less, but you were an active participant in making it, you're likelier to be accepting of it. But if you place no intrinsic value on the choices at hand, it's very hard to make that kind of active, patient-directed decision-making that's being pushed here. I cared about the decision making process for my 2nd CS because I felt I had been deprived of a participatory voice during my first, but beyond valuing certain trade-offs involved with each choice, I placed very little intrinsic value on the options. I didn't consider a VBAC because I felt it was inherently worthwhile to have a vaginal birth.) 

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