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What did they do before c-sections?

post #1 of 104
Thread Starter 
A friend and I were talking today. She didn't progress with her first child and had a c-section. THe dr told her that her pelvis is too small. And she asked me what would they have done before c-sections. Would she have just died. I don't know the answer to that.

What about breech babies? Why do dr's not want to deliver breech babies? Even my midwife goes to the hospital for a section for breeches. If I were to have another baby I wouldn't want to have a c-section just because the baby is breech.

So what did they used to do? Anyone know?
post #2 of 104
Breech babies were delivered vaginally. Often, breech wasn't diagnosed until baby's feet or buttocks appeared. Though vaginal breech birth has risks, the risks for cesearean section are much greater.

Before c-sections, there also weren't epidurals or inductions, so many women went into labor when they were ready and were able to be mobile so as to facilitate rather than hinder birth.

That being said, sometimes mothers did die in childbirth. Sometimes mothers still die in childbirth.
post #3 of 104
Well, her doctor was most likely lying. CPD is very very very rare. And yes, in those REAL cases, the mother died. Breech babies were born vaginally (like they should be). Babies died, but it had more to do with nutrional problems, bad sanitation, too young of women having babies, and messed up bones (corsetting).
post #4 of 104
Kmom gives revealing definitions of failure to progress & CPD at her site PlusSizePregnancy:

Failure to Progress (FTP) - also known as labor dystocia. This occurs when labor deviates from a normal or average pattern of labor, but is strongly subjective and differs greatly from one provider to the next. Midwives often call this "Failure to Wait" by the physician, since it can result from an impatient doctor or one who does not recognize that labors that deviate from the 'normal' labor are not necessarily pathological. Just what constitutes a normal labor and an abnormal labor that needs intervention is highly controversial and will differ significantly from provider to provider. True FTP can occur, of course, but it is difficult to separate out the cases that are caused by obstetric mismanagement vs. naturally-occuring cases. Common in induced labors.

Cephalopelvic Disproportion (CPD)- a baby that is 'too big' for the mother's pelvis. This is a catch-all phrase that doesn't have a lot of meaning; the baby's presentation and position usually has more to do with CPD than the actual size of the baby. An 8 lb. baby that is malpresenting, for example, is likely to get stuck, whereas a 9+ lb. baby that is perfectly positioned and where the mother gets to use optimal delivery positions is likely to come right out. Many women who are given a c-section for CPD and told that their pelvises are 'too small' actually go on to later deliver a baby vaginally that is much bigger. The presentation/lie of the baby, maternal positioning, and forcing labor unnaturally are the keys in many cases. True CPD can occur, but is usually seen in mothers who have had pelvic injury or disease, had rickets, or who were chronically malnourished as children, although it is possible occasionally in normal circumstances too. CPD is most often actually a case of cephalopelvic malpresentation or 'failure to wait' by the physician, but this is often overlooked as a cause.


In the old days there was no "active management of labor" i.e. time limits. There was no one waiting for you to pass the allowed time limit with a scalpel in hand telling you your body couldn't birth.
post #5 of 104
Quote:
Originally Posted by velcromom
Kmom gives a definition of failure to progress & CPD at her site PlusSizePregnancy:

Failure to Progress (FTP) - also known as labor dystocia. This occurs when labor deviates from a normal or average pattern of labor, but is strongly subjective and differs greatly from one provider to the next. Midwives often call this "Failure to Wait" by the physician, since it can result from an impatient doctor or one who does not recognize that labors that deviate from the 'normal' labor are not necessarily pathological. Just what constitutes a normal labor and an abnormal labor that needs intervention is highly controversial and will differ significantly from provider to provider. True FTP can occur, of course, but it is difficult to separate out the cases that are caused by obstetric mismanagement vs. naturally-occuring cases. Common in induced labors.

Cephalopelvic Disproportion (CPD)- a baby that is 'too big' for the mother's pelvis. This is a catch-all phrase that doesn't have a lot of meaning; the baby's presentation and position usually has more to do with CPD than the actual size of the baby. An 8 lb. baby that is malpresenting, for example, is likely to get stuck, whereas a 9+ lb. baby that is perfectly positioned and where the mother gets to use optimal delivery positions is likely to come right out. Many women who are given a c-section for CPD and told that their pelvises are 'too small' actually go on to later deliver a baby vaginally that is much bigger. The presentation/lie of the baby, maternal positioning, and forcing labor unnaturally are the keys in many cases. True CPD can occur, but is usually seen in mothers who have had pelvic injury or disease, had rickets, or who were chronically malnourished as children, although it is possible occasionally in normal circumstances too. CPD is most often actually a case of cephalopelvic malpresentation or 'failure to wait' by the physician, but this is often overlooked as a cause.
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post #6 of 104
First of all, getting off of your back and onto a squatting position will open up the pelvic area 42% larger than being on your back. So, "too small" depends on which position you are in.

In the extremely rare case of ACTUALLY being too small, the baby might die (after two or three days of labor) and then could be passed......because dead babies are smaller than live babies.
post #7 of 104
Why are dead babies smaller than live ones?

I know that in some cases, doctors used to section fetuses (cut them apart with a scalpel) when labor failed to progress for a very, very long time. This killed the baby, if it hadn't died already, and was very dangerous for the mother. This is one of the reasons that women were extremely unwilling to allow doctors into the delivery room in the 18th century, even though some doctors offered laudanum for pain relief. WOmen associated the presence of a doctor during labor with almost-certain death. Doctors weren't welcome until some time after the invention of forceps (I can't remember the date for that).
post #8 of 104
Quote:
Originally Posted by velcromom
Midwives often call this "Failure to Wait" by the physician, since it can result from an impatient doctor or one who does not recognize that labors that deviate from the 'normal' labor are not necessarily pathological. Just what constitutes a normal labor and an abnormal labor that needs intervention is highly controversial and will differ significantly from provider to provider. True FTP can occur, of course, but it is difficult to separate out the cases that are caused by obstetric mismanagement vs. naturally-occuring cases. Common in induced labors.
My first instinct was to laugh, but actually this is not funny at all. If anything results in a c-section more often than an impatient OB, I don't know what it is.
post #9 of 104
Quote:
THe dr told her that her pelvis is too small. And she asked me what would they have done before c-sections. Would she have just died.
Nope, she wouldn't have died....she probably would have delivered vaginally. Check out the statistics. If you have a birth in a hospital with an OB you are way more likely to have a c-section. And most likely the dr is going to tell you there was a some reason for it afterwards...to cover his own behind. Women who birth at home with a midwife rarely have this problem.

Also for breech, the really really sad thing is that we have grown to rely on technology to solve the problem. Yes many were delivered breech, but there is a greater risk there. Still very possible in many cases though. BUT...there is a really really highly successful way to turn a breech baby that is not advocated enough...WEBSTER through a chiro. My OB was totally ingorant to this techinque when my ds was breech at 37 weeks. SO many people are unaware. Sorry to rant...just taking this opportunity to spread the word as much as I can.
post #10 of 104
Well i didnt read every bit of this thread, but no, she most likely wounldnt have died. In almost all cases of that the baby and or mom are having positioning problems. Most cases you can get baby to turn and have a problem free vag delivery. In the extreamly rare case that baby really didnt fit, one or both probably would have died.

breach babies were delivered normally, most situations ended just fine. Of coarse there are sometimes situations that do require a c/s for a healthy outcome, we cant deny that and in those cases death would have been likely, many cases of true placenta previa would be one of those times.

Death rates of both mom and baby were higher before c/s but there are many other factors that most likely played a part in that as well.

I dont know of all the offical numbers and statistics, mostly because you have to be really careful where you get that kind of info and who cam e up with it, but I know in my state from the info I have gathered, about 1 percent of c/s PERFORMED are nessasary. And we have about a 34 percent c/s rate statewide. So that comes to be about 1 in 300 births should end in c/s not 1 in 3!!!!
post #11 of 104
Safety of breech birth has more to do with caregiver competence rather than breech birth being inherently dangerous. I have given birth to a breech baby, I spent 10 weeks preparing for her birth. There are cases where turning the babe is not an option (pm me for long version).

There are no guarantees that your friend would/wouldn't have died in her circumstances. Definitely a certain percentage of births will benefit from cesarean birth, unfortunately birth politics and $$ seem to get in the way of true statistics.

Education and support go a long way toward having a normal labor/birth. Unfortunately we live in a society that depends on experts to tell us what to think and do. Yet when the experts make a mistake our courts fill with lawsuits from the very people that didn't take responsibility in the first place.
I am fortunate that I was raised to question experts and research my decisions. I am prepared to take full responsibility for my decisions.

You may want to gently introduce your friend to books/websites that will educate and inform her for future childbirth choices.

Best wishes,
Sarah
post #12 of 104
That "pelvis too small" thing really grates my nerves!
I actually DO have a small pelvis. I have pituitary dwarfism and puberty had to be chemically induced when I was 14 years old when it was discovered that I had stopped all growth and development at around 8 years old. Because of this completely unnaturally puberty, I ended up with weird growth patterns and a lot of hormonal problems. For one, I never developed hips. My pelvis literally didn't change shape. I started my period and my breasts started growing but otherwise I had no puberty-related growth. Not even my facial bones changed shape (normal for puberty) so I tend to have this very child-like look to me and get mistaken for a very young teenager.

Can I deliver vaginally?
HELL YES!

And I have. I will again, too.
Your pelvis opens during delivery, different positions change its size and shape, and there are all sorts of variables.
post #13 of 104
I think its a misnomer to think that all breech babies were born vaginally and alive. Some did die, some died being born vaginally, and some got hung and the mother got her bottom butchered. Its easy in a an era of time where we do have medical intervention to say how wrong it is.

I had a transverse breech baby, I can tell you for certain that I would have never delivered my baby vaginally. What would have happened is my baby would have died probably due to a failing placenta or had my water broke, died from prolapse cord. I would have probably died too, because my uterus is deformed and there is no way a baby was coming out unless it was grossly premature.

I just hope women don't use the past as a judgement on what is happening to women in the future. I don't believe we have real accurate statistics or outcomes for what really did happen. Also, we have less skilled professionals when it comes to delivering breech babies vaginally today.
post #14 of 104
There is more risk in vaginal breech birth- not only with how the legs are positioned (can increase or decrease risk of prolapse cord), but with the positioning of the head too. Thankfully, MOST breech babies are in relativly good positions for vaginal birth. I wouldn't think the ratio of positioning has changed that much over the past 1000 years. Although, I did have a prof. of A&P who insisted that before chairs and things of that kind humans had much better movement and posture, which would have at least a little to do with positioning.
Most breech babies were delivered vaginally right up to the 1970's- this was long after the advent of the Cesarean section.
post #15 of 104
Well, for me, I will never really know if I could've delivered vaginally or not.

dd had not started labor AT ALL, at 44 weeks. Yes, the dates were correct. Nothing done to my body started labor. And I did everything! Many times!

So, who knows what would have happened. Yes, I know the statistics, asnd I know homebirth is the way to go. I guess I am just happy we have medical intevention avilable for the real cases in which it can really be helpful.
post #16 of 104
Both my mother and my uncle were vaginal frank breeches. One full term, one preemie. Back then no one considered doing it any other way, nor did they even talk about "how risky" it was and how the baby "could die".

But when I had a frank breech?
"Do you want your baby to die? Do you, do you!? Have a c-section!"
post #17 of 104
Quote:
Originally Posted by Leilalu
Well, for me, I will never really know if I could've delivered vaginally or not.

dd had not started labor AT ALL, at 44 weeks. Yes, the dates were correct. Nothing done to my body started labor. And I did everything! Many times!

So, who knows what would have happened. Yes, I know the statistics, asnd I know homebirth is the way to go. I guess I am just happy we have medical intevention avilable for the real cases in which it can really be helpful.
A friend of mine just went 45.5 weeks UC. She had absolutely zero labour symptoms at 44 weeks, too. That's just how long her baby needed to be in there.
post #18 of 104
Well, I would've surely died. I was breech and had the cord wraped around my neck at birth, several times. my mom did not die, and I did not die.
post #19 of 104
My mom had me at just past 44 weeks
post #20 of 104
Quote:
Originally Posted by littleteapot
A friend of mine just went 45.5 weeks UC. She had absolutely zero labour symptoms at 44 weeks, too. That's just how long her baby needed to be in there.
iI can understand that. but I am talking about my personal situation. I had a choice to make, adn it was a scary one.
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