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C sect mothers right - Page 2

post #21 of 60
MRCS is a woman's *choice*, but it is still an elective surgery. Homebirth is just the normal physiological process of birth, only at home. Yes, at the end of both a baby is the end result, but they are night and day as far as cost goes. Like the pp said, it comes down to the insurance company's bottom line. This choice is more expensive for them, and without a medical reason, they should have the right to deny it. Homebirth has equivalent outcomes and fewer interventions than hospital birth overall, and is the norm throughout most of the world. If an insurance company will pay for a hospital vaginal birth, then they should pay for a homebirth. But to compare that choice with elective surgery is like comparing apples and oranges. I don't think my insurance premiums should increase because someone chooses any kind of elective surgery.
post #22 of 60
Quote:
Originally Posted by OnTheFence
Then insurance should not pay for any form of birthcontrol, any infertility treatment, etc. If women want to fight to have homebirth covered on insurance (and some are) then elective csections should be covered as well.
I don't see this as even a related issue. We're talking about a completely unnecessary surgery such as RIC - something a person has elected to have done while not having a medical reason to do it (I'm not even talking about repeat C-sections that are doctor recommended). I do not believe that insurance premiums should have to go up because women make a CHOICE to have major surgery. Does she have the right to have the surgery? Yes. Does that mean insurance companies have to pay for it? No. I have the right to have breast implants, but I don't expect that my insurance company would pay for it. Homebirth and elective c-sections are also not the same thing.
post #23 of 60
Quote:
Originally Posted by wifeandmom
A mother should have the choice to birth her child however she feels safest doing so. It appalls me that insurance companies often do not cover licensed midwives for homebirths, yet that is not a birth choice I would *ever* make for myself.

You don't have to AGREE with a choice, but if you expect others to respect your choices, it only seems fair that the same respect be shown in return.

I support any method of birthing a child where mom knows, understands, and accepts the risks inherant to that particular choice. Again, the risks are going to vary depending on which type of birth mom chooses, but there are risks REGARDLESS of whether or not she squats by herself in the back yard or heads straight to the OR table at 38 weeks.
I think I agree that a fully informed mother should have the choice of birth. However, we're talking about what OBs support. And, the same professionals who jumped all over a woman's "right to choose a cesarean" don't seem to believe that women have the right to choose a homebirth or a VBAC...and god forbid choosing a VBAC at home. I think that's a fairly serious double standard.

Also - fully informed is an interesting concept. I've had three c-sections that I didn't want. I've only been "fully informed" if there is no risk to a c-section, because no doctor involved in my care has ever so much as mentioned any risk to me. My first one was done over my protests and I was bullied and coerced (to my lasting regret) into my second and third. Nobody thought I had any right to choose whether or not I was unnecessarily cut open. Nobody thought I had any right to choose (or even know!) which drugs were pumped into my body. But, now that they've done the damage, they're very willing to defend my right to "choose" to have it done again.

I hope none of the women who want to choose an elective primary cesarean with no medical indicators mistakenly believe that they'll have any further right to choose, if things don't go as well as they're expecting.
post #24 of 60
Quote:
Originally Posted by Storm Bride
I think I agree that a fully informed mother should have the choice of birth. However, we're talking about what OBs support. And, the same professionals who jumped all over a woman's "right to choose a cesarean" don't seem to believe that women have the right to choose a homebirth or a VBAC...and god forbid choosing a VBAC at home. I think that's a fairly serious double standard.

Also - fully informed is an interesting concept. I've had three c-sections that I didn't want. I've only been "fully informed" if there is no risk to a c-section, because no doctor involved in my care has ever so much as mentioned any risk to me. My first one was done over my protests and I was bullied and coerced (to my lasting regret) into my second and third. Nobody thought I had any right to choose whether or not I was unnecessarily cut open. Nobody thought I had any right to choose (or even know!) which drugs were pumped into my body. But, now that they've done the damage, they're very willing to defend my right to "choose" to have it done again.

I hope none of the women who want to choose an elective primary cesarean with no medical indicators mistakenly believe that they'll have any further right to choose, if things don't go as well as they're expecting.
You managed to say it so much better than I did!
post #25 of 60
Quote:
Originally Posted by Storm Bride
I think I agree that a fully informed mother should have the choice of birth. However, we're talking about what OBs support. And, the same professionals who jumped all over a woman's "right to choose a cesarean" don't seem to believe that women have the right to choose a homebirth or a VBAC...and god forbid choosing a VBAC at home. I think that's a fairly serious double standard.

Also - fully informed is an interesting concept. I've had three c-sections that I didn't want. I've only been "fully informed" if there is no risk to a c-section, because no doctor involved in my care has ever so much as mentioned any risk to me. My first one was done over my protests and I was bullied and coerced (to my lasting regret) into my second and third. Nobody thought I had any right to choose whether or not I was unnecessarily cut open. Nobody thought I had any right to choose (or even know!) which drugs were pumped into my body. But, now that they've done the damage, they're very willing to defend my right to "choose" to have it done again.

I hope none of the women who want to choose an elective primary cesarean with no medical indicators mistakenly believe that they'll have any further right to choose, if things don't go as well as they're expecting.

1. OB's can and do tell women every day that they will not attend a VBAC delivery if that is how mom chooses to deliver. At this point in time, it often has very little to do with what the OB thinks about VBAC at all, it's more about the fact that malpractice premiums for docs who attend VBACs are through the roof (if they can even get coverage, since many policies now refuse to cover the doc in the event of a lawsuit resulting from a VBAC attempt). It's about the fact that many hospitals across the country are unable and/or unwilling to meet the very strict guidelines set forth by ACOG for VBAC patients. Malpractice carriers for hospitals are also refusing to cover hospitals who are sued as a result of a VBAC gone wrong.

As for a doc not 'allowing' a woman to have a homebirth...how exactly are they going to STOP her from doing so? They certainly aren't likely to pat her on the back and tell her to 'go for it' with their blessing, but they can't FORCE her to go to the hospital, so I fail to see how an OB being unsupportive of homebirth or HBAC is even applicable to the discussion.

2. You had THREE c-sections and never signed a consent form for any of them? I truly am shocked. Speechless. What hospital(s) did this occur in? My understanding is that a consent form MUST be signed by either the patient or patient's next of kin if patient is incapacitated. The only way they could section you otherwise is if you presented unconscious with no next of kin and you &/or baby were in danger of dying.

3. A woman can CHOOSE to birth vaginally (or attempt to do so) after a dozen c-sections. She is unlikely to find a midwife willing to attend her birth, but NOBODY can FORCE her to have surgery again. Ever.

I do think it's a sucky choice to put a woman in...either ERCS or VBAC with no licensed provider present at the birth. However, women suing for VBACs gone wrong has done much to create the current climate where malpractice carriers aren't willing to take the risk of paying out millions of dollars when a VBAC goes wrong and mom wants someone to pay for HER decision to take that risk to begin with.

I also believe that a woman who CHOOSES to have an elective section should understand that it may very well be impossible to find someone willing to attend any future attempts at vaginal birth. That's part of the package deal of asking for an elective section IMO and should be explained and discussed fully prior to surgery. It should also be discussed that some women' can only 'handle' a limited number of sections, so if she wants a half dozen kids, elective primary c-section isn't a very good plan overall. To me, those are part of the risks associated with elective primary c-section and should be covered under informed consent.

In the end, there's a big difference between woman being unable to find a doc willing to attend a VBAC attempt and a woman being unable to find a doc willing to perform a c-section. The woman refused a VBAC *can* choose to have her baby vaginally right by herself if it came down to it and was THAT important to her. The woman refused an elective section can't just hack her belly open when the time comes. She *must* have a doc willing to operate, thus the doc truly does hold all the cards in that particular situation.
post #26 of 60
I didn't say OBs could stop women from having a VBAC or a homebirth. I said they wouldn't support it, yet they're all for supporting a woman's right to choose a primary cesarean. Provided there are no major complications in either case, choosing a vaginal birth or homebirth doesn't affect a woman's options in a future birth, while choosing a cesarean does.

I signed a pre-registration form with my first. I arrived at 8 cm dilation, and my baby was breech. I was cut open over my loud verbal protests. I didn't say that I never consented to my second and third surgeries - I said I didn't want them. There's a difference between being bullied and coerced and being forced. I was bullied and coerced into my second and third sections, but I wasn't forced. I caved - no excuses, many regrets.

If I have another baby, it will be a HBA3C (or an emergency section as a homebirth transfer). There's no other possible way for me to have a good outcome.
post #27 of 60
Quote:
Originally Posted by wifeandmom
I do think it's a sucky choice to put a woman in...either ERCS or VBAC with no licensed provider present at the birth. However, women suing for VBACs gone wrong has done much to create the current climate where malpractice carriers aren't willing to take the risk of paying out millions of dollars when a VBAC goes wrong and mom wants someone to pay for HER decision to take that risk to begin with.
I agree. However, I also think OBs have largely put themselves in the position they're in. Women used to know and understand that birth was risky and that things can go wrong. OBs gloss over that and try to make it go away. "Be a good girl, do what I tell you, and you'll be holding your healthy baby in no time." When you deliberately try to put yourself on a pedestal, you've got nobody to blame but yourself when it gets uncomfortable up there.

Quote:
I also believe that a woman who CHOOSES to have an elective section should understand that it may very well be impossible to find someone willing to attend any future attempts at vaginal birth. That's part of the package deal of asking for an elective section IMO and should be explained and discussed fully prior to surgery. It should also be discussed that some women' can only 'handle' a limited number of sections, so if she wants a half dozen kids, elective primary c-section isn't a very good plan overall. To me, those are part of the risks associated with elective primary c-section and should be covered under informed consent.
I see three problems with this.
The first is that it's not about "some women" only being able to "handle" a limited number of sections. I had no physical problems after my first two, but now have no feeling in my abdomen or bladder. Some women get that after their first - some never get it at all. It's luck of the draw, and has nothing to do with how many you have. Your phrasing here is just one more case of "we don't know what's wrong with your particular body - hedge your bets".

The second is that doctors have their own limits. My OB will do up to four sections, but no more. (He'd have to do a fifth if a woman presented at the hospital requiring it while he was OB on-call, but he won't take an OB patient with four prior sections.) It doesn't matter if the woman could "handle" a dozen, because he's decided how many kids she can have.

The third is that it's human nature to discount things that don't seem applicable to you. A woman who goes in for an elective primary section and is told that she shouldn't have more than two children (or whatever) isn't going to worry about that much if she's only planning on two. But, people do change their minds, and I've seen a fair number of people with an "oops" pregnancy who went on to have three or four kids because once they were parents, they found that they loved it. While that's certainly on their own heads if they chose major surgery, it's understandable that people don't really concern themselves about this aspect when they haven't yet experienced parenthood.
post #28 of 60
Quote:
Originally Posted by wifeandmom
In the end, there's a big difference between woman being unable to find a doc willing to attend a VBAC attempt and a woman being unable to find a doc willing to perform a c-section. The woman refused a VBAC *can* choose to have her baby vaginally right by herself if it came down to it and was THAT important to her. The woman refused an elective section can't just hack her belly open when the time comes. She *must* have a doc willing to operate, thus the doc truly does hold all the cards in that particular situation.
The woman refused an elective section can *also* choose to have her baby vaginally. You make it sound as though her choice is to find a doctor or cut herself open, and that's nonsense.

Anyway - we obviously see things very differently. I've made my mistakes, and know better now. If I ever do have another baby, no doctors will be involved. I want people around who actually give a crap about me and my family.
post #29 of 60
Quote:
Originally Posted by Storm Bride
The woman refused an elective section can *also* choose to have her baby vaginally. You make it sound as though her choice is to find a doctor or cut herself open, and that's nonsense.
My point was that if a woman WANTS a c-section and is UNABLE to find a doc willing to perform one for her, she CANNOT do it herself.

If a woman WANTS a vaginal birth, she doesn't REQUIRE the assistance of a doctor or midwife to make her choice possible.

Yes, a woman refused an elective section would obviously eventually have to at least attempt a vaginal delivery, but it would literally be FORCING her to do something she wasn't comfortable with for whatever reason. The same simply is not true for a woman wishing to birth vaginally. No doctor on this planet is going to come to your house and physically force you into a vehicle, transport you to the hospital, and forcibly cut you open against your wishes.

To me, it's about a WOMAN'S choice, something I believe should be protected and respected even if I don't happen to agree with her particular choice. I would never ever support any attempts whatsoever to make homebirth illegal, even unassited homebirth.

If a woman is willing to take on the risk of birthing her child without anyone present to assist in a medical emergency and her child dies as a result of that choice, that's no different than me choosing an ERCS that might result in my child's death. We all have to look at the risk factors for our own particular situations and decide what we feel is the best course of action from there. I can't and wouldn't WANT TO force my own opinion on what is safe vs. what is not safe on another woman simply because I cannot imagine having that done to me.
post #30 of 60
Quote:
Originally Posted by wifeandmom
Yes, a woman refused an elective section would obviously eventually have to at least attempt a vaginal delivery, but it would literally be FORCING her to do something she wasn't comfortable with for whatever reason.
I think if she's that uncomfortable with vaginal birth, avoiding pregnancy in the first place might be a good idea. She could have someone ready to cut her baby out at 38 weeks, and go into labour at 36 and be unable to reach a hospital. Vaginal birth is (well - used to be) a fairly inevitable result of pregnancy.

Quote:
The same simply is not true for a woman wishing to birth vaginally. No doctor on this planet is going to come to your house and physically force you into a vehicle, transport you to the hospital, and forcibly cut you open against your wishes.
No - but they will cut women open against their wishes once they're at the hospital, and they will sic CPS on women who are "irresponsibly" endangering their infants by homebirthing. Homebirth isn't illegal, but there are factors at work that make it incredibly stressful for many women. I just hope I can avoid any legal crap being thrown at me because I'm selfish enough to not want to be assaulted again.
post #31 of 60
Quote:
Originally Posted by wifeandmom
If a woman is willing to take on the risk of birthing her child without anyone present to assist in a medical emergency...
Every single woman who ever got pregnant takes that risk. This is part of what our entire cultural mindset about birth completely overlooks.
post #32 of 60
Quote:
Originally Posted by Storm Bride
I think if she's that uncomfortable with vaginal birth, avoiding pregnancy in the first place might be a good idea.
Wow. Are you serious? Because, as I have posted many times, normal birth terrifies me. Really...to the point I think it may be an actual phobia. I have 4 kids...is what you're saying that I shouldn't of had them? :
There's so much more to being a parent than how you birthed, and there's so much more to life than how you were born!
post #33 of 60
Quote:
Originally Posted by Storm Bride
I agree. However, I also think OBs have largely put themselves in the position they're in. Women used to know and understand that birth was risky and that things can go wrong. OBs gloss over that and try to make it go away. "Be a good girl, do what I tell you, and you'll be holding your healthy baby in no time." When you deliberately try to put yourself on a pedestal, you've got nobody to blame but yourself when it gets uncomfortable up there.
I don't agree. I think the consumerist mentality of society has a lot to do with the expectations of a perfect baby and birth. The prevailing attitude seems to be that you've paid for a perfect baby, and you damn better well get one. There are lawsiuts where families say they weren't urged strongly enough to have prenatal screening, where preemies are saved and the hospitals sued for their disabilities. At what point do Americans accept that risk cannot be removed from life and that they are not entitled to compensation for everything? Frankly, sometimes shit happens.
post #34 of 60
Thread Starter 
I think many that choose the Csect because to post to push ( someone like britney spears) they are NOT thinking about their child. There are many beneficial things a baby gets squeezed by contractions, coming out of the birth canal, receiving the mothers natural oxytocin. This is what I DONT understand. It isnt as simple as saying "oh vaginal c sect same thing... baby in the end" ONCE AGAIN HOWEVER I am NOT talking about true emergency csections..

michele
post #35 of 60
Quote:
Originally Posted by kstsmith
MRCS is a woman's *choice*, but it is still an elective surgery. Homebirth is just the normal physiological process of birth, only at home. Yes, at the end of both a baby is the end result, but they are night and day as far as cost goes. Like the pp said, it comes down to the insurance company's bottom line. This choice is more expensive for them, and without a medical reason, they should have the right to deny it. Homebirth has equivalent outcomes and fewer interventions than hospital birth overall, and is the norm throughout most of the world. If an insurance company will pay for a hospital vaginal birth, then they should pay for a homebirth. But to compare that choice with elective surgery is like comparing apples and oranges. I don't think my insurance premiums should increase because someone chooses any kind of elective surgery.
I disagree, should a homebirth go wrong and it has to transfer it becomes incredibly expensive. Some problems could have been managed, treated and resolved in a hospital setting early on at less expense. So I don't think its like comparing apples and oranges. With birth comes an unknown, with an elective csection, the risks are spelled out, its fast, and the results are pretty much known. While it may cost than a natural vaginal birth initially, it probably is less expensive than a homebirth transfer. (actually I know it is)
If insurance were to pay for homebirth, don't think premiums wouldn't rise, they would. Because in the long run, should something go wrong, the cost is much higher. Also the insurance industry wouldn't be able to gage who were transfers from home or not because in many states, people lie when they transfer as to not get their midwives in trouble. (like here in AL)
post #36 of 60
Quote:
Originally Posted by OnTheFence
I disagree, should a homebirth go wrong and it has to transfer it becomes incredibly expensive. Some problems could have been managed, treated and resolved in a hospital setting early on at less expense. So I don't think its like comparing apples and oranges. With birth comes an unknown, with an elective csection, the risks are spelled out, its fast, and the results are pretty much known. While it may cost than a natural vaginal birth initially, it probably is less expensive than a homebirth transfer. (actually I know it is)
If insurance were to pay for homebirth, don't think premiums wouldn't rise, they would. Because in the long run, should something go wrong, the cost is much higher. Also the insurance industry wouldn't be able to gage who were transfers from home or not because in many states, people lie when they transfer as to not get their midwives in trouble. (like here in AL)
Most insurance in WA does cover homebirth, and our premiums sure aren't any lower.
post #37 of 60
Quote:
Originally Posted by OnTheFence
I disagree, should a homebirth go wrong and it has to transfer it becomes incredibly expensive. Some problems could have been managed, treated and resolved in a hospital setting early on at less expense. So I don't think its like comparing apples and oranges. With birth comes an unknown, with an elective csection, the risks are spelled out, its fast, and the results are pretty much known. While it may cost than a natural vaginal birth initially, it probably is less expensive than a homebirth transfer. (actually I know it is)
If insurance were to pay for homebirth, don't think premiums wouldn't rise, they would. Because in the long run, should something go wrong, the cost is much higher. Also the insurance industry wouldn't be able to gage who were transfers from home or not because in many states, people lie when they transfer as to not get their midwives in trouble. (like here in AL)
Ugh...MDC ate my reply, so I'm trying again.

You are correct that birth is an unknown. But elective c/s is not as simple as knowing the risks. Are women told of their risk of infection? It's the most common risk and results in a longer hospital stay, more treatment, and on occasion reopening the surgical wound for cleaning and then remaining open for weeks for wound treatment. What about iatrogenic prematurity? Are parents really aware that their baby stands a good chance of being in the NICU as a result of a c/s for prematurity or breathing difficulties? What about the babies who are cut by a scalpel...happens more often than we hear about. What about all the other things that can go wrong with anesthesia as a direct result of the c/s? Insurance companies will pay for c/s knowing that complications can arise from them, making them even more costly than they already are. The same is true of vaginal birth. A vaginal birth in the hospital could have complications resulting in more cost to the insurance company, so how is homebirth any different?

Midwives have a lesser rate of costly interventions, including c/s. Because of this, the homebirth transfer rate is a very small percentage of all homebirths. And not all transfers are automatic c/s. Some go in for pain relief so labor can progress, or medications like antibiotics for a fever and have the baby vaginally. Insurance already pays for a more expensive hospital vaginal birth and accepts the risk that it could be more costly because of the unknown. How is homebirth any different? Insurance already pays for vaginal birth, so in reality, they are not being asked to pay for something extra by covering homebirth. They are simply being asked to allow women to choose the midwifery model of care or the medical model of care.
post #38 of 60
Thread Starter 
All I have to say is OBGYN DO have a higher intervention rate. With DS1 I showed our MW ( medwife ) my birthplan and consulted her on what ifs... She gave answers that I thought she would. However when I met the Dr one time I had asked him the SAME exact question. lets just say he wrap things up quickly with

fluids ARE needed through iv during labor
episiodomy is done so no trouble getting the baby out and quickly
After the baby delivers I would give pitocin for the placenta
if baby stays breech we will just do a csect ( dont ya love how easily this can be said :irk

and sooo on.. thank goodness i didnt have to see him again

AND when he heard i delievered naturally he gave me this big huge congrats like i just did something totally unheard of and unpossible.. Some may think im odd but i dont think giving birth naturally needed a congrats!

Michele
post #39 of 60
Quote:
If insurance were to pay for homebirth, don't think premiums wouldn't rise, they would. Because in the long run, should something go wrong, the cost is much higher.
I don't understand why you are saying premiums would rise? In a majority of HBs, there aren't transfers. In a hospital setting the risks are SO much higher that "something would go wrong" just by the virtue of the medical model of interventions/timelines/etc. The Miehl study risks come to mind. It's really frightening to see even old stats of how much risk is involved birthing in a hospital.

The mw I used transfers to the hospital about 10% of her clients....w/a rate of around 3% who actually have cesarean. The local hospital where her back-up has privileges (sp?) has a c-s rate of over 35%. So, I don't get why premiums would rise. Thanks for helping me understand the reasoning
post #40 of 60
Quote:
Originally Posted by rmzbm
Wow. Are you serious? Because, as I have posted many times, normal birth terrifies me. Really...to the point I think it may be an actual phobia. I have 4 kids...is what you're saying that I shouldn't of had them? :
There's so much more to being a parent than how you birthed, and there's so much more to life than how you were born!
I never said there wasn't more to being a parent. I think I'm a decent mom and I never gave birth to any of my children. (I'm not interested in debating this...if your c-sections were births for you, that's fine. They absolutely were not births for me.)

What I was pointing out is that vaginal birth is the normal, natural result of getting pregnant. You had four c-sections, but any one of those could have easily ended up being preterm labour, with you ending up having a vaginal birth somewhere. You were lucky (considering your feelings) that you made it to a hospital and OR in time to avoid a vaginal birth. But, there is no guarantee that that will happen. What my post meant was the only way to be sure you can avoid a vaginal birth is to avoid getting pregnant in the first place. A baby can be vaginally born anywhere (we had one arrive in our complex parking lot on June 27th)...but a c-section requires an OR. The only way a woman can be sure to avoid a vaginal birth is to spend the last half of her pregnancy (roughly) at the hospital so she can be immediately transferred to OR if everything gets going early.

So, no - I'm not saying that you shouldn't have had your children - not at all. What I'm saying is that, considering your fear of normal birth, you were taking a big chance. I think you're very, very brave.
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