Why Are People Against Elective C-Sections?? - Page 2

[dahlsk]

As someone who is lucky enough to have health insurance, but is seriously strained by the $1200 a month I will have to pay during my maternity leave to keep my coverage, I think the increased costs of medicalized birthing is very important to remember. Obviously, health care costs are out of control, and this hurts everyone (unless you're the lucky one who can pay cash for a c-s). It's a symptom of our whole health insurance disaster: don't pay for natural processes (HB, prevention, etc.) but cover the really expensive technical procedures needed once things get too far advances for the simpler fix.

I have a friend who was excluded from coverage for her birth because she was 7 days from coverage after a 1 year black out period. Not to mention the fact that the black out period was instituted because she changed the type of coverage she had after years with the same company, not that she was brand new to the company!

She was basically told that if she had the baby at home in the tub and then called 911 for assistance, they would take her to the hospital and cover that as it was "an emergency" but if she planned in advance for a natural hospital, bc or home birth, they would cover nothing.

[Teenytoona]

Originally Posted by Robinna

My basic philosophy is that I support whatever choices an informed woman makes for her birthing. That being said, I have a problem with the trend towards spurious or cosmetic surgical births.

For me, it's really a feminist issue. I believe firmly that most women who would choose an elective c/s are NOT completely informed, because I find it impossible to believe that if they WERE completely informed, they would make this choice. It is just too fundamentally illogical to choose surgery if you don't *have* to - it is a very rare person who, in posession of all the facts, would deliberately choose what is so obviously a riskier path. So. I believe that *most* women who want c/s "instead" have been sold a bill of goods through the medicalized birth model that our culture embraces, and each time a woman makes that choice it feeds into our cultural acceptance of medicalized birth as the "norm". And the stronger the medical model of birth becomes entrenched, the harder it becomes for those of us who *do* know, to opt out. So, bottom line, I believe that the trend towards elective c/s sets precedents that limit my choices and the future birthing choices of my daughter, sister, nieces, friends...

Now. If a woman is TRULY informed, and still chooses elective c/s? For sure - her body, her choice. But I think it's a very rare informed woman who would make that choice.

[nausicaamom]

My biggest beef with the increased cesarean rate is that instead of the uneventful VBAC I should be having, I am having a repeat section because the hoops I would have to jump through to get a VBAC would have put entirely too much strain on myself, the baby and my entire family. I am all too aware of the increased risks that come with the surgery, so while it can be said I am making an informed choice based on my personal circumstances it is by no means a willing choice and I'm sure one that many women having repeat sections find themselves in whether they are aware of it or not.

[MsBlack]

I am pro choice, and I very much DO think this is a feminist issue. That said--I have to also say that a very large part of this feminist issue is that women now have been raised in such a highly medicalized environment that many who presumably 'choose' such things as elective csec are NOT making an informed choice--they have no idea of, or belief in, the normalcy and perfection of their own bodies and birthing capacities--and how every bit of the way that birth is designed, is FOR THEIR OWN AND CHILDREN'S HIGHEST WELLBEING. THAT to me is a feminist issue worth fighting for.

Our range of choices have been under a state of seige for quite some time, and simply 'knowing all the risks of csec' is STILL not making an informed choice. The ripoff to women (and our children and partners) being perpetrated through this so-called 'informed consent' is quite insidious, devious and pervasive. You see, the problem is, women today (in general, and present company obviously excluded) is that we are never taught how perfectly suited natural birth is to the short term and long term wellbeing of mother and baby both (and for the family in general).

Knowing 'the risks' of csec is only 1/2--or maybe only 1/4--of the picture. True Informed Consent (under the law) means not only being told the benefits and risks of a particular procedure. It also includes being told the benefits and risks of OTHER OPTIONS, including the option of doing nothing. Women who are informed of the risks of csec (which I believe, as also true with epidural and various other common obstetrical interventions, are presented in a 'harmless' and quite watered-down way), are NOT being told why natural birth is best for all concerned in the vast majority of cases. Most docs do not even know the full range of benefits to natural birth, physically, emotionally, psychologically for mom and baby. The best we get from seemingly 'natural minded' obs is that they are willing to support the mom's wish for a certain 'experience' (so long as all goes well in the doc's mind). They do not acknowledge, and certainly do not promote, the facts which show that natural birth is hands down the very safest, healthiest way for babies to be born/women to give birth, in both the short and long term (for MOST women/babies, with exceptions, obviously).

So, to my way of thinking, this whole 'elective csec' is one of the most horrific of subversions handed to women in this technologically--and still very much patriarchally--oriented era. Separating out those women who do have good reason to choose csec (as with story of a pp), all others who--for no real health reason--seem to 'freely choose' elective csec, are being coerced by a deep and dangerous deception! There is simply no other way to put it.
They are NOT making truly informed choices--and the majority are not even aware of what Informed Consent under the law is and they surely do not know the myriad and deep benefits they are choosing against, by choosing csec.

They are women who have had their femininity stolen from them from the get-go, in the sense that they have been conditioned to believe that having a womanly body is something that can freely be 'bypassed' via patriarchal technologies, INSTEAD of being raised in an atmosphere that celebrates and honors woman's body and reality fully as a sacred and very much necessary element of this dualistic plane we inhabit. They are women who have been taught to believe they can 'bypass' their womanly body via technology, and not pay a price for that, now and on into their own and their children's lives--physically, emotionally, psychologically.

Yes, this is a feminist issue allright! It is very much a feminist issue.

[Mrs-Mama]

Originally Posted by dlm194

In general "elective" c-sections are normalizing surgical birth. Your body is meant to pass a baby out of your vagina. Why is there even a push for elective c-sections? This blows my mind.

As the demand and push for elective c-sections go up (therefore normalizing it as a method of birth), it makes it more difficult for women to have a normal vaginal birth. And forget VBAC. Since c-sections are so common, women desiring a vaginal birth after a c-section are seen as radical. They are told they are putting themselves and their babies at risk. But major abdominal surgery is okay. Hmmm..... Go figure.

:

[~Megan~]

I don't think women are really informed by their doctors. All I was told when I had one (b/c of breech positioning) was that a c-section was safer. I was not told of any risks or common complications related to the c-section. I was, in fact, told I could have a vaginal birth next time and then right after it was done the OB told me it would be safer to do a repeat c-section next time.

[Ruthla]

Originally Posted by LaLaLaLa

An elective c-section is by no means right for everyone, and I made the decision the first time around that it was not right for me. But for my second pregnancy.... I wouldn't have had it any other way.

I think that very few women who choose elective c/s have put as much thought into it as you have. You had specific medical concerns about vaginal birth that applied to your own personal body, not a generic "I don't want my vagina to get stretched out" or "I'm afraid of labor pain."

[Mrs-Mama]

Originally Posted by Ruthla

I think that very few women who choose elective c/s have put as much thought into it as you have. You had specific medical concerns about vaginal birth that applied to your own personal body, not a generic "I don't want my vagina to get stretched out" or "I'm afraid of labor pain."

I agree with this.

Slightly : I also think that the term "elective c/s" is misleading in this case. There are truly elective c/s's, medically indicated c/s's, medically required c/s's (transverse breech, etc), and true emergency c/s's. As I will likely have a medically indicated c/s in the future (due to J-incision), it pains me to have that lumped in with "elective" since I would never elect a c/s if it weren't medically indicated (and I had done research to back up that medical indication).

[Romana]

I personally am not opposed to elective c/s (not the medical definition - I do mean purely elective, I don't want to birth vaginally non-medically indicated c/s). However, I am opposed to any situation in which a woman is not fully informed of her options and the risks and benefits of different procedures and has the opportunity to make an informed choice.

Part of the problem is that the current social communcations and understanding regarding vaginal birth is that it's scary, unpredictable, dangerous, painful, and otherwise very unpleasant. And its counterpoint is scheduled, elective c/s, which is generally presented and perceived as calm, safe, predictable, and easy (or at least, easier). That's not to say that everyone feels this way or communicates this, but the "big picture" that most first-time moms get is just that. I know I did. If I wasn't such a research junkie and felt compelled to learn everything I could, who knows - I might have been fighting for a non-medically indicated c/s. More and more FTM are.

With that kind of background color, information about natural birth - or even just vaginal birth - is pushing uphill. Under those circumstances, I feel that it should be more difficult to obtain an elective, non-medically indicated c/s than to obtain a NCB in a hospital. Instead, in my experience, the opposite is true.

Women seeking non-medically indicated elective c/s should be required to read and understand information pertaining to their choice. Women seeking NCB should be supported and while education is always important to success in NCB, I would set the bar lower.

There's more to this, though. There may come a time when it really is safer, statistically, to birth surgically than vaginally (at least for the baby - maybe not for mom, or maybe not for some time for mom). At that point, the question becomes deeply complex. Are there still other benefits to vaginal birth? Probably. Are they superior or do they justify the choice for vaginal birth?

One corner I do not want to be backed into as a birth education advocate and NCB supporter is the "Now, scheduled c/s has been proven in studies to be safer for babies than NCB. How can you justify encouraging NCB, or even allowing the option?" This is one reason why I really do support each woman's informed choice regarding the way she wants to birth. If she is ignorant and uninformed, I will not be able to respect her choice to birth surgically. And I will question (inwardly) her chance of success at NCB if she says she's "hoping for NCB" but knows nothing about it. Women have to take an active role in their care and in birthing long before labor starts if they are going to have a chance at birth experiences that are positive for them.

I know that, today, non-medically indicated c/s carries additional risk to both mom and baby, and potential long-term health complications that, IMO at least, outweigh the benefit of, say, avoiding the pain of a natural delivery (not to mention post-op pain with a c/s). However, I still recognize that a rational, informed mother may, for reasons that I may not fully understand, choose a non-medically indicated c/s. I support her right to do that, just as I support the right of women to have unassisted births. I may not understand her reasoning, but I believe patients should have a great deal of autonomy in regards to their care, and that absolutely extends to pregnant and birthing women. Ultimately, the woman should have the right to choose what is right for her and her baby, and she should be supported by HCPs in her decision.

And I think the bigger problem has absolutely nothing to do with non-medically indicated c/s by mother's request and absolutely everything to do with the kind of care provided. How many women are set up for a c/s from the beginning? I'm thinking of my co-worker's wife, who was told at her 8 wk appt that she was probably too small to give birth vaginally (she is completely normal-looking, just 5'2"). How many doctors say things like, "Well, he's estimated at 8.5 lbs already on the ultrasound, and that's an awfully big baby - and you're only 37 weeks. This baby could be 10 lbs by the time you deliver! If you want, we can just schedule a c/s for next week." It goes on and on. THAT is the erosion of patient autonomy. Even if after that you say "Oh and by the way <boilerplate boilerplate>" if you've gained a woman's trust and have already convinced her that she is going to need a c/s, or that it's the best thing to do, what real choice does she have? For the average woman, the average patient, the wiggle room to choose is practically nil at that point.

I think I'm repeating myself so I'll stop. But I don't think we can really blame the huge increase in c/s on women choosing non-medically indicated c/s, as media stories tend to. I think the bulk of that responsibility falls squarely on the shoulders of medical professionals who wield all the power in the doctor-patient relationship.

I would like to see all women better informed and more empowered. It's not an easy thing to do. And it wouldn't eliminate non-medically-indicated c/s, but that's not the point and it's not the goal, either.

Disclaimer: I made some generalizations above WRT how doctors/OBs approach patients. I feel that, as a generalization, it's rather accurate. That is not to say that there aren't great doctors out there, or non-c/s-happy OBs. I just do not think they are a large proportion of the whole. And I very strongly feel that few doctors really do a good job of ensuring patients are informed and aware of their options and risks/benefits of different procedures. A good deal of why that is is simple: they don't have the time.

[JavaFinch]

After paying almost $40,000 to GET pregnant without help from my insurance company, I am already bothered by the fact that others paying the same amount as I can have a child every year for a decade if they want and cost the insurance company $100,000's, but they won't even help an infertile couple have ONE child. So if they're also giving them free C-sections for all those pregnancies without ANY medical reason? No, I'm not cool with that.

I also just don't understand WHY someone would choose it??? I might have to have one due to previa and I will be SO disappointed if that happens. Obviously, my main fear is not having complications or bleeding from previa, but also on my mind is a c-section that I do NOT want! How can someone just choose that? I don't get it.

[erin_brycesmom]

Generally speaking, I would say that I am against elective c-sections but I do support women's choice. I advocate against them for many of the reasons mentioned here and more. Ultimately, it should be the mother's choice. There are times when I completely understand why some choose that and there are other times when I don't agree but it doesn't really matter what I think. I think a lot less women would choose elective c-section if they were fully informed about not only c-sections but vaginal birth as well. Honestly, the way some vaginal births go down in the hospital - I don't blame a mother for wanting a c-section instead. Many people don't realize that a vaginal birth doesn't have to be that way. For me, the main issue is awareness not so much the choice. I'm glad it is an option, I just wish it was *way* less used.

[darsmama]

Originally Posted by karina5

Okay, I know I am on MDC. And *I* wouldn't have a C-Section by choice, personally.

But why such a backlash against them? Isn't it in the general realm of "A Woman's Right to Choose" and all that? And shouldn't a person be able to have the birth experience THEY want, just as there are Mama's here who choose to have an unassisted birth.

I am all for a person having a natural and/or unassisted birth, but really, there is risk involved in ANY method of childbirth.

So why are people so against a mother having an elective c-section if she wishes to do so?

I am very much in the camp of a woman can and should decide for herself how and why she wants to give birth.
That being said, there are reasons why an Elect. C is a bad idea, just as there are scenerios where a UC or a HB are a bad idea.

Whats that saying - Can't trust me with a choice, how can you trust me with a child?
That.

[ZoeyZoo]

Originally Posted by thismama

I am pro informed birth choices, including elective c sections.

I am too. I just don't think most people fully understand the consequences of that choice. The evidence is so strong on the benefits of NCB but I don't think most women get any clear evidence-based information.

[Benji'sMom]

Originally Posted by karina5

And shouldn't a person be able to have the birth experience THEY want, just as there are Mama's here who choose to have an unassisted birth.

Yes they should. I agree with what some others have said, it's only the elective c/s that's being allowed, people aren't being allowed to make other choices like VBAC. So there's going to be a backlash against that.

I think if I could go into any hospital and tell any doctor "I want a VBAC" and they'd just say "okay no problem," I wouldn't even care or notice that other women are choosing elective c/s. But if I have to go from hospital to hospital, and from doctor to doctor just to find one that would even *consider* VBAC for any patient, I'm going to get angry that the doctor is pushing surgery on me, and I'm going to backlash against the normalization of surgical birth.

It would be nice if all birth choices were equally respected and seen as equally legit, but it's just not that way.

[sapphire_chan]

Things have pretty well been covered, but I'll restate them anyway. (cause this is better than homework )

1. How many people who get elective c-sections are actually educated about the risks and such? For instance, how many are done because the woman wants her body to stay the same "down there" and then she's surprised when she gets a tummy pouch because the muscles never recover after the surgery?

2. If the c-section is done under group insurance, everybody in the group gets higher rates. As well as getting to help cover health care costs for the baby if the baby wasn't ready. Fortunately, I don't think any state health care plans cover elective c-sections, so taxes probably aren't an issue. And admittedly they tend not to be covered by insurance at all.

3. Every one done makes doing c-sections for any stupid reason that much more acceptable. And makes people who want natural births have to fight that much more to not get interventions--after all, what's the big deal with an induction? it'll still be a "natural" birth! :

4. A woman's right to choose for her own body? Well ye-es...but then it'd also be her choice to choose to drink heavily and smoke and live on cheetos. I would not be surprised to find that most women who get elective c-sections take very good care of themselves and their babies during pregnancy, so it's all kind of incongruous to risk everything at the last minute.

5. Not all birth choices are treated equally. Every woman doesn't have a chance to choose the birth she wants. Homebirth, VBAC, etc.

[sapphire_chan]

Originally Posted by karina5

I know what you're saying, but our bodies are meant to do a lot of things that medicine has changed over the last century. Some could argue some of this is good, and some not so much.

And which thing that our body was designed to do has medicine changed in a good way over the last century?

I mean, we don't need the appendix's store of digestive bacteria anymore since we're rarely away from other people, but appendectomies were done in the 18th century.

[thismama]

Originally Posted by ZoeyZoo

I am too. I just don't think most people fully understand the consequences of that choice. The evidence is so strong on the benefits of NCB but I don't think most women get any clear evidence-based information.

I have a good friend who is both a nurse and a medical malpractice lawyer. She is extremely informed, and she chose elective c/s for both her births.

[sapphire_chan]

Originally Posted by thismama

I have a good friend who is both a nurse and a medical malpractice lawyer. She is extremely informed, and she chose elective c/s for both her births.

A nurse and a medical malpractice lawyer? A person in her professions would have a ton of work to do just to get over the prejudices of her professions.

Did she educate herself about birth besides observing the same hospital births that give many nurses a distorted view of birth and looking at the medical malpractice laws that lead OBs away from evidence-based practices?

I'm sure she educated herself to her satisfaction and, as long as she doesn't use her positions to influence other women into having elective c-sections, it was her choice to make.

[Ironica]

As to the issue of food allergies and c-section, here's an article with some insight on that:

http://www.americanscientist.org/tem...rint=yes#54477

After reading this thread, I think that to a certain extent the outrage against non-medically-indicated c-section is a backlash. I'm right with the folks who wouldn't bat an eye at Super Star getting her baby cut out of her body so she can get the lipo at the same time if it wasn't such a friggin' battle to be allowed to push MY baby out my vagina. When women who have options choose c-section, they ARE making it harder for other women to go with vaginal births.

I'm actually not necessarily on board with the "fully informed" choice either. If someone's paying *entirely* out of pocket, maybe. But I don't personally believe that having children is an automatic right, so I do think that people need to take the good with the bad. It gets hazy when someone's had a traumatic vaginal birth. I think that, in an ideal world, we should be able to count on our birth professionals to examine what went wrong and help us to avoid the same circumstances... but too many doctors view vaginal birth like it's some kind of mysterious voodoo that they can't *possibly* hope to understand, so there's no concept of avoiding the same circumstance next time. The same thing happens in reverse for a primary c-section patient who wants a VBAC; you get some catch-all diagnosis like FTP or even something more precise like secondary uterine inertia (*raises hand*) that doesn't really capture the ENTIRE process that led you to the OR. It's left to the patient to reconstruct what happened and determine if she, herself, feels like SHE has the power to make different decisions and have a better outcome. Unfortunately, whether the initial birth was vaginal (but traumatic) or surgical, the default choice when mom can't process the experience and feel that sense of control is to give birth surgically in the future.

[alegna]

Originally Posted by thismama

I have a good friend who is both a nurse and a medical malpractice lawyer. She is extremely informed, and she chose elective c/s for both her births.

I can not come up with a more likely to be biased combination...

-Angela