Why Are People Against Elective C-Sections?? - Page 3

[starling&diesel]

Here in Canada, insurance premiums are not an issue, as all birth options are funded by our universal health care system.

That being said, I'm coming to this as a paramedic and thinking of all the women I've encountered in my job.

Culturally, vag births are definitely the first choice, with reluctant cs being a distant second. Elective CS just are not the done thing here, in my experience anyway. I can honestly say I've NEVER had a patient who birthed via elective CS. Never.

What I notice the most in terms of birth choice oppression here is the medical system constantly telling women that VBAC is impossible.
I take every opportunity to tell grieving women I am transporting pre- or post- reluctant CS that it is possible.

One patient I've seen a lot lately is a now full-term primip complete placenta previa. The first time we raced down to the nearest hospital (3 hours away) was almost three months ago for a dangerous bleed ... she and her partner were so scared, both to lose the baby and because of having to have a CS. I was with the same couple last week, and now their biggest concern is the CS. Everyone is telling her she'll never have a VBAC.

I think the overall issue here is education. Nevermind the doctors. Women need to share their wisdom with each other, free of judgement.

[erin_brycesmom]

Originally Posted by starling&diesel

Here in Canada, insurance premiums are not an issue, as all birth options are funded by our universal health care system.

Why would that make it not an issue? The money to pay for universal health care doesn't come from trees, it still comes from the citizens. If anything it effects you more because you don't have the option of choosing an insurance carrier who does not cover elective c-sections.

[sapphire_chan]

Originally Posted by alegna

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

-Angela

OB who trained in Brazil (90% c-section rate) who's now a malpractice lawyer in the U.S.?

Sorry, I tend to read "can not come up with" as a challenge to my imagination.

[applejuice]

I am against elective caesarean sections because they are never presented to the mother as possibly affecting her future fertility and gynecological health and future.

Doctors present elective caesareans as the modern woman's way of birthing.

After one caesarean section, many women suffer PPD, miscarriages, stillborns, infertility, blocked tubes from infection from the surgery, anemia, PP hemorrhage, inability to breastfeed, uterine rupture, placenta previa, placenta accreta. These occur without the incidence of surgical birth, but surgical birth has increased the incidence of these complications dramatically.

And the baby can be hugely affected by prematurity, RDS, and death. Doctors act as if they can guarantee you a perfect baby if you let them cut you open, but that is not true. Babies are born dead when they are delivered "from above" also. Usually this can be a problem from the previous surgery.

There are no guarantees in this life, never.

When women who have options choose c-section, they ARE making it harder for other women to go with vaginal births.

Very true. This is how the march from home births to a virtual 100% hospital birth rate happened. The mothers who had the option, still opted for the hospital, and after decades, birthing in the hospital became the rule.

[dinahx]

If insurance automatically covered homebirths with a midwife or even if hospital births with an INDEPENDANT midwife (one who doesn't have her paycheck signed by an OB) were available in all areas and covered by all insurance companies, then there wouldn't be an economic bias toward medicalized birth in general, and c-sections in particular.

But in the USA there is a clear economic bias. :cry


(I personally don't bother with my insurance company. If they want to make a donation, that's nice, but I am NOT going to ask an insurance company how to get my baby out. They are too biased and too lame for me. )

[1006baby]

One of the problems I have with elective c-sections that I have not seen addressed in this thread yet (although I might have missed it) is the conflict of interest for the physician.

Within the US healthcare system doctors get paid more money for a c/s than for a vaginal birth. Hospitals loose money on vaginal births that last longer than about 20 hours. For Hospitals that are very efficient, c-sections can even be a profit center. (Obviously I work in this area for a living!)

So, how can the people (doctors and hospitals) who are financially incented to encourage c-sections be responsible for ensuring informed consent for an elective c-section? Another question I have is if elective c-sections are so acceptable why is there no official diagnostic option for that choice? When a woman chooses an elective c-section, doctors do not write in the chart c-section due to maternal choice. They lie and say c-section due to “x,y,z” (something ambiguous and hard to disprove) because they want to be certain that they get reimbursed.

If a woman wants to make a choice for an elective c-section, I think she needs to be made to review unbiased information provided by someone other than a physician who is getting more money to perform the c-section or a hospital that can also profit from the surgery.

[GooeyRN]

Originally Posted by thismama

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

me, too. Not what I would choose to do that, but others should be able to do what they want, whether it be homebirth, elective induction, elective c-section, etc. I personally would like to never have a c-section, just b/c I don't want to go through the long recovery. Others would like to avoid a sore vulva.

[georgia]

Hi, just a friendly reminder from the User Agreement:

Mothering.com is the website of natural family living and advocates natural solutions to parenting challenges. We host discussion of nighttime parenting, loving discipline, natural birth, homebirth, successful breastfeeding, alternative and complementary home remedies, informed consent, and many other topics from a natural point of view. We are not interested, however, in hosting discussions on the merits of crying it out, physical punishment, formula feeding, elective cesarean section, routine infant medical circumcision, or mandatory vaccinations. We do not tolerate any type of discrimination in the discussions, including but not limited to racism, heterosexism, classism, religious bigotry, or discrimination toward the disabled. We will not host discussions that involve explicit sexual references and are cautious about discussions on volatile topics such as abortion, religion, and race. See statement of purpose below.

Any questions or comments, please PM me, Arywn or courtenay_e. Thanks!

[alegna]

Originally Posted by sapphire_chan

OB who trained in Brazil (90% c-section rate) who's now a malpractice lawyer in the U.S.?

Sorry, I tend to read "can not come up with" as a challenge to my imagination.

Yeah yeah yeah....

There could be worse...

-Angela

[thismama]

Originally Posted by alegna

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

-Angela

Everyone is biased. We all have a right to our biases. She is definitely not uninformed.

[alegna]

Originally Posted by thismama

Everyone is biased. We all have a right to our biases. She is definitely not uninformed.

Honestly I would deeply doubt if she's truly informed. One does not become informed with the background she has.

Also, admittedly, I have a very difficult time fathoming how a semi-intelligent person could possibly fully informed and choose an elective section (barring another reason- previous trauma etc) It's not a logical choice. The evidence does not indicate that it is a safe or wise choice.

-Angela

[thismama]

Originally Posted by alegna

Honestly I would deeply doubt if she's truly informed. One does not become informed with the background she has.

She is informed. We have had the discussion. She can talk circles around me with her medical knowledge and stats about various risks, she is not just some ignorant woman under the spell of her OB because she chooses differently than I would. That is my point here.

Also, admittedly, I have a very difficult time fathoming how a semi-intelligent person could possibly fully informed and choose an elective section (barring another reason- previous trauma etc) It's not a logical choice. The evidence does not indicate that it is a safe or wise choice.

-Angela

Well, and that would be your bias. It is one that I share (re: risks), but I can assure you my friend is very intelligent and well informed, and yet she makes different choices than you or I would.

Her body, her births. I support her fully. Which is what I am saying in this conversation, ITA that there is a general lack of info about birthing perpetuated by the medical industry, and I feel women should have full access to information when making our choices. But, that doesn't always mean they make the same choices you or I would.

And that is totally cool with me.

[chiro_kristin]

"Informed" and "conscientious" are not the same thing. Well maybe conscientious isn't the word I want to use, but I can't think of a better one right now.

[anne1006]

I think that if someone wants and elective procedure, then they should pay for it. If there isn't a medical need for it, then it should be out of pocket and not driving up insurance premiums. My premiums won't pay for my homebirth, and I don't want to pay for someone who is too posh to push. If our medical standards and practices went along more with current research, there would be far fewer interventions and elective procedures, and our insurance would be better off. Though the hospital pocket books probably wouldn't be.....

[applejuice]

True, anne1006.

[thekimballs]

Originally Posted by alegna

Honestly I would deeply doubt if she's truly informed. One does not become informed with the background she has.

Also, admittedly, I have a very difficult time fathoming how a semi-intelligent person could possibly fully informed and choose an elective section (barring another reason- previous trauma etc) It's not a logical choice. The evidence does not indicate that it is a safe or wise choice.

-Angela

Why can't she be informed? Are nurses and lawyers forced to live in a box somewhere and not allowed to read medical literature?

It's ridiculous to say that no semi-intelligent person can choose an elective section (because of the published risks) unless you're also going to say that no semi-intelligent person could ever have a vaginal breech (where the published risks show that it is riskier than a c-section) or a UP/UC (where the published risks show that no prenatal care is associated with a worse outcome).

No woman makes (informed) decisions based solely on statistics, unless she is a Vulcan or a robot. The evidence and statistical predictions are weighed against her desire and need for an experience that empowers her and validates her, and against her emotions and attachment to the vision of the experience.

I have no issue with the idea that for some women a c-section is in fact empowering and validating. I know several who have had two or three sections, the first or second medically necessary and the subsequent "elective." Am I supposed to accuse them of being deluded or lying when they talk about how much more they were empowered by the elective section than by the attempted vaginal birth that went to section in the end?

This assumption that no woman who is truly informed can possibly choose X is very, very dangerous. How would you like it if an MD used that type of logic against you? Or if the courts assumed that type of logic when granting court orders for medical treatment? It's the polar opposite of individual empowerment; it's enslavement to statistical risk.

[dinahx]

I *know* I have to pay for my HB OOP, so why shouldn't elective sections be the same???

But I agree that someone could know *all* the facts and still make a different choice. I just learned that with Circ . . . I thought for sure, no one as smart as me AND who had a intact husband would choose to Circ, but then I met *that* mama. With an intact husband and she's a CRNA . . . so she's even seen circs . . . Go figure!

[starling&diesel]

Originally Posted by erin_brycesmom

Why would that make it not an issue? The money to pay for universal health care doesn't come from trees, it still comes from the citizens. If anything it effects you more because you don't have the option of choosing an insurance carrier who does not cover elective c-sections.

Therefore, everyone has an interest in keeping the costs reasonable.
Perhaps that's why we aren't so keen on them here? And why you have to have a good reason to have one?

[felix23]

Originally Posted by thismama

She is informed. We have had the discussion. She can talk circles around me with her medical knowledge and stats about various risks, she is not just some ignorant woman under the spell of her OB because she chooses differently than I would. That is my point here.



Well, and that would be your bias. It is one that I share (re: risks), but I can assure you my friend is very intelligent and well informed, and yet she makes different choices than you or I would.

Her body, her births. I support her fully. Which is what I am saying in this conversation, ITA that there is a general lack of info about birthing perpetuated by the medical industry, and I feel women should have full access to information when making our choices. But, that doesn't always mean they make the same choices you or I would.

And that is totally cool with me.

I Thismama! I totally agree with you, people can be informed and choose an elective c-section.

[SneakyPie]

Oh for crying in the night. We all know "elective" doesn't mean only "because I don't feel like having a vag. birth." "Elective" also covers every situation in which the mother has any time and warning at all beforehand and makes a DECISION (with her practitioner) that c-birth will be best for her and the baby. The medical profession themselves are the ones who have classified that as "elective," meaning "the opposite of emergency." So ANY non-emergency c-section is "elective" by this definition, and to slam all mothers who have to make that choice as semi-intelligent, not possibly REALLY informed, and undeserving of medical coverage, is just kneejerk and unthinking.