no shock in elective c-section declaration from ACOG

[Marlena]

http://www.washingtonpost.com/ac2/wp...nguage=printer

It is ethical for doctors to deliver a baby by Caesarean section even if the mother faces no known risks from conventional labor, the nation's largest group of pregnancy specialists has decided.

The American College of Obstetricians and Gynecologists' ethics committee is issuing a statement today that for the first time addresses the increasingly popular elective Caesarean sections -- those performed when there is no medical necessity.

...

The new statement could help accelerate a rapid increase in Caesarean sections by making doctors more willing to perform the procedure on an elective basis, some experts said.

I suppose it will help make up some of the revenues lost to rising medical malpractice premiums, and will also relieve docs of some of those inconveniently timed deliveries. Pregnant medical consumers can sleep soundly tonight. :

[stayinghome]

Unbelievable. I don't even know what to say.

[spero]

Grrrrrrrr...just think of all those women who will buy right into this concept...I can't tell you how many women I have encountered who "would just love a schedulled c-section, so I don't have to go through labor!"

[Mere]

Geez, the way it's going in a 100 years people won't even remember that babies can be born naturally...how sad.

[Tigerchild]

Before jumping headfirst into the pileup here, in support of the mamas here who have had cesarean births I'd like to point out one thing...

I wonder how many mamas would qualify as 'elective' based on that criteria?

I would. *Labor* posed no great risk to my health. Keeping the guys inside did. So, I elected to have the cesarean after we knew their lungs were mature.

But I'll still punch anyone who dares to call me lazy, ignorant, or thoughtless as to the well being of my children right in the mouth. At least in regards to the kids' method of birth.

[Marlena]

I also ended up with a c after hours of allegedly significant decellerations whenever my contractions would start to speed up. I guess dd liked it in there. At the time, it was billed as a necessary c, but I suspect that, in the care of a good midwife who was not affiliated with a group of OB/Gyns (mine was), I probably would've delivered safely and naturally, vaginally.

That being said, I don't have any genuine regrets about the section. The point was to end up with a healthy child, and that's what I ended up with. So I'm happy.

The point being: it is not my intent by having started the thread to bash women who have or had c-sections. Rather, it is merely to point out another step in the direction of further medicalizing and controlling childbirth, after a number of years in which the use of midwives increased, as did other practices in hospital births such as rooming in, allowing family members to be present in the room at birth, etc. etc.

[Greaseball]

If any woman has the right to request a section, any woman should have the right to request a vaginal delivery as well. And I mean ANY woman - footling breech, VBAC with classical incision, triplets, 14-lb baby, 3-day labor, under 5 feet tall, 4 weeks overdue, membranes broken for 24 hours, herpes, or even a woman with all of these conditions!

[Marlena]

Um...not really. No. I don't think you'll even find many midwives who'd agree with that position.

Rather, it's sorta like saying (though somewhat more extreme) that you can wait for the kidney stone to pass, or we can take it out surgically. The former may have less morbidity, and is certainly more "natural," but both are reasonable medical choices. I think you'd have a hard time finding anyone, however, who'd think it's ok to deliver an 11 lb breech baby vaginally where the mother is tiny with a small pelvis and who had a broken coccyx and who also has active herpes.

[Greaseball]

Well I think it's OK! Too bad I'm not a birth attendant, moms would seek me out!

I read of a woman who was able to deliver at home with a midwife in spite of: age over 40, twins, breech, 2 weeks overdue, and VBAC for past CPD. (Open Season) Women have also delivered vaginally in each of the situations I listed in my last post; sometimes more than one.

Open Season lists several extreme circumstances under which women have been able to VBAC, such as herpes, more than 5 cesareans, muscular dystrophy, classical incision (one woman had a homebirth after 3 classical incisions), and triplets. It's a fascinating read!

[kama'aina mama]

Originally posted by Tigerchild
But I'll still punch anyone who dares to call me lazy, ignorant, or thoughtless as to the well being of my children right in the mouth. At least in regards to the kids' method of birth.

As well you should! I suppose it might be possible that an induction might have had a good outcome for you (as good a C birth, I mean) but that is not for other people to decide. You were in the situation, you made the best choice for your family. I am never comfortable when general conversations of this nature become specific. No one has a right to judge anyone else.. but I think it is still okay to say "Gee, there are probably way too many C's in this country, and this new statement is clearly not going to do anything to change that."

[Marlena]

but I think it is still okay to say "Gee, there are probably way too many C's in this country, and this new statement is clearly not going to do anything to change that."

Absolutely!

[detergentdiva]

I've had 3 sections now
Number 1 heart decels failure to progress

Number 2 planned vbac 24 hour labor severe pain, no progress, dr thought I was rupturing from #1, turned out I had adhesions from #1

Number 3 planned section, started having issues at 8 weeks, large amount of adhesions from #1 and #2 had problems keeping baby in, had more issues during surgery, baby premature

Spent next year on pain meds, July 2002 hysterectomy, continued problems from adhesions

Why do I say all this because thank God for the medical advancement that saved my children and myself, without it I would not have them.

BUT I do NOT think sections should be elective. Too many people think it is a minor surgery with no complications let alone death. Women are made to have children vaginally and although there are a small number of us who for one reason or another can't that doesn't mean that every other person should say het I want baby on this date so I can "Plan" my borth. Please get over yourself and start thinking about the child you are about to give birth to and the consequences of your elected major surgery!!

[gurumama]

Originally posted by Greaseball
Open Season lists several extreme circumstances under which women have been able to VBAC, such as herpes

ACOG has actively promoted vaginal delivery in cases of herpes (since the early '90s) unless the mother has active lesions or is going through her primary (first ever) outbreak.

Otherwise mothers with herpes can have safe vaginal deliveries--it's NOT a medical condition that automatically qualifies one for a c/s, and not a condition that HMOs will automatically consider a valid reason for a c/s.

I think the ACOG's policy on elective c/s is an attempt to normalize ELECTIVE c/s and to give women more "choices". Sadly, it'll be touted as a progressive thing among certain sectors of women (like that urologist, Jennifer whatever, one of the sex sisters).

[daylily]

I suppose it will help make up some of the revenues lost to rising medical malpractice premiums

Exactly. Doctors charge a lot more for a c/s. Maybe this will help the economy--:

[DaryLLL]

See the correlation between this and the rise of popularity of artificial feeding? Doctors say, Species specific milk? Nah, too much trouble and besides, your nipples might be sore for a couple weeks.

Vaginal birth? Nah, too much trouble, and labor might hurt for a few hours. (Don't tell moms they will have pain, severe pain, from the c-sec site for weeks or months and numbness for a year. Shhh...)

What. A. Scam.

[InfoisPower]

IMO this is just another example of following the $$$$.

Doctors cannot stand by and do nothing even when it's the best thing to do. Doctors cannot resist using toys (reminded of the Monty Python skit and the machine that goes boooooing) to back up taking inappropriate action.

That and they like to disempower women and *deliver* them.

I 'm totally disgusted and want to :Puke

rant off.

[Greaseball]

The countries with the lowest c/s rates do not give dr's bonuses for them the way we do here. Doctors are paid a flat fee for every delivery.

What if we gave them bonuses for vaginal births here?

About herpes - I have spoken with some midwives who will deliver a woman with an active outbreak. They put plastic over the lesions. Some midwives have a policy of doing nothing at all, even if lesions are present in the vagina, and have never seen a baby get herpes.

I just got Open Season out, and here are some more VBACs that occured under special circumstances - bone spurs, placental abruption, meconium, severe obesity, type 1 diabetes, previous fibrioid removal, and one with fibroids currently in the uterus. Before c/s was invented even mothers with complete placenta previa were delivered vaginally and in about half the cases the babies lived. (Of course, if I were in that situation I'd opt for surgery.)

My point is, if women with normal pregnancies are able to decide for themselves they will have surgery, than women with pregnancies that are variations of normal should be able to decide they will not have surgery.

[kama'aina mama]

Originally posted by InfoisPower
(reminded of the Monty Python skit and the machine that goes boooooing)

The machine goes PING!

[InfoisPower]

Ah well details,details...I was remembering the sound it made as I heard it. Not what the characters called it. Therefore your Ping = my Booooing! :LOL

[Meiri]

"I do think it's a step forward in that the college has grudgingly agreed that it might be a reasonable thing to do. That's new," Walters said. "They should have said that in the absence of compelling evidence to support the superiority of either vaginal birth or Caesarean section that either one is a reasonable alternative for delivery and should be considered equally."

If the stat is accurate, wouldn't a 4 times higher death rate for caesarean be rather compelling evidence that vaginal is safer?:

Let's see possible incontinence issues vs. adhesions or death? hmmm difficult choice!:LOL

And this from a mom who has had 2 emergency caesarians after hours of pushing each time because the sprouts were flat out Stuck: one with head cocked to the side a bit, the other facing my leg.