Trying to make sense of uterine rupture fear... - Page 2 - Mothering Forums
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#31 of 37 Old 08-04-2007, 03:39 PM
 
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Originally Posted by f&p'smama View Post
Yeah, I do KWYM. And I agree. But I also think part of the responsiblity lies in the litigious culture in the US. I think many OBs are terrified of a law suit and that drives their decision making, instead of what is best for this particular patient. That sucks and it's not right and it should not enter their decision making. Their oath is to first do no harm & if they're pushing surgery which is risker than a breech birth, it's wrong. There certainly are crappy doctors who push for a C-section because it's 7:30 on a Friday night and they want to get home. My Mom swears that her doc pushed Pitocin on her with my sister because he wanted to get to a golf game on a Saturday. I think many OBs are human and think about themselves and protecting their careers in addition to what's best for their patient. And I think there is some collective cultural responsibility for that. That's all I meant.

It's sad that things like breech birth are less and less a part of medical training and there are fewer and fewer OBs who even know how to do them. :
This is true. Women are more apt to sue if their baby isn't born perfectly healthy, even if it is no one's fault. Let's examine the roots of this. When doctors took birth into hospitals, there were promises of better infant mortality. But really, this was not the case, although women who could afford it gave into the illusion. But the doctors couldn't leave well enough alone. They had to improve on nature, they had to find a way to control the uncontrollable. They invented machines and procedures and gave drugs that would make birth more "scientific" under the guise of making it safer for babies. Why go through the pain of labor and have to push the baby out on your own when a doctor could knock you out, give you an episiotomy that would alter your genitals for the rest of your life and use forceps to rescue your baby from your body? The whole obstetrical system is based on the fact that women's bodies are flawed and our babies must be saved from them. And so big promises were made... if you give your flawed body to us, we make sure you have a healthy babies.

Women were set up for failure, especially as they started placing more and more strict guidelines on what was "normal" It only got worse when c-sections were made safer* Because this was the ultimate in controlling women's bodies. Only dialated to 5 after ten hours of labor? C-section! Baby is breech? C-section! 5'2" and 110lbs? Your baby must be too big for you to birth- C-section!

And thus the roots of why women are so ready to sue a doctor of something goes wrong. Because they promised us that if we gave ourselves over to them, knocked us out, cut our genitals, cut our bellies to save our babies from us and sacrificed our births that they could produce a healthy baby

*Please note, i am only talking about c-sections that are for not medically sound reasons. I thank God that c-sections were made safer for the women that truly do need them for themselves and for their babies

Midwifery Student and Mama to 2 daughters and 3 sons.     
ribboncesarean.gif vbac.gifhomebirth.jpg I have given birth a variety of ways and I am thankful for what each one has taught me.

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#32 of 37 Old 08-04-2007, 09:36 PM
 
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Originally Posted by milkydoula View Post
And thus the roots of why women are so ready to sue a doctor of something goes wrong. Because they promised us that if we gave ourselves over to them, knocked us out, cut our genitals, cut our bellies to save our babies from us and sacrificed our births that they could produce a healthy baby
:
My doctors (family physician and OB) never once said "you and your baby will be healthy if you have this section, and you won't be if you don't", but the message was carried in everything they said to me for months...right down to my FP's emotional blackmail about how she couldn't sleep at night because she was so worried about me (because I was insisting on VBA2Cing) and the never-ending mantra of "you're making a mistake - I wouldn't do this - we want a healthy mom and a healthy baby". I still managed to stick to my guns until the final ultimatum, but the pressure was unbelievable...and there was an implied promise there.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

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#33 of 37 Old 08-05-2007, 12:40 AM
 
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Interesting thread. There is absolutely no way in the world I'd have an amniocentesis because I would never accept a 1 in 200 risk of miscarriage as acceptable. If my baby had a 1 in 200 chance of dying from VBAC I'd have a c-section in a heartbeat. But the risk to the baby is obviously much less than this making an uncomplicated VBAC the safest mode of delivery for my baby.

What I want from this pregnancy is a living baby and a living mama and I'm quite comfortable with operative intervention to achieve this if necessary. I had a csection due to severe HELLP syndrome and without the interventions we had my son and I would both be dead. At the time I did feel betrayed. I truly trusted that my body could grow and birth a baby and in fact it couldn't do it without putting both of us is lifethreatening danger.

Now I trust my body to do the best that it can and I am so thankful that I live in a time when if I get one of the lifethreatening diseases associated with pregnancy again it is likely that my child and I will be able to survive it, unlike legions of women and babies over the centuries before this one. Even twenty years ago my cousins died in similar circumstances (birth at 28 weeks) to those which my son has survived and thrived following.

Unnecessary csection does endanger women and babies, along with unnecessary amnio and so many other interventions. As a medical practitioner I counsel women to avoid all such unnecessary interventions.

Anna mum to Bede 7 and Emmett 3.5 partner to LEah for 10 years
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#34 of 37 Old 08-05-2007, 02:08 AM
 
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I don't think you'll find a mama here who thinks that all c/s are unnecessary. There are, however, many mothers here who have had unnecessary surgery the first time, and then subjected to even more unnecessary surgery because of the first one. It just makes us : trying to understand why. If we can see through it and understand VBAC is as low risk as birth with an unscarred uterus, then why can't the obstetrical community?

I'm glad to hear there are medical practitioners advising against unnecessary interventions. We need more advocates like that in obstetrics.
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#35 of 37 Old 08-05-2007, 03:06 AM
 
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Originally Posted by TanyaS View Post
If we can see through it and understand VBAC is as low risk as birth with an unscarred uterus, then why can't the obstetrical community?
But it's *not* as low risk as birth with an unscarred uterus.

Rupture rates for VBAC are drastically different than rupture rates in the unscarred uterus. 1 in 15,000 is not even comparable to 1 in 200. It just isn't.

That doesn't mean that 1 in 200 is too risky to consider, but to suggest that laboring with a scarred uterus is 'as low risk' as laboring with an unscarred one simply is not true.
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#36 of 37 Old 08-05-2007, 10:11 AM
 
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Sorry. That's what I get for posting late at night.

What I meant with my post is that the UR risk associated with VBAC is not any riskier than the other things that can go wrong with vaginal birth sans scar (i.e. cord prolapse, etc). Some things associated with pregnancy even have a higher rate of incidence than UR.
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#37 of 37 Old 08-05-2007, 01:19 PM
 
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Originally Posted by wifeandmom View Post
Rupture rates for VBAC are drastically different than rupture rates in the unscarred uterus. 1 in 15,000 is not even comparable to 1 in 200. It just isn't.
But the other thing to note here is that in labor is not the only time a woman with a prior c/s can experience ur. What TanyaS is probably referring to is the fact that most docs tend to ignore that fact. They put all the risk on moms who want a VBAC and ignore the fact that ur can happen ANY time in a pregnancy. Just thinking that one can automatically avoid the ur risk if they go with a repeat c/s is simply not true.

Of course...part of that assumption for "high risk" when it comes to ur also has a lot to do with obstetrical "management" of labor...but that's a whole 'nother post.
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