70% c-section rate...mom's are happy and pain free! - Mothering Forums
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#1 of 56 Old 05-12-2009, 01:43 PM - Thread Starter
 
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I was just reading about a hospital in Southern Florida that has a 70% c-section rate. How is that even possible or allowed to happen?!? I don't get it. I wrote a little blog post about it because of some comments a local OB professor wrote about women being pain-free and happy with the c/s. This just infuriates me. Are there really moms who have had c-section who are thrilled that they had one and are pain free?

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#2 of 56 Old 05-12-2009, 01:48 PM
 
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In many South American countries the c/s rate is higher than that in most private hospitals (where women can choose an elective c/s). I think it has to do with cultural attitudes concerning women wanting to "keep things tight" in their pelvic area, though it could also have to do with the degree of convenience involved in being able to schedule the birth and have it "over with" in just a few minutes.
I also have a hunch, after reading about hospital birthing conditions in many Asian and South American countries, that the practices still common there (similar to American practices in the 50s) may lead to such horrific vaginal birth experiences that women will choose c/s just to avoid that.
I would imagine there are similar forces at work in that Florida hospital...

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#3 of 56 Old 05-12-2009, 01:54 PM
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Someone feel free to correct me if I am wrong, but I think I read that Brazil has the highest C-section rate in the world...Elective C-section and just C-section period...80% elective or something like that.
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#4 of 56 Old 05-12-2009, 01:56 PM
 
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I was pain free and walking around the same day after both my vaginal births.

A friend of mine who had 3 c/s (first was due to pre-e, 2nd and 3rd were repeat...our local hospital put a ban on VBAC) hated her c/s. She still mourns the fact that she never got to labor. She was THRILLED that she got to feel a couple ctx with her third...she called me the night before the c/s and says "Guess what? I'm pregnant with my 3rd and just felt my first contraction. It is SOOOO cool!!!" She is happy she has healthy children but does feel she missed out on something special. And pain-free isn't the word I'd use considering she had a Morphine machind for the first 24-hours...

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#5 of 56 Old 05-12-2009, 01:59 PM
 
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Some women deal with surgical recovery really well. And some imagine some really improbable things about vaginal delivery. And anyway, if you ask them while they're still on the morphine drip... Or, I suspect, if you don't ask them at all.

"Moms are happy and pain-free!" is a very general, and therefore probably untrue, statement especially because we're talking about people who've just had abdominal surgery here - when are they pain-free? Because I can't imagine they all get through recovery without so much as a twinge. It's puffery. A comparable and more probably accurate statement would be something like "64% of our perinatal patients report that they are "very satisfied" or "satisfied" with the care they received during labor and delivery."

That C-section rate suggests that doctors who work at that hospital are engaging in kinds and levels of patient management that boggle the mind. At a guess, a large number of their sections are reported as "elective". I hate this, because it implies that those women just shrugged, said "I don't feel like pushing, cut the baby out", and the doctor said "sure!". In fact, a lot of elective sections are the result of physician management, pressure, or tactics like telling a mom that she can have a regular section now, or a crash section in a few hours (when that's not necessarily true).
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#6 of 56 Old 05-12-2009, 02:04 PM
 
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pain-free? yeah right

Maybe when you have a morphine drip and an ambien to go to sleep...

surely they aren't talking about right after the procedure. I've had 5 major abdominal surgeries (4 were c/s) and while I know some women are relatively comfortable moving around and going about life after a few days/a week, I really doubt anyone is truly pain-free after being cut open and stapled shut.

70-80% is insanely high. that's really sad

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#7 of 56 Old 05-12-2009, 02:28 PM
 
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Are there really moms who have had c-section who are thrilled that they had one and are pain free?
Well, I was not thrilled to have one, but after my second csection I was basically pain free. I was walking without issues about 5 hours after (with no pain meds). I was totally back to normal within a week (no issues walking up stairs, sex, taking care of a newborn and a 15 month old who still needed to be carried almost everywhere, etc.) I heal really quickly, and each surgery gets easier. I've had 5 major surgeries, at the same incision site. (not all csections)

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#8 of 56 Old 05-12-2009, 02:35 PM
 
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Originally Posted by MeepyCat View Post
Some women deal with surgical recovery really well.
This is me. I had a full on labor that ended with an emergency c/s due to a number of factors. I labored for 30 hours and had been up, oh IDK something like 40. The Dr was shocked(he really did look like that) I was up and walking 12 hours after all of this. Was I pain-free? Oh hell no, I had double pain going on from my DD being so impacted in the left side of my pelvis from pushing and had a c/s to boot, ugh. People were seriously shocked that I wanted to get my catheter out and go for a friggin walk, I could not lay in that bed one more minute. Gosh I never even had more than a half of a vicodin(other than in surgery).

I just thought that was how it was. That is until I saw my nephew's wife after her c/s, she was a miserable wreck, she seriously could. not. walk. for 10 days. She couldn't change her son's diaper. Here I was a few days later going shopping and making dinner.

One local hospital is baby-friendly, that's the one I go to and they have a c/s rate of 20%. The other option has a c/s rate of 50%, and most women I know who have had babies there are c/s's due to the stupid OB who resides there. He just tells women they have oval-pelvises and dumb stuff. It's pretty sad.

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#9 of 56 Old 05-12-2009, 02:47 PM
 
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I was able to go shopping 3 days after my C-section. I recovered very well and very quickly, with little pain. Actually, the pain relief was the worst part of it. The morphine made me puke like crazy and I had lots of sweating and itching all that night. Plus the fact that I couldn't walk to go see my newborn under the Oxihood and I didn't even get to hold him until 5am the next morning (he was born at 1:19pm) when shift change happened and bitchy night nurse was replaced by sympathetic day nurse and I was able to complain my way into getting my catheter removed early so I could go see DS. Once the morphine was out of my system, I was ok. All I needed was Tylenol 3 for a few days and I was good.

So while it went extremely well for surgery, it was still surgery. I was NOT happy about being bullied into surgery. I was NOT happy about not pushing out my child. And I was NOT happy about the issues that come with a C/S - trouble nursing, the cut on my son's butt, the issue of VBAC bans, increased risk in future pregnancies, etc.

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#10 of 56 Old 05-12-2009, 03:43 PM
 
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I have friends who do describe their c/s as pain free and easy (this includes friends who have had both vaginal and c/s births), and who cannot understand why I wanted a vbac and why I want another one. So while I think the quote is probably just a sound bite sort of thing I also think they could find plenty of women who would give that statement for them with honesty and feeling.

As for the rate... well, there are no sanctions or anything out there that would apply. As long as the hospital could justify each section then even malpractice probably wouldn't attach. There is a practice here with a 50%+ primary c/s rate and some months their rate is closer to 80% (when they have a lot of moms birthing at the same time)... but when we complain to the hospital the response is "We are aware that the rate is higher than average, but each individual surgery was completely justifiable". Until there is some sort of oversite system and some sort of guideline that could be applied across the board there really isn't much to stop c/s rates from climbing at the institutional level.

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#11 of 56 Old 05-12-2009, 03:53 PM
 
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Originally Posted by minkajane View Post
I was able to go shopping 3 days after my C-section.
You know...if you were pain free, or close to it, that's great, but this one always amuses me. I went shopping 5 days after we had Aaron...but I wasn't even close to pain free for weeks. It was kind of a strange situation, but we needed groceries, dh can't drive, and I was already out running another errand - talking to ds1's school counselor about the stillbirth of his brother - with my mom driving. I figured I might as well get it done.

So, I know what you mean, but it does strike me as funny when women say "I was doing such-and-such" as an indicator of a pain-free, or even good, recovery. My recovery with Aaron sucked. I was in excruciating pain, and I went shopping at least a week before I could even get off the bed by myself.


And, back to the topic at hand. "Moms are happy and pain-free." Okay. That might even be true. "Moms" is plural, so if they have two moms who self-report as happy and pain-free, they can say that without lying. Some women don't have pain after c-sections. I never encountered it until I came here, and it still boggles my mind, even four years after first hearing about it...but it definitely does seem to happen...

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#12 of 56 Old 05-12-2009, 04:01 PM
 
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Originally Posted by Norasmomma View Post
That is until I saw my nephew's wife after her c/s, she was a miserable wreck, she seriously could. not. walk. for 10 days. She couldn't change her son's diaper.
I couldn't change ds1's diaper, but it wasn't from pain. I was so weak and woozy from the labour (didn't eat for over a day), the post-op liquid diet, the anesthetic, the sleeping pill, and whatever other drugs they gave me, that I simply couldn't stand up long enough to do it. It was so incredibly frustrating.

Honestly...if I were to try to describe my entire c-section experience with a single word (can't really, of course), it would be "frustrating". Everything about it is so frustrating.

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#13 of 56 Old 05-12-2009, 04:28 PM
 
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My first c-section was pretty pain free and easy. I really didn't need hardly any pain medication, and I could button up pants (and they were low rise), in 2 days.

My second was a whole different story, though, and I'm kind of dreading a third.

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#14 of 56 Old 05-12-2009, 05:38 PM
 
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My first c-section was pretty pain free and easy. I really didn't need hardly any pain medication, and I could button up pants (and they were low rise), in 2 days.

My second was a whole different story, though, and I'm kind of dreading a third.
This was me - first was a walk in the park - literally.

The second one I was caring for twins plus my 3 year old w no help besides DH and it was terrible because i was not rested and I was lifting weights too heavy for me (2 babies/car seats/strollers) too early.

The thrid was okay.

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#15 of 56 Old 05-12-2009, 06:07 PM
 
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I wasn't thrilled to have one and I surely was not pain free for a very long time. I really wanted to give birth naturally with no meds, but unfortunately it didn't happen that way. Even though it didn't happen the way I would have liked, our son is now happy and healthy...

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#16 of 56 Old 05-12-2009, 08:12 PM
 
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o, I know what you mean, but it does strike me as funny when women say "I was doing such-and-such" as an indicator of a pain-free, or even good, recovery.
Well, in my case, I definitely would not have been doing those things if I were having any pain. I can not imagine going shopping after surgery if I were still having any type of pain. It was the same for the lapraotomy I had last year which left me with a 6 1/2 inch incision. Within a week I felt totally normal. I'm not saying it's a good idea to go right back into a normal routine after a major surgery, but I truly felt fine so I did.

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#17 of 56 Old 05-12-2009, 08:17 PM
 
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[QUOTE=JamesMama;13752371]our local hospital put a ban on VBAC)/QUOTE]

That is sooo ridiculous!!! Do you know what the Merck manual says about the actuale chance you have to rupture your uterous with a VBAC??

1% !!!!!!! that's it!!!!:

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#18 of 56 Old 05-12-2009, 08:18 PM
 
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[QUOTE=ChristSavesAll;13754809]
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Originally Posted by JamesMama View Post
our local hospital put a ban on VBAC)/QUOTE]

That is sooo ridiculous!!! Do you know what the Merck manual says about the actuale chance you have to rupture your uterous with a VBAC??

1% !!!!!!! that's it!!!!:
I was that 1%. It happens. I NEVER thought it would happen to me. Never in a million years did I think I would be in that 1%.

If a hospital does not have the equipment to care for these patients, I can understand their thinking when they come up with the ban policies.

Our local hospital will not take a patient who comes in before the 37 week mark because they do not have a NICU.

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#19 of 56 Old 05-12-2009, 08:24 PM
 
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I think the Landon study cited 0.4% after a single c-section. Of course, that's going to be more than high enough if you happen to be the one who has one...but it's definitely not anywhere near the risk they try to make it sound. When I was fighting with my doctors to have a VBA2C, they made it sound like my odds of rupturing were about 50%...and when I pinned my OB for a number, he used 3.7%.

A lot of hospitals have banned VBAC...they say it's an unsafe "procedure". Gag.

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#20 of 56 Old 05-12-2009, 08:34 PM
 
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A lot of hospitals have banned VBAC...they say it's an unsafe "procedure". Gag.
That is always a head scratcher for me. If your hospital is safe enough to handle say, an emergency cord prolapse or fetal distress, it is safe enough to handle UR, right? Either the hospital can handle emergencies in childbirth or it can't. The lack of logic is astounding.

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#21 of 56 Old 05-12-2009, 08:38 PM
 
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Originally Posted by ChristSavesAll View Post

I was that 1%. It happens. I NEVER thought it would happen to me. Never in a million years did I think I would be in that 1%.

If a hospital does not have the equipment to care for these patients, I can understand their thinking when they come up with the ban policies.

Our local hospital will not take a patient who comes in before the 37 week mark because they do not have a NICU.
If they can't handle a VBAC rupture, they can't handle cord prolapse, or an unscarred uterine rupture, either. And those are more likely to end in maternal or fetal death if they happen.
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#22 of 56 Old 05-12-2009, 08:46 PM
 
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my c section was nearly painless and my recovery was very quick.. so quick even the hospital staff was surprised. i still want a vbac next time i get pg. i dont consider childbirth something to be avoided at all costs. i think there are benefits to natural child birth that are basically ignored by many medical professionals.

IMHO it is very likely that c sections will become even more popular as women become so afraid of that mysterious thing we call child birth... c sections will be known as the safest, easiest, and most pain free way to wrench that baby out of your poor unsuspecting body.
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#23 of 56 Old 05-12-2009, 08:48 PM
 
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That is always a head scratcher for me. If your hospital is safe enough to handle say, an emergency cord prolapse or fetal distress, it is safe enough to handle UR, right? Either the hospital can handle emergencies in childbirth or it can't. The lack of logic is astounding.
they dont want to deal with the risks. i know some birthing centers around here have had to turn down women for VBACs b/c they could not find an OB willing to take them on.
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#24 of 56 Old 05-12-2009, 08:53 PM
 
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A truly painfree birth would never be a c-section. Even with the best of them, a vaginal birth is less amount of time in pain (on average). If you are up and about 24 hours after a c-section, that is about 10 hours later than most vaginal births from start to finish. Most c-sections take weeks.

I tell friends that talk about being really, really scared of pain to skip a c-section and get an epidural. I had two natural births, but I took walks within 30 minutes of birth and wouldn't trade that for the world. Why women think c-section's are painfree is confusing to me. When has surgical recovery ever been painfree. I say this with two surgeries under my belt and MAN!!! One was a finger and I was downing the percocet. LOL.

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#25 of 56 Old 05-12-2009, 09:35 PM
 
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[QUOTE=ChristSavesAll;13754809]
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Originally Posted by JamesMama View Post
our local hospital put a ban on VBAC)/QUOTE]

That is sooo ridiculous!!! Do you know what the Merck manual says about the actuale chance you have to rupture your uterous with a VBAC??

1% !!!!!!! that's it!!!!:
I'm also that 1%, but since my scar is a T-internally, it's probably much higher from the research that I have done. My Dr told me flat out that vbac are completely safe for most women who have a c/s, but in my situation the scar is so weird that no one really knows what the odds of rupture are, but they are higher for sure than a traditional bikini incision. Plus I can just tell being pregnant again, I feel my T and it definitely feels like probably wouldn't do well during full on contractions.

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#26 of 56 Old 05-12-2009, 09:59 PM
 
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That is always a head scratcher for me. If your hospital is safe enough to handle say, an emergency cord prolapse or fetal distress, it is safe enough to handle UR, right? Either the hospital can handle emergencies in childbirth or it can't. The lack of logic is astounding.
Exactly. Plus, my real pet peeve. VBAC is not a "procedure". It's a non-procedure, happening after a procedure. The terminology around this one drives me crazy.

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#27 of 56 Old 05-12-2009, 10:03 PM
 
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Exactly. Plus, my real pet peeve. VBAC is not a "procedure". It's a non-procedure, happening after a procedure. The terminology around this one drives me crazy.
remember though a lot of people have that completely backasswards and think vaginal birth (let alone natural birth) is barbaric, unnecessary, and dangerous. figure that one out.
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#28 of 56 Old 05-12-2009, 10:28 PM
 
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I wasn't happy with having a c section but I think I had a decent recovery. I would still like to have a vbac but we'll see when that time comes. I really hope to not be as worried about things as I was the first time around. I have to say that the worst thing was the not being allowed to eat, and if they do that again I'm so having the hubs get me some food, lol. I would also really, really like more information about sucessful breastfeeding after a c section, me and the baby just couldn't figure it out. That's the thing I mourn far more than the natural childbirth.
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#29 of 56 Old 05-12-2009, 10:42 PM
 
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Do they mean that moms are free of labor pain? Thats what came to my mind at least....
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I've had birth both ways (natural and scheduled c-section) and c-section was much less painful for me. I felt soreness after the c-section and some random brief sharp pains for a couple of weeks, but that was it. If I had to have another scheduled c-section, I would not be afraid.
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