Elective C/S - Mothering Forums

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#1 of 32 Old 04-13-2004, 10:30 PM - Thread Starter
 
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I was just reading an article in the new Time Magazine today about the US C-section rates. I was shocked to see that a full 20% of all c/s are completely elective (meaning no medical reason to do one) and that amounts to 63,000 of them a year!!! I was thinking why would someone do that? Why aren't they better educated? Then the article included the story of the Director of OB/GYN at some hospital who elected a c/s simply because she didn't want to risk future incontinence and said she will definitely do it again next time.

So, that made me really examine my feelings about the whole idea. Women who are educated are choosing to do it and can I say women should have control over their bodies and then condemn them for making a decision I don't agree with? I've kind of gotten myself into a quandry between these two beliefs, so let me know what you think and it will probably help me sort this out in my own head!

Maybe what we need to work on is bringing down the number of women who are given "nonelective" c/s who don't really need them instead of trying to impact women who have chosen them.

As a side note, the article quoted a study saying that c/s isn't any more risky to mother and baby than vaginal birth. What pissed me off about it is that the study just compared a huge group of vaginal with a huge group of c/s. That doesn't prove anything. To prove c/s isn't riskier, you would have to compare a group of low-risk pregnancies that delivered vaginally with a group of elective c/s - thereby removing the bulk of extenuating circumstances.
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#2 of 32 Old 04-13-2004, 10:46 PM
 
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I'm a bit surprised at this simply b/c I didn't think insurance would cover a cesarian for no medical reason. It's way more expensive than a vaginal birth and, despite what that article may say, I believe the general guidelines by the OB's is that vaginals are still safer than C/S. So...are these women paying for them out of pocket?

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#3 of 32 Old 04-13-2004, 10:50 PM
 
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Ug, I promised myself I wouldn't read anymore Birth and Beyond during this pregnancy, because I don't want to get riled up...

I just don't believe you should be able to schedule a totally elective cesarean or induction for light and fluffy reasons... these are *medical* procedures. There *is* a risk of complications. They should be reserved to be used only when they're needed. I totally stand behind *necessary* cesareans as life and health preserving procedures. But *elective* surgery? Eek!

If we're all for giving women what they *want* in birth, then why don't more hospitals allow VBACs? I think "convenience" cesareans happen because they're convenient for drs.

To be honest, I *don't* think these procedures should be allowed, for several reasons... it's not good medical policy (I don't see how doing something injurious, invasive, and complicated can be superior to mother nature, when mother nature hasn't even been given a chance), it's costly, and it *can* and *will* affect policies and procedures for women who *don't* want cesareans, if they become popular enough.
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#4 of 32 Old 04-13-2004, 11:15 PM
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I disagree about making them unavailable. Plastic surgery is medical, risky, costly and TOTALLY elective. This isn't any different. Elective surgery is already an established practice in the medical world. What needs to be examined, however, is the ramifications for those of us that would only have one under dire circumstances. I agree that more elective c-sections seems to coincide with less options for natural birth and that is inexcusable. If women are given more medical options, they should also be given more options to refuse them.

But I am pro-choice, my body, my choice and I believe the same should go for others. If they want to do that to their body, it is their choice.

Also, what is the impact on the rest of us? How many of these babies are inadvertently born premature? How many spend time in the NICU? Because a portion of those costs come from our tax dollars and the rest can result in higher health insurance rates for the rest of us. In fact, we could be looking at higher rates in general to offset the surgery itself, let alone any complications. This is why motorcycle helmet laws came into effect. Who cares if someone is stupid enough to get their brains spread all over the road, except that it results in higher taxes, higher insurance, etc for the rest of us.
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#5 of 32 Old 04-13-2004, 11:21 PM
 
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I disagree about making them unavailable. Plastic surgery is medical, risky, costly and TOTALLY elective. This isn't any different. Elective surgery is already an established practice in the medical world.
I respectfully disagree. I can just choose *not* to have plastic surgery. If I'm pregnant, I can't choose to skip birth, and if practices like this change the "birth culture" or influence policy statements from ACOG, I definitely could be affected by someone else's frivolous decision.

But I totally agree with the rest of your message.
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#6 of 32 Old 04-14-2004, 12:25 AM - Thread Starter
 
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Originally posted by mattjule

But I am pro-choice, my body, my choice and I believe the same should go for others. If they want to do that to their body, it is their choice.

And that's where my problem lies. Is me saying, "How can you do that to yourself? You must not be educated" any different from someone who is anti-choice saying, "How can you have an abortion. You must not be educated."

I hadn't thought about your point of how the election of c-sections would drive up the cost of insurance though. It must, because I know that insurance companies cover them, even when elective. In fact, they would have no way, really, of knowing whether it was elective or not.
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#7 of 32 Old 04-14-2004, 12:36 AM
 
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Elective c-sections have been around for a long time. THe only difference is, before, the doc would just assign a "reason" for the c-section before labor.

The rising c-section rates serves doctors. Doctors make up the boards on medical insurance companies. Some malpractice insurance companies offer lower premiums to those doctors that have higher cesarean rates.

Make no mistake: There is a goal of a 50% cesarean rate by MANY practices in the US. It's considered a good way to DECREASE your malpractice risk.

Above all, we have to put pressure on docs to reveal TRUE risk of any procedure. Many times, even with epidurals, these risks are downplayed and often omitted.

I don't think that many women are really informed of risks of so many things. Especially if it suits and benefits the doctor in so many ways.

Then again, we have a whole culture of women walking around believing that their bodies are broken (and I'm not talking about those medically necessary cesareans), just like women who say that they are part of the less than 1% that don't make enough milk.

Sadly, it's the system that is broken. I doubt that things will get any better anytime soon. Our current atmosphere of litigation only offers fewer choices for women, rather than more.
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#8 of 32 Old 04-14-2004, 11:57 AM
 
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Just as I didn't want anyone telling me that I shouldn't choose VBAC (yet many people did), I would never presume to tell another woman what she can or cannot choose regarding the birth of her baby.
It's her choice to make, however informed or misinformed she may be.

What I think needs to happen, is for more women to take it upon themselves to inform and educate themselves before making any decisions, rather than just blindly believing what their doctors tell them. Ultimitely it's still their decision to make, whether I agree with it or not.
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#9 of 32 Old 04-14-2004, 12:53 PM
 
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Women absolutely should have the right to choose elective c-sections. But I should also have the right not to pay (through my insurance premiums) for them and complications that arise from them. Anyone who chooses elective surgery of *any* kind should have to pay for it themselves.

Sistermama wrote: "I was thinking why would someone do that? Why aren't they better educated? Then the article included the story of the Director of OB/GYN at some hospital who elected a c/s simply because she didn't want to risk future incontinence and said she will definitely do it again next time.

So, that made me really examine my feelings about the whole idea. Women who are educated are choosing to do it and can I say women should have control over their bodies and then condemn them for making a decision I don't agree with?"

Just because someone has a degree and a fancy position and title doesn't mean that she knows how to think critically. The fact is that birth doesn't cause incontinence, mismanagement of labor does. But OB/GYNS are good little sheep and believe only what they've been taught, and what they are being taught does not reflect reality. (See Obstetric Myths vs. Research Realities, Goer.)

"the article quoted a study saying that c/s isn't any more risky to mother and baby than vaginal birth."

I'd LOVE to see that study. Have a link to it by any chance?
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#10 of 32 Old 04-14-2004, 01:58 PM
 
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I'm reading conflicting things here...

On the one hand, we all seem to believe that natural birth is safer and less risky than an elected C/S. Well, if that is the case, why are hospitals striving for increased C/S rates based on costs and malpractice? Doesn't this suggest that women are more likely to have complications and increased costs with a vaginal birth? One thing you can count on with insurance and HMO's - they are thinking mainly of the bottom line - the money. So if C/S aren't any safer, and we know that they are more expensive a procedure (surgery is always more expensive - you need more staff, anaesthetics, etc...), then doesn't that suggest that there are more problems with vaginal births?

The arguement about paying for it yourself if you choose the C/S is a very risky place to put yourself. Because that suggests that women choosing VBACs and other "risky" procedures should have to pay for it, too. That would be a real tragedy.

Finally, if malpractice is the driving force behind the impetus to get more women into C/S then would it be a fair statement that the problem lies with too many women suing hospitals for problems occuring during a vaginal birth that are just part of the normal risks of birthing? Should we be directing our activism towards the legal side of things? (ie. limiting case settlement, restricting patients' rights to sue, signing wavers, etc.)?

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#11 of 32 Old 04-14-2004, 04:01 PM
 
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I disagree about making them unavailable. Plastic surgery is medical, risky, costly and TOTALLY elective. This isn't any different.
It's a little different, because elective c/s is risky to the baby, who has no choice. It's an emergency procedure (at least it used to be) and normal babies are safest when born vaginally. A woman who doesn't want to feel pain or doesn't want to miss work is risking her baby if she decides to make the birth convenient. One who has cosmetic surgery is hurting only herself.

Birth, like parenting, is inconvenient. There isn't supposed to be a way around this. One is supposed to just accept the fact that their social life and their job and their house are now of secondary importance. Having a baby changes everything.

I think women "choose" surgery because people are telling them lies. Lies like vaginal birth leads to pooping yourself all the time, when really that is only likely if you have an episiotomy. Some women on this board have said that they became incontinent after a c/s, when they had never had a vaginal birth.

I don't even think that having women pay for it themselves is the answer. If that's what it comes down to, doctors will go back to making up "medical reasons." Anyone can claim fetal distress, maternal distress, failure to progress. There is no way to prove these conditions did not exist. (Do you think a doctor is going to write in the medical records, "I lied to the patient to get her to have surgery"?)

There are kinds of elective c-sections that sound rational, like when a mother has herpes or HIV. It is not necessary to have a c-section to prevent these diseases from getting to the baby, but some women are just more comfortable with that. I also don't see VBAC as a risky procedure, but if a woman isn't comfortable with it, it most likely will not go well, so she should have the option of a repeat. Of course, if women weren't lied to all the time, they would probably be more comfortable with it.
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#12 of 32 Old 04-14-2004, 04:13 PM - Thread Starter
 
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Originally posted by Greaseball

I think women "choose" surgery because people are telling them lies. Lies like vaginal birth leads to pooping yourself all the time, when really that is only likely if you have an episiotomy. Some women on this board have said that they became incontinent after a c/s, when they had never had a vaginal birth.
This doesn't explain why intelligent, educated women choose to have them, like doctors
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#13 of 32 Old 04-14-2004, 04:16 PM - Thread Starter
 
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Originally posted by Piglet68

Finally, if malpractice is the driving force behind the impetus to get more women into C/S then would it be a fair statement that the problem lies with too many women suing hospitals for problems occuring during a vaginal birth that are just part of the normal risks of birthing? Should we be directing our activism towards the legal side of things? (ie. limiting case settlement, restricting patients' rights to sue, signing wavers, etc.)?
I totally agree with you on that one.

Blueviolet - it was a harvard study that they quoted and I'll try to find it online. Have you seen any studies that show vaginal birth is safer?
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#14 of 32 Old 04-14-2004, 04:25 PM
 
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[I always try to write about this subject carefully - I have no negative opinion for what individual women choose for the health of themselves and their babies - I know it's hard to talk about this subject without some mamas feeling bad! ]

Having said that:
I wish there were more research into & more awareness about the impact of cesaren birth on babies.
There are some findings about the benefits of labor & vaginal births for newborns -- I am thinking for example on the effect of oxytocin production on the triggering of seratonin & later prolactin, improving bonding and lactation from a physiological standpoint. And also the effect labor contractions have been found to have on preparing babies lungs for breathing.
[I don't have time at the moment to link to research but I could try to later.]

When labor has begun on its own and then a cesarean birth follows, then these benefits for baby are there. Also it is usually a sign baby is 'ready' to come. I know moms who have cesareans for medical reasons but wait for first labor signs.

As we all know, there are a number of conditions & circumstances in which the risk of doing this are significant. IN THESE CASES we understand that every woman and (her care provider) will have to weigh risks and benefits and make the right decision for themselves.

We are all in agreement about supporting women making choices about their bodies. But we want those to be *informed* choices, and there should be more solid information available, all risks and benefits of birth choices made very clear. And always we need to take into account impact on babies. Knowing these impacts, any given woman will still have to weigh all her own factors, but ideally these impacts are part of the equation.

So this is what concerns me about scheduling surgical births for non medical reasons. Are most moms making this choice even being given complete information? (Similar to the question about whether risks and effects of epidural use are always well explained so that choices are informed ones ... In my experience as a doula, usually not, lol!)

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#15 of 32 Old 04-14-2004, 04:28 PM
 
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This doesn't explain why intelligent, educated women choose to have them, like doctors
:LOL Doctors are intelligent and educated about certain things, but normal pregnancy and birth is not one of them! They go to schools where they are educated by other doctors, who tell them the same things they tell their patients. They are unqualified to attend a normal birth. What they are doing is basically attempting to practice midwifery without a license.

Education doesn't seem to equal common sense. I'd rather have an illiterate midwife attend my birth than a Harvard-educated physician.

Have you read Birth as an American Rite of Passage? It interviews some doctors about why they chose OBGYN, and none of them say "Because I like taking care of women and babies" or anything like that. Some say they chose it because they love to operate. In A Woman in Residence, the author describes her experience as an OBGYN resident and says that one of her colleagues can only tolerate working in OBGYN because "childbirth is a surgical procedure."
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#16 of 32 Old 04-14-2004, 10:32 PM
 
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Originally posted by Piglet68
On the one hand, we all seem to believe that natural birth is safer and less risky than an elected C/S. Well, if that is the case, why are hospitals striving for increased C/S rates based on costs and malpractice? Doesn't this suggest that women are more likely to have complications and increased costs with a vaginal birth? One thing you can count on with insurance and HMO's - they are thinking mainly of the bottom line - the money. So if C/S aren't any safer, and we know that they are more expensive a procedure (surgery is always more expensive - you need more staff, anaesthetics, etc...), then doesn't that suggest that there are more problems with vaginal births?

While the HMOs and insurance companies would love to get costs down, consider that as long as the doctor claims that the c-sec is necessary for medical reasons, the insurance companies have their hands tied. And the doctor, of course, is going to be looking to make as much money as possible, and c-secs bring in a lot more money than vaginal births.

There's got to be some heavy lobbying involved too. We all know that homebirth is by far less costly than hospital birth, yet many insurance companies don't cover it. This suggests to me that the lobbying done by doctors has been powerful enough to pull the wool over even the insurance companies' eyes.

The arguement about paying for it yourself if you choose the C/S is a very risky place to put yourself. Because that suggests that women choosing VBACs and other "risky" procedures should have to pay for it, too.

I don't think so. Because determining "risk" is such a subjective process. It would be impossible to do -- every birth choice could be considered "too risky". So in my mind the argument against elective cesarean cannot be about risk -- it must be about the fact that it is, like having a nose job, medically unnecessary. The line must be drawn somewhere. I should not have to pay for anyone to have medically unnecessary surgery of *any* kind.

Finally, if malpractice is the driving force behind the impetus to get more women into C/S then would it be a fair statement that the problem lies with too many women suing hospitals for problems occuring during a vaginal birth that are just part of the normal risks of birthing? Should we be directing our activism towards the legal side of things? (ie. limiting case settlement, restricting patients' rights to sue, signing wavers, etc.)?

Personally, I don't think it *is* primarily about malpractice, I think it is about ignorance (doctors do not know anything about the normal process of birth, so when their efforts undermine the process, they are relieved to be able to "fix" it with surgery) and greed (cesareans are SO lucrative.)

I know women that have been deeply harmed by their doctors in vaginal birth, and their lawyers have told them "don't bother to sue, you won't win." I think malpractice for vaginal birth seems to be actually extremely rare. Have you ever heard of a case? And given that the death rate for cesareans is twice as high... you would think that malpractice would be higher for cesareans.
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#17 of 32 Old 04-14-2004, 10:39 PM
 
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"Blueviolet - it was a harvard study that they quoted and I'll try to find it online. Have you seen any studies that show vaginal birth is safer?"

Yes, I have. And I have seen ones that don't. It seems to depend on what exactly they are looking at -- what they consider to be "complications", and what kind of vaginal birth they are looking at -- I wouldn't be surprised to see obstetrically-managed vaginal births coming out looking very awful indeed. OBs are after all, experts at surgery, but know very little about normal birth. Any study that looks only at obstetrically-managed birth is naturally going to be skewed then in favor of what doctors do best -- cesareans.
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#18 of 32 Old 04-14-2004, 11:00 PM - Thread Starter
 
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Originally posted by blueviolet
I think malpractice for vaginal birth seems to be actually extremely rare. Have you ever heard of a case? And given that the death rate for cesareans is twice as high... you would think that malpractice would be higher for cesareans.
It must not be that rare, because all the ambulance chasing legal firms in my area are constantly running ads telling you to call them if your doctor "failed to perform a timely c-section" that resulted in some type of injury to your child.

But of course when I transferred to the hospital during my legal and insurance paid for homebirth (after calling and making sure they would take me) the on call doctor refused to come in and treat me and I had to drive 30 minutes to another hospital where I was horribly treated, I didn't have any legal options because as one lawyer told me, "the baby would have had to have DIED before you got to the next hospital." Side note, that dr did just get fired a couple of months ago for being an ass, so I feel a little vindicated. Although I'm sure he's just working somewhere else now.
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#19 of 32 Old 04-14-2004, 11:09 PM - Thread Starter
 
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I was just trying to find some malpractice rates and I found this scary website belonging to birth injury lawyers. medical lawyers

Is it really any wonder that the malpractice rates are as high as they are? Failure to inform of the risks in vaginal delivery of a large baby? You mean like the 10 lb one I delivered without a tear? Failure to estimate the baby's weight before delivery?
Failure to perform a caesarean section?

I think we spend some much time complaining about the medical community (much of it well deserved) that we forget to look at the other side of the coin for what is really driving things like increased c/s rates. However, of course, if the medical community would properly police and discipline their offending members, the costs of malpractice insurance wouldn't be so ridiculously high and we wouldn't be having a lot of the problems we are having now. I once read that the tiniest % of drs are responsible for a large % of malpractice awards, so get rid of them and the cost to everyone goes way down.
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#20 of 32 Old 04-15-2004, 10:59 AM
 
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This is a very fascinating discussion, and a complicated one too. I actually work for an insurance company so these types of discussions come up in conversation quite often. Everyone's complaining about the cost of health insurane and unfortunately, for group insurance plans the risks are spread across the entire population. Pregnancy and childbirth are by far one of the highest cost drivers for insurance. And, we were just discussing the other day, OBGYN doctors pay the highest malpractice insurance premiums of any doctors. My company's website gives these average costs for hospital and doctors charges related to childbirth:
Cesarean Section w Complications and Comorbidities $13,358
Cesarean Section w/o Complications and Comorbidities $13,722
High Risk Cesarean Section w/o Complications and Comorbidities $13,845
Vaginal Delivery w Complicating Diagnoses $8,217
Vaginal Delivery w/o Complicating Diagnoses $7,617

AND YET no matter how much I begged and pleaded and reasoned, they would not pay the measly $1700 facility fee for my Birth Center birth. I hate the fact that I may be paying for other women's elective cesareans every month with my premiums and yet they wouldn't pay for my birth, mainly out of concern for liability.

But I know realistically, it doesn't take much for the doctor to manufacture a reason for the insurance company to pay for a c-section the mother requested. And sorry, I know from personal experience that there is a very adversarial relationship between Doctors and Insurance Companies to where they probably don't feel it is unethical to do it.

But what if one of these elective c/b's goes wrong? Does the woman sign away her right to sue? If not, then I really feel that allowing this to continue is exacerbating the problem.

And then there are the doctors, whose fears of being sued may lead them to err on the side of caution when it comes to making a decision of c-section vs not.

There is just no clear answer to this. I don't personally agree with elective cesareans but I don't think we can say that women should'nt be able to make a choice.

Mainly, it's about education. I recently read Redisovering Childbirth and it totally blew me away. The statistics in this book pretty clearly show that childbirth didn't become "risky" in the United States until doctors took over the procedure. I wish more of this information was out there in the public eye and not discounted as "granola" or "fringe" ya know?

Tamara
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#21 of 32 Old 04-15-2004, 01:45 PM
 
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Originally posted by Piglet68
I'm reading conflicting things here...

On the one hand, we all seem to believe that natural birth is safer and less risky than an elected C/S. Well, if that is the case, why are hospitals striving for increased C/S rates based on costs and malpractice? Doesn't this suggest that women are more likely to have complications and increased costs with a vaginal birth? One thing you can count on with insurance and HMO's - they are thinking mainly of the bottom line - the money. So if C/S aren't any safer, and we know that they are more expensive a procedure (surgery is always more expensive - you need more staff, anaesthetics, etc...), then doesn't that suggest that there are more problems with vaginal births?

First off, we know that not everything that modern medicine does is evidence based. But, from a legal standpoint, there is an attitude that "nobody has ever been sued for performing a cesarean". THat is the truth, unfortunately. The push for higher cesarean rates has to do with lowering malpractice insurance. There is a general belief among juries in our country that cesareans are the one thing a doctor can do to avoid any complications. However, losing your uterus or having your baby cut during the surgery is just a unmentionable side effect.

I imagine we may start seeing more suits from cesarean complications. But, I have heard leading doctors in the country and malpractice insurance companies say that the ideal goal is a 50% cesarean rate. The malpractice insurance companies have NEVER been into evidence-based medicine. It's all about covering your ass and what looks good in court.

As an insurance holder, I'm saddened that my premiums are creeping up due to people that smoke, people that don't take care of their bodies, and yes, high interventions and unnecessary surgeries in birth.
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#22 of 32 Old 04-15-2004, 01:59 PM
 
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I'm sitting here holding my 2 wk old baby so can't read all the replies...

but on incontinence (sp?)--just carrying the baby can cause it, not just having a vaginal birth. I've had 4 c-sec and had mild incon. issues following each of the first 3. This was recently discussed on another site and several c-sec moms had the same experience.

And about elective vs. emergency...well 2 of mine were emergency, 2 elective but all of the last 3 were written up as elective...I mean in my med records & for the insurance companies. Seems it didn't matter that #3 was technically an emergency, she was considered elective because of prior sections. And insurance covered all of them (well, we didn't have ins. for this last one so we're paying off the whopping $20,000 bill out of pocket).
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#23 of 32 Old 04-15-2004, 02:24 PM
 
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Thanks for all the good info, ladies.

While it seems apparent that doctors "get more money" for performing C/S births...how much of that money actually goes to profit for the hospital or the OB practice? THAT is the real issue. B/c surgery itself is WAAAY more expensive than a vaginal birth, so the increased charges to the insurance companies don't surprise me.

I have to say that I still believe the reason so many OB's and hospitals push for C/S is that they have a better chance of no complications and less chance of being sued. However, I'm going to qualify that statement by agreeing with blueviolet: I'm strongly suspecting that the risks and complications of vaginal births done *outside* the medical setting (i.e. homebirths and birthing centres) have much better success rates and much more satisfied customers. I also think that C/S are considered the "last resort to saving baby" so if complications arise people just assume "well, they did the best they can" whereas if complications arise during a vaginal, the question is always "would a C/S have been better?". As for the issue of suing for "not telling me the risks of carrying a big baby'...geez, I'm sorry but that just sounds to me like greedy-guts ignorance on the part of the patient. We all know that big babies can be delivered just fine, and that estimating size using things like U/S is notoriously inaccurate. I am afraid I'm seeing plain old greed here.

I hope somebody can do a proper study comparing elective C/S to non-high-risk vaginal births done in a birthing centre or homebirthing situation to see what the real statistics are. I'm tempted to say (and please don't flame me, b/c I"m truly open to hearing other stats) that you have more risk of dying when you get into your car and drive on the highway than you do having an elective C/S for a non-high-risk, non-medical-complications, birth. I think that goes back to soemthing in another thread, which is that it isn't just the absolute risk, it's the risk relative to other risks we take in life, and where our personal risk-benefit scale weighs in. The risks for me, personally, in attempting a V-birth were too much. But had I had my heart set on a v-birth, I would have been encouraged to try, and perhaps would have succeeded.

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As an insurance holder, I'm saddened that my premiums are creeping up due to people that smoke, people that don't take care of their bodies, and yes, high interventions and unnecessary surgeries in birth.
be careful, lol. i got in a LOT of trouble in the activism forum by suggesting that the reason the government was trying to get involved in the anti-obesity message (albeit a poorly done job) was b/c of the huge health care costs associated with obesity. I got pretty royally flamed. It's very hard to draw the line between who is "not taking care of themselves".

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#24 of 32 Old 04-15-2004, 02:28 PM
 
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We all know that big babies can be delivered just fine, and that estimating size using things like U/S is notoriously inaccurate.
Well, WE (MDC members and other natural birth advocates) know that, but many ignorant people don't know. I know one woman who let herself be talked into a c/s "because the baby was 8 lbs!" And this was a large, tall woman. When I overhear conversations about birth, everyone talks about how large babies cannot be delivered vaginally and how they know their baby is large "because the ultrasound said so." Sometimes, after they have already had surgery, they will say the baby wasn't nearly as large as the u/s said, but they don't seem to mind the fact that they were unnecessarily cut open.
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#25 of 32 Old 04-15-2004, 03:05 PM
 
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Quote:
Originally posted by Piglet68
be careful, lol. i got in a LOT of trouble in the activism forum by suggesting that the reason the government was trying to get involved in the anti-obesity message (albeit a poorly done job) was b/c of the huge health care costs associated with obesity. I got pretty royally flamed. It's very hard to draw the line between who is "not taking care of themselves".

I hear ya. I try not to be fatphobic, but it's hard when I am fat and know that my risk for developing diabetes or hypertension is pretty high as I get older. I also know that my sedentary lifestyle will predispose me to poor knees and a bad back. This, to me, is something that I'm willing to talk about. Diabetes is becoming big business and I imagine that it will continue to be so.

It's one thing to be fat and healthy. It's quite another - and most fat Americans, including myself, fit into this one - to be fat and unhealthy.

I'm not afraid of fat. Then again, I don't think that being fat is necessarily great for everyone. It's impacting our healthcare system, just like smoking. Again, I'm speaking of unhealthy fat lifestyles. McDonalds, watching TV all day, then taking Lipitor to control your cholesterol rather than changing your diet or lifestyle.

It's why I'm working on creating a healthier body for myself. If that results in weight loss, fine. I'm not opposed to weight loss (I don't think anyone is), but I'm not going to do it in an unhealthy way.
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#26 of 32 Old 04-15-2004, 05:20 PM
 
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but many ignorant people don't know.-Greaseball

I find this offensive-if someone doesn't know something it does not make them ignorant. If someone knows something and chooses a different path it does not make them ignorant. I understand we're just casually speaking here but words are powerful and I think they need to be chosen carefully and respectfully.
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#27 of 32 Old 04-15-2004, 05:27 PM
 
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Well...OK...maybe I just chose the wrong word. Some people don't like the word "ignorant." How about "they are not given accurate information"?

If they know something and choose a different path, they have looked at both sides and made their choice. So they have all the information that they need.

I think I know what you mean about words...
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#28 of 32 Old 04-15-2004, 05:36 PM
 
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Originally posted by ladylee
I find this offensive-if someone doesn't know something it does not make them ignorant.
Well, actually, that is EXACTLY what it means. Greaseball used the word the way I use it, in its true and literal meaning. Other people use it as an insult. Then it is offensive.

ignorant:

1. Lacking education or knowledge.
2. Showing or arising from a lack of education or knowledge: an ignorant mistake.
3. Unaware or uninformed.

I am ignorant about many things and have no problem saying that or being called that b/c it's true and nothing to be ashamed about. It's also not an insult nor is it offensive, when meant to describe someone who was not informed or educated on a particular issue.

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#29 of 32 Old 04-15-2004, 06:37 PM
 
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to me, there is a very distinct difference from people who have educated themselves a choose a different route. It's about empowerment, and most modern mainstream medicine does not empower. People turn their power (and responsibility of outcome) over to another person. There are quite a few people out there who don't even want to know the risks/benefits of anything. They want their provider to tell them what is best.

This happens with homebirth clients, too.

I fully respect informed decision making. Even when it differs from a path I would take. However, we are not talking about informed decision making.

That, to me, makes an ignorant or uninformed decision.

I"m guilty of being ignorant and uninformed around my care. Believe me, I don't think there's too many of us that have gotten away from the "doctor knows best" routine.
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#30 of 32 Old 04-15-2004, 08:28 PM - Thread Starter
 
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I think, though, that we have to be careful in how we define "informed decision making" because I think we often intentionally or unintentionally include an ethical element. People who are pro-choice or who have had an abortion are often told by anti-choice people that they didn't make an "informed decision" because they (the person against the abortion) are including what they consider to be facts relating to ethics or religion. And honestly, I don't know about you, but sometimes I fell downright religious about my belief in natural birth. So I wonder if I am including some of my ethical beliefs in what I consider to by the facts.

Also, as we have commiserated about earlier, there just aren't the studies out there that compare things in a fair and meaningful manner. Much of what we know about birth we know antecdotally and personally. I think many women make decisions on what limited information is available. So they could very well think they are making informed decisions. edited to add - which I know is, of course, a main part of the problem.
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