Join Date: Sep 2003
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Evergreen- Loving my girls Dylan age8, Ava age 4 and baby Georgia (6/3/11).
|An alarming rise in the number of emergency hysterectomies performed on Victorian women after childbirth has prompted an obstetrics expert to warn doctors against performing elective caesareans without medical cause.
The warning follows a report commissioned by the Department of Human Services to investigate claims of an increase in hysterectomies to stem severe bleeding in new mothers. The report found that, although still rare, the incidence had risen from 20 post-partum hysterectomies in the state in 1999 to 48 in 2002. Over the same period, caesarean rates rose from 22.8 per cent of births to 27.4 per cent. The report's author, obstetric epidemiologist James King, said it was likely there was a causal link between the two.
|Route of delivery as a risk factor for emergent peripartum hysterectomy: a case-control study.
Kacmar J, Bhimani L, Boyd M, Shah-Hosseini R, Peipert J.
Women & Infants Hospital, Providence, Rhode Island 02905, USA.
OBJECTIVE: To evaluate whether cesarean delivery is a risk factor for emergent postpartum hysterectomy. METHODS: We performed a case-control study of patients who delivered at Women & Infants Hospital between January 1989 and February 2000. Fifty cases of emergent postpartum hysterectomy performed within 14 days of delivery met our inclusion criteria. Using a computer-generated list, two patients admitted to the labor department at a time point similar to that of each case patient were selected as controls (n = 100). We reviewed medical records for demographic data, route of delivery, labor characteristics, surgical history, and indication for hysterectomy. Cases and controls were compared, and logistic regression was used to calculate the odds ratio (OR) and the 95% confidence interval (CI) for the association of delivery route and emergent hysterectomy. RESULTS: Cesarean delivery was associated with a 13-fold increased risk of emergent hysterectomy when we controlled for previous cesarean delivery, dilation and curettage or abortion before the index pregnancy, use of prostaglandin, and use of pitocin (OR 12.9; 95% CI 5.2, 32.3). CONCLUSION: Cesarean delivery is a significant risk factor for postpartum hysterectomy.
PMID: 12850620 [PubMed - indexed for MEDLINE]
|The TIME magazine just out (April 19 cover date) has an article in the Medicine section “Too Posh to Push? As more pregnant women schedule c-sections, doctors warn that the procedure is not risk-free.” While the subheads were pretty good, to me the article was disappointing, mostly more OB marketing of unnecessary cesareans. The article does include some information about the risks of cesareans, and some OBs mildly speaking against c-sections by choice. However, it also includes celebrity c-sections, mis-information, quotes from ACOG and individual OBs supporting patient choice c-sections, and it ends with a resounding affirmation by a female OB. There is no mention of conflicts of interest. For one example, there is no mention that OBs generally get paid more for a cesarean section, can be much more productive (more paid surgeries in less time) with planned “patient choice” cesareans, and their hospitals also stand to gain economically with more scheduled cesareans rather than the unpredictable timing and length of natural labor and birth. For another example, HealthGrades is described as “a company that rates the quality of health care in the U.S.”, in itself an inaccurate description which also fails to mention that the HealthGrades’ “Strategic Quality Initiative provides unique business development tools and marketing solutions to, among other things, “Increase volume and gain market share,” and “Improve profitability”(see HealthGrades’ website http://www.healthgrades.com under “business solutions.” This company is the only source of the statistic that “22% of c-sections – or 63,000 births per year – are purely by patient choice, a 20% increase since 1999” (the TIME article). In fact, I have read HealthGrades’ report on this data, which was never published in a peer-reviewed journal. The report was based on assumptions and birth certificate and hospital records – no one ever spoke to a mother. These were “elective” cesareans before labor began, according to the doctor of record, but not necessarily “purely by choice” of the mother, although HealthGrades persists in calling them “patient choice.” Since we know that both obstetricians and hospitals benefit economically from more planned cesarean sections, this “data” coming from a company, whose real business is advising hospitals on marketing strategy, is clearly dubious.
I am sure you will find many other troubling statements in this article, as well as a couple of good points. What if lots and lots of us wrote letters to the editor! Suggestion: pick ONE thing to comment on. Note: many of the published letters are only 30 words; the longest maybe 100 words.
Here is the info:
TIME Letters to the Editor:
or Fax: 1-212-522-8949
or send to TIME Magazine, Letters, Time & Life Building, Rockefeller Center, New York, NY 10020
Letters should include the writer’s full name, address and home phone and may be edited for purposes of clarity and space.
Susan Hodges “gatekeeper”
|The Maternity Center Association of New York City has just unveiled their new booklet “What Every Pregnant Woman Needs to Know About Cesarean Section.” Finally, women have a way to be truly “informed” before “consenting” or getting talked into a cesarean section!
Initiated after the ACOG Ethics Committee Opinion publicized last fall (which said it is okay for OBs to perform cesarean sections for no medical reason – see Grassroots Network Message 311033), the booklet has been endorsed by many organizations, including Citizens for Midwifery.
Like other MCA projects, the booklet looks thoroughly at the evidence, while at the same time being easily readable and accessible. The text provides a synthesis of virtually ALL the research about cesareans, providing women with information on the risks and benefits of cesarean sections, short term and long term, for mother and for baby. Fully informed, women can then make up their own minds (and question their doctors). In addition, the booklet includes information about what women can do to lower their chances of ending up with a cesarean section.
The booklet is available free online as a PDF file, along with a complete bibliography, description of how MCA went about this project, and evidence tables showing the results of studies on which the booklet is based.
Find the booklet and additional information at:
This is well worth printing out!
Susan Hodges “gatekeeper”
|Originally posted by blueviolet
Just another good example of how obstetrical beliefs (masquerading as science) have convinced the populace that childbirth is inherently dangerous. But these events are not associated with natural childbirth, they are associated with obstetrically-managed childbirth. In how many of those situations have episiotomies been done? In how many is the mother pushing on her back, holding her breath, to counts of ten, when and how she is told to? In how many has she received drugs?
|Grassroots Network Message 404027
ACTION ALERT: Petition about Cesarean Sections
Are you angry about the increasing rates of cesarean sections? Here is something you can do – results are not guaranteed but it sure can’t hurt: Sign this petition!
The Association of Labor Assistants and Childbirth Educators (ALACE) has a petition you can sign on-line that will be mailed to Tommy Thompson, the, Secretary of Health and Human Services on Mothers Day, May 9, 2004. The petition challenges him to take action to reduce the cesarean section rate. More specifically, the petition asks the U.S. Dept. of Health and Human Services to take the skyrocketing Cesarean section rate as a serious threat to maternal and child health, and to take steps to combat this by endorsing the Mother-Friendly Childbirth Initiative written by the Coalition for Improving Maternity Services and by developing a Blueprint for Action to Reduce Cesarean Surgery.
Click on http://www.petitiononline.com/1in4 to sign the petition.
(If you live in Massachusetts, please also click on this link http://www.petitiononline.com/cesarean/ to sign a similar petition.)
You’ll see that you can put in a comment – a wonderful place to mention midwives and the Midwives Model of Care (proven to reduce cesarean sections) if you feel so inclined!
Mother’s Day will be here before we know it! Don’t wait to sign the petition!
Susan Hodges “gatekeeper”
|On Aug. 22, 2003, Warner and her husband arrived at St. Joseph, where about 15 of their closest friends and family members were waiting. Within half an hour, Warner was in recovery holding a baby girl named Kiah; the next day mother and child were home. "Everything was just smooth as silk," says Warner. "I wouldn't think twice about having another C-section." But, she adds, "I'd think twice about having another baby. It's hard work."|