What IF C-Section Was Proven Safer Than Natural Birth? - Mothering Forums
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#1 of 143 Old 08-09-2013, 10:34 PM - Thread Starter
 
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This is just a hypothetical question.  I'm interested in the motivations behind how we judge information.

 

If you happened to see strong supporting evidence that proved to you that giving birth via scheduled c-section at 39 weeks is now safer/better for mom and baby than giving or even attempting birth vaginally at 40+ weeks in an uncomplicated scenario, would you still go ahead and attempt vaginal birth?

 

Why or why not?  (Assuming you lived in an area and had access to care that had been included in the studies proving the safety of the procedure).

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#2 of 143 Old 08-10-2013, 02:30 PM
 
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I think it would depend on how big the difference was in safety.  Is it dramatically safer for mom and baby or is it slightly (statistically even, but a small percentage) safer?  I would choose the way I make all my decisions---what is reasonably safe, what is my preference, what can I afford.  I am comfortable with people choosing VBAC and out of hospital birth because while you can arguably see that there are situations where mom or baby might benefit from a different setting, it is a reasonably safe choice.  I would also consider the long term consequences---future risk of pregnancy complications, newborn gut health, recovery time, cost increase.  I do not have a strong feeling that I have to do things "naturally" for them to be safest or best. 


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#3 of 143 Old 08-10-2013, 02:54 PM
 
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In terms of absolutes I would still want to know how much safer a c-section was vs vag birth. If it were a matter of 1 in a 1000 vs. 2 in a 1000 baby deaths, for instance, then no, I am no getting cut open for that. If it were 1 in 1000 vs 1 in 100, then maybe, probably. 

 

In terms of relativety and me/my child, I am absolutely going to take the risks of c-section to me for a transverse baby, a prolapsed cord, or other child in serious danger. Very likely for other less emergent things.

 

But I stumbled across a book awhile back and they seemed to be arguing that sections are absolutely safer for all women due to risk of pelvic floor damage. And while I don't want to dismiss women's real concerns about that, I find it really disingenuous and slightly infuriating that these men are telling all women to base their decision on that.

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#4 of 143 Old 08-10-2013, 02:58 PM
 
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Oh, on the why... for the same reason that I am unlikely to have a g-tube put in, if the studies showed that it was slightly, but absolutely, safer to receive nutrients that way. It isn't the way my body was designed to eat. I may be less likely to choke, but I'd be missing all the benefits that come with actually eating my food.

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#5 of 143 Old 08-10-2013, 03:08 PM
 
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knowing this is hypothetical, but still... i can't imagine there would be any info that would make me think that a new surgical procedure would be better for mom and baby than millions of years of nature having us have babies a certain way. i would think the piece was a bunch of garbage. seriously. it isn't even logical.

that doesn't mean if something came up and i felt that a c-section was the safest way for my baby to be born i would go and have a vaginal birth anyway. i think each birth needs to be looked at individually. that is why any paper that says 1 way of doing things is 100% better than another, i don't believe it. i mean YES vaginal birth in most cases is the best way for a baby to be born, but even it isn't 100% safe in all cases.

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#6 of 143 Old 08-10-2013, 05:25 PM
 
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  Nope.  Unless it was necessary, like someone mentioned-a prolapsed cord, rupture, previa etc, I'd go with vaginal birth.  There are too many benefits to baby via natural birth.  Natural labor triggers hormones for breastfeeding, helps with infant gut flora to name just two things.  A csec isn't going to help with that.  

 

mamaofthree-you said it-we've got thousands of years of natural birth, and only recent surgery for babies to be born. 

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#7 of 143 Old 08-11-2013, 03:30 PM
 
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But the thought experiment IS that it's safer, so "I don't believe it is" isn't much of an answer. Presumably, in the thought experiment, all the issues you mention have been thought of. That's why it's a thought experiment, not reality. 

 

It's a question about how you prioritize statistical safety. 

 

The idea that it must be better because it's natural is a logical fallacy. Nature doesn't require perfection; all that counts is a low enough failure rate. Historically, with no intervention, birth has not been a safe process, and nature has been satisfied with that. Modern birth is not truly natural at all. We've made it safe by not having everyone do it "naturally." The question here is, what if the risks of C-section were made so low that the odds were that it was always the safer birth for you? We're already at the point where NICE in the UK has said that the risks of C-section are now sufficiently low that if a woman wants a CDMR, it may be considered. 


It's slightly irrelevant for me--a C-section is personally safer for me, so this wouldn't really add anything to my decision making process. 

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#8 of 143 Old 08-11-2013, 04:05 PM
 
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This is just a hypothetical question.  I'm interested in the motivations behind how we judge information.

If you happened to see strong supporting evidence that proved to you that giving birth via scheduled c-section at 39 weeks is now safer/better for mom and baby than giving or even attempting birth vaginally at 40+ weeks in an uncomplicated scenario, would you still go ahead and attempt vaginal birth?

Why or why not?  (Assuming you lived in an area and had access to care that had been included in the studies proving the safety of the procedure).
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#9 of 143 Old 08-11-2013, 04:51 PM
 
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Interesting question. I'm struggling with the premise though smile.gif every other "procedure" in medicine is going for more and more minimal and small incisions, if possible through the vagina even! This is because cosmetically, recovery time, and post op complications almost across the board are better that way.

I wish we had safer, more effective methods of induction myself. While I wouldn't go for an elective c/s at 39 weeks, induction between 39 and 40 weeks if that were proven to be safer for both me and baby than waiting until after 41 weeks, I would go for it.

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#10 of 143 Old 08-11-2013, 06:44 PM - Thread Starter
 
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But I stumbled across a book awhile back and they seemed to be arguing that sections are absolutely safer for all women due to risk of pelvic floor damage. And while I don't want to dismiss women's real concerns about that, I find it really disingenuous and slightly infuriating that these men are telling all women to base their decision on that.

I'm not sure which book you are referring to, but I did recently read Choosing Cesarean, which I believe is cowritten with a female OB and a journalist, each of whom advocate c-section being safer in developed countries. Their reasons were many, and pelvic floor damage is a good enough reason for me; but there are still risks for major surgery and I don't like the idea of it.

 

However, the reason I started this thread was to understand why there is so much resistance to the idea despite the presence of data.  I expected most women, especially here, to still prefer natural.  I am trying to figure out how much of this is ideological for women because it was for me, initially.   Now I HAVE pelvic floor damage and it SUX and it's FOR LIFE.

 

There is such a huge public outcry against the inappropriate interventions and c-sections and it means that we aren't seeing all the data because the data that goes against popular sentiments rarely ever sees the light.  I am trying to understand it better, basically.  For example, why are there so many warnings about c-sections, but virtually none about natural birth?  There is an ideological force at work here that spans all religions and affects how we make our decisions.

 

I am not arguing that c-sections are safer, BTW.  Nobody wants to hear that even if I did have the time and inclination to make such an argument.

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#11 of 143 Old 08-11-2013, 06:57 PM - Thread Starter
 
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But the thought experiment IS that it's safer, so "I don't believe it is" isn't much of an answer. Presumably, in the thought experiment, all the issues you mention have been thought of. That's why it's a thought experiment, not reality. 

 

It's a question about how you prioritize statistical safety. 

 

The idea that it must be better because it's natural is a logical fallacy. Nature doesn't require perfection; all that counts is a low enough failure rate. Historically, with no intervention, birth has not been a safe process, and nature has been satisfied with that. Modern birth is not truly natural at all. We've made it safe by not having everyone do it "naturally." The question here is, what if the risks of C-section were made so low that the odds were that it was always the safer birth for you? We're already at the point where NICE in the UK has said that the risks of C-section are now sufficiently low that if a woman wants a CDMR, it may be considered. 


It's slightly irrelevant for me--a C-section is personally safer for me, so this wouldn't really add anything to my decision making process. 

 

This is why I stressed in my question if it proves it for you. That whatever data you require to be present is available.  If people are saying that no amount of studies or data convince them, then I would like to know if they hold this policy in general or only when it applies to something they prefer to not have to contemplate?  I know some people strongly prefer to make decisions based on anecdotal information, and I certainly can see why when there is almost always a political, ideological, or financial motivation behind the studies presented to the public.  Almost.

 

For me personally, if  I put myself in the shoes I was in before I had the birth experience that I had, I know without a doubt that I would have had trouble even putting myself in such a scenario to answer such a question; my brain would have simply revolted against the idea of accepting such data.  I wouldn't WANT it to be true.  The question is, why?

 

There is something about the idea of science and medicine having that big of a leg up on mother nature that I just don't think I would like to fully accept.  ESPECIALLY in light of all the questionable things modern medicine is taking part in where childbirth is concerned.  I would like to think that I was born to give birth and get into my spirit trip and powow in a cave with other earth mamas.

 

I think a lot of women want this right of passage.  Yeah, the bottom line is, nature is not "nice". Not one bit.

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#12 of 143 Old 08-11-2013, 07:13 PM
 
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Surgery has inherent risks, always has, always will. So I can't even imagine a scenario in which surgery would be inherently safer.
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#13 of 143 Old 08-11-2013, 07:55 PM
 
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Well, speaking for me personally--after having been through a CS twice, while i feel some regret that I will never experience vaginal birth, it's not enough to trump my surety about CS being safer for me. So in the end, I'm data driven. But after having been through the process of deciding between VBAC and RCS, I have a certain amount of comfort with uncertainty. I'm okay with the concept of choosing my odds and balancing my preferences. 

 

But I wouldn't have that perspective had I not had the CS to begin with. And now that I've had 2, and I've had 2 children in the way that was safest for me--none of the regret over a rite of passage is enough to trump feeling that I made the best decision given the data available to me. 

Getting really sick (with severe preeclampsia) was also enough to disabuse me of the notion that Mother Nature is a kindly old lady. She really isn't. It's one thing for me to say, "I don't need to do anything unless something goes wrong," but I'm no longer capable of a priori valuing something because it's "natural." Left entirely to Nature, things wouldn't have gone too pleasantly. 

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#14 of 143 Old 08-11-2013, 08:24 PM
 
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I agree that it would depend on the degree of improved safety. It would have to be what I would consider a significant improvement in safety before I would consider it. I am also one who would find it hard to believe that a study could be done that would provide adequate measures to prove to me that c/s was safer for every mother and every baby, because I don't believe we fully understand all the ways that birth method impacts the future health of the mother and baby. Also, I plan to have more children, and the evidence is very clear that each c-section you have increases the risks for both mother and child in all subsequent pregnancies. I would not be interested in risking myself and future children for the current child unless the current child and/or I were at very serious risk of harm. Frankly, I would not want to deal with the discomfort of being post-op while also caring for a newborn, if the odds were relatively the same, safety-wise.

 

I agree that the idea that it's "natural" for all pregnancies, labors, and deliveries to end well for mothers and babies is a fantasy. The natural system works well enough for enough (I would even argue, the majority of) babies and mothers to survive, thus propagating the species. But the idea that ALL mothers and ALL babies are best served by letting nature take its course is just as dangerous as the idea that ALL mothers and ALL babies are best served by having the most high-tech interventions available.

 

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There is such a huge public outcry against the inappropriate interventions and c-sections and it means that we aren't seeing all the data because the data that goes against popular sentiments rarely ever sees the light.  I am trying to understand it better, basically.  For example, why are there so many warnings about c-sections, but virtually none about natural birth?  There is an ideological force at work here that spans all religions and affects how we make our decisions.

 

I'm curious where you go for news besides Mothering. Because frankly, I'm not seeing this outcry and suppression of data at all. I see plenty of articles on why medical interventions are better. And there are scores of stories of mothers who were told by their doctors that waiting for spontaneous labor would/could kill or maim their baby, but were not told of any of the risks of induction and/or c-section.


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#15 of 143 Old 08-12-2013, 06:27 AM
 
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I appreciate what you are trying to ask here, but after some consideration I don't think I can adequately express my full thoughts on the issue without offending some people and/or turning it into a religious discussion. I do think Monkey brought up a good point about future children. As we are open to as many future children as we are given, I absolutely have to keep that in mind when making these decisions.

 

I have not experienced a c-section but two of my planned homebirths ended in transfers to the hospital and my last child, who was my first planned hospital birth, ended with a pit induction after she failed her bpp/nst and became very sluggish in her movements. At the time I was very concerned about her health and safety and needed her out. I was given the option of pit or cytotec. I knew enough about both, that it was absolutely no question to me about which one to go with. I would have also gladly submitted to a c-section right then if they had told me that she needed it.

 

Lastly, I have been in the ncb and hb community for about 15 years. I don't always like what I see, but there have only been a handful of times where I felt that the mother or midwife in question was being completely dismissive of all sound evidence and trusting "nature" despite the obvious issues right in front of their faces.

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#16 of 143 Old 08-12-2013, 09:40 AM - Thread Starter
 
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Surgery has inherent risks, always has, always will. So I can't even imagine a scenario in which surgery would be inherently safer.

 

Well, your point that surgery has inherent risks and always will is a valid point. Natural birth also has inherent risks.  I can see a lot of people have a hard time imagining surgery being safer, so I'm trying to understand why.

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 I think over the years lots of stuff is deemed safe and unsafe and resafe and then black boxed. I would not trust that statement at all.
 

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Surgery has inherent risks, always has, always will. So I can't even imagine a scenario in which surgery would be inherently safer.

 

Well, your point that surgery has inherent risks and always will is a valid point. Natural birth also has inherent risks.  I can see a lot of people have a hard time imagining surgery being safer, so I'm trying to understand why.

 

I think that is because, whether you are scientifically or religiously minded, we were evolved/created to give birth through our vaginas. That is how the system is set up to work. Like all systems, it doesn't have a 100% success rate, and it can go catastrophically wrong. We are not at all evolved/created to undergo c-sections. How well we withstand that is entirely dependent on how good the technology is. I think a lot of us have a hard time believing that just a few hundred years of surgical experimentation could surpass the millions of years of evolution and/or the work of an all-knowing God in terms of outcomes.

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#19 of 143 Old 08-12-2013, 10:11 AM
 
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I am scientific AND religiously minded. <3 I believe deeply in the safety of 'expectant management' in most areas of human health so elective management is less safe always IMO. Obviously you can't totally elect for either method of birth (you might have PTL even with a scheduled C), so then it is just a question of more or less aggressive management.
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#20 of 143 Old 08-12-2013, 10:12 AM - Thread Starter
 
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I'm curious where you go for news besides Mothering. Because frankly, I'm not seeing this outcry and suppression of data at all. I see plenty of articles on why medical interventions are better. And there are scores of stories of mothers who were told by their doctors that waiting for spontaneous labor would/could kill or maim their baby, but were not told of any of the risks of induction and/or c-section.

 

 

I understand and agree with all your points until this very last paragraph.  Obviously my exposure to information on c-sections is quite different from yours.  If I google c-section, the first ten articles coming up mostly do outline the risks of the surgery.  Maybe they aren't ideal, but it's a start.  Women who educate themselves find this information quite easily in comparison to the risks of natural birth.  I have heard numerous reports in major news broadcasts that hospitals are being accused of performing too many c-sections.  I know several mothers who underwent the procedure and have expressed doubts as to the necessity of it.  Anyone who digs in the very least will have been exposed to the natural childbirth movement. NBC is major one news source that has reported on it extensively over the years.   http://www.nbcnews.com/health/c-section-rate-stable-third-year-new-report-shows-6C10459239

 

I see a lot of supression of data. My mom worked for the CDC and the reports published on this kind of topic seem entirely politically motivated. And often inaccurate. The questions we have on this topic rarely even get asked in the first place. I am asking why. All the great points you brought up in your first paragraph and the many unknowns, are knowable and publishable.  The public just generally doesn't  want to hear it right now.  

 

As to not being told the risks of c-section, in my state we have to sign a waiver to consent to a c-section in which we are informed of the risks of c-section.  No such information is provided for in the consideration of a natural birth or the vast number of interventions and injuries that might take place during one.  More to the point:  google natural childbirth and compare the number of times the word "risk" appears in the headings.  It doesn't come up for me even once.

 

It's my own impression that there is a bias at work which implies that something is OK if it's natural and less than ideal if medicalized.  Birth is inherently dangerous and many women like myself often start out very naive as to its risks either way.  This creates a missing piece of the puzzle in educating women about childbirth.  

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#21 of 143 Old 08-12-2013, 10:15 AM - Thread Starter
 
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 I think over the years lots of stuff is deemed safe and unsafe and resafe and then black boxed. I would not trust that statement at all.
 

 

I'm not sure which statement you are referring to?

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#22 of 143 Old 08-12-2013, 10:21 AM - Thread Starter
 
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I think that is because, whether you are scientifically or religiously minded, we were evolved/created to give birth through our vaginas. That is how the system is set up to work. Like all systems, it doesn't have a 100% success rate, and it can go catastrophically wrong. We are not at all evolved/created to undergo c-sections. How well we withstand that is entirely dependent on how good the technology is. I think a lot of us have a hard time believing that just a few hundred years of surgical experimentation could surpass the millions of years of evolution and/or the work of an all-knowing God in terms of outcomes.

I agree that it is hard to believe that a few hundred years of medical/surgical experimentation can surpass hundreds of millions of years of evolution-or even better-intelligent design.  But it very clearly has in many cases.  Otherwise the vast majority of people wouldn't go to the doctor when their health is at risk and there wouldn't be life saving surgeries that we use when mother nature fails to keep us alive and feeling good.  I don't think that means life should be created in petri dishes going forward, but hopefully I am making some sense.

 

It again goes back to what seems like an ideological argument.  

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#23 of 143 Old 08-12-2013, 10:41 AM
 
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How about an economic argument? Expectant management of birth AND miscarriage saves me money in the short AND long term. Which improves my quality of life. In a country with the highest medical costs in the world without the corresponding best outcomes, that is worth considering. Especially because I value & want to preserve my fertility, my uterine integrity, my hormonal function, keep my abdominal cavity adhesion free, etc.

At the base of the Section vs. Vaginal debate is a maternal safety vs. fetal safety debate. That is @ the very origin of Cesarean (before that they used to do a D&X in obstructed labor). Now it is deeply preferable to have a Cesarean & a live baby vs. a D&X, obviously. But I do NOT accept that in a country where I can end my pregnancy for any or a gender/diasability reason, to viability & beyond, that I have to patently increase my health costs & risks in a non-emergent situation for a statistical calculation of intrapartum safety!

Any difference on a population level would be super tiny. Even choosing a HomeBirth with any type of Midwife only increases intrapartum mortality from 0.07/100 to 0.243/100. And those are Dr. Amy's numbers. So any increase NEONATAL safety would be totally WAY too fractional for 39 weeks to ever become public health policy in any universe.

Dr. Amy has a great post on the concept of 'diminishing returns' that is worth reading on this topic.

As far as the idea that Pelvic Floor injuries would ever compete with actual abdominal intrusion, no. And I find the notion that vaginal birth irreprably damages the Yoni to be very unfeminist & less than accurate. My second birth IMPROVED my Yoni.

Just like you can't get a true rate of 'necessary Circ' in a culture that forcibly retracts & refuses to understand the foreskin, you can't get a true rate of injury in expectantly managed birth in an active management culture.
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#24 of 143 Old 08-12-2013, 11:04 AM
 
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I agree that it is hard to believe that a few hundred years of medical/surgical experimentation can surpass hundreds of millions of years of evolution-or even better-intelligent design.  But it very clearly has in many cases.  Otherwise the vast majority of people wouldn't go to the doctor when their health is at risk and there wouldn't be life saving surgeries that we use when mother nature fails to keep us alive and feeling good.  I don't think that means life should be created in petri dishes going forward, but hopefully I am making some sense.

 

It again goes back to what seems like an ideological argument.  

I go to the doctor when something's wrong. I go to the doctor to make sure nothing's wrong, and if something's wrong enough- I get medical treatment to fix it. But you do not get major surgery when everything's hunky dory!

 

By this argument- shouldn't we be hooking everyone up to feeding tubes?  We could ensure proper nutrition, eliminate unhealthy things, eliminate allergy concerns, etc. Given the rate of things like diabetes and people dying from allergic reactions- eating is horribly dangerous! But we don't. I've never even see anyone suggest that I should go to the doctor because they know better than me how to eat to the degree that I can't be trusted to eat myself.

 

"When their health is at risk" is not "When your body is functioning as it should and everything is going fine"- most births are the latter. Some births are the former, which is why we have c-sections and medical interventions. The problem is, we've gotten it into our head that- to go back to the food metaphor- healthy people with healthy bodies can't be trusted to eat dinner on their own just because some people have problems that prevent them from doing so without severe risk (and, yes, sometimes healthy people choke or get food poisoning or whatever else- so there's wisdom in having a medical professional around when giving birth, but having a medical professional around doesn't mean getting sliced open).

 

If there's a sign that natural birth will seriously put myself and/or my baby at risk- hell yeah I'm getting a c-section. I don't know a rational, responsible person who would refuse to get a c-section even when it's clear  But simply being pregnant is not a sign that my baby or me is at serious risk!


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#25 of 143 Old 08-12-2013, 11:05 AM
 
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dinahx-do you have Dr Amy link?  I'd like to read her stuff.  

 

This is turning into an interesting conversation.  I may have missed some things.  What about mortality rate and csec?  I'm sure the numbers could be wrong, but in states with increased csec, mortality went up.  So how is that safer?  Finding a breakdown on how many of those were inductions, not elective, may be hard.  Maybe comparing US cesarean/mortality rates with a country with low cesarean/mortality rates would give some clear information.  Or even just high % vs low % among states.

 

 The US has a big problem with not education women on childbirth practices.  (on a lot of things imo)  No one ever told me csec risks. Nor breastfeeding info, or vaginal birth info.  The birthing class went over labor stages.  Not much else. 

 

Going back to natural, someone brought up bp problems-wouldn't the higher percent be nutritional problems and perhaps stress related,  not genetic?  When did eclapmsia/preclampsia start becoming a common problem?  Information tell us the higher percent is in many first time moms.  First time moms are stressed out and afraid-they have no idea what to expect.  And the diet in the US is horrible, for the most part.

 

My thoughts on birth, are that perhaps former delivery problems can be overcome, though not for everyone.  With guidance/counselling etc.  My 2 births were very different.  I had a lot of fear the second time of a repeat of the first, and the women surrounding me were very strong and helpful.  I read some empowering books on trusting the body during birth.  It was a different outlook than the first time.  

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#26 of 143 Old 08-12-2013, 11:05 AM
 
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I think that is because, whether you are scientifically or religiously minded, we were evolved/created to give birth through our vaginas. That is how the system is set up to work. Like all systems, it doesn't have a 100% success rate, and it can go catastrophically wrong. We are not at all evolved/created to undergo c-sections. How well we withstand that is entirely dependent on how good the technology is. I think a lot of us have a hard time believing that just a few hundred years of surgical experimentation could surpass the millions of years of evolution and/or the work of an all-knowing God in terms of outcomes.

I agree that it is hard to believe that a few hundred years of medical/surgical experimentation can surpass hundreds of millions of years of evolution-or even better-intelligent design.  But it very clearly has in many cases.  Otherwise the vast majority of people wouldn't go to the doctor when their health is at risk and there wouldn't be life saving surgeries that we use when mother nature fails to keep us alive and feeling good.  I don't think that means life should be created in petri dishes going forward, but hopefully I am making some sense.

 

Talking about medical treatment/surgery for an illness or abnormality isn't what you referred to in your original post, though. I thoroughly agree that a c-section is a much better option than a natural delivery for a mother with a complete previa, for example. What you appear to be saying is that because c-section is better in that case, it's better in all cases. That doesn't make sense. Dialysis is also an awesome modern medical innovation. But it's only for people with kidney problems. There is no reason for someone with healthy kidneys to opt to have their kidneys removed and be on dialysis for the rest of their life. I absolutely agree that modern medicine does wonderful things. But I have a hard time believing that modern medical intervention in a process that would otherwise occur naturally is a good idea, absent of specific problems or indications of risk.

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#27 of 143 Old 08-12-2013, 11:15 AM
 
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I understand and agree with all your points until this very last paragraph.  Obviously my exposure to information on c-sections is quite different from yours.  If I google c-section, the first ten articles coming up mostly do outline the risks of the surgery.  Maybe they aren't ideal, but it's a start.  Women who educate themselves find this information quite easily in comparison to the risks of natural birth.  I have heard numerous reports in major news broadcasts that hospitals are being accused of performing too many c-sections.  I know several mothers who underwent the procedure and have expressed doubts as to the necessity of it.  Anyone who digs in the very least will have been exposed to the natural childbirth movement. NBC is major one news source that has reported on it extensively over the years.   http://www.nbcnews.com/health/c-section-rate-stable-third-year-new-report-shows-6C10459239

 

I see a lot of supression of data. My mom worked for the CDC and the reports published on this kind of topic seem entirely politically motivated. And often inaccurate. The questions we have on this topic rarely even get asked in the first place. I am asking why. All the great points you brought up in your first paragraph and the many unknowns, are knowable and publishable.  The public just generally doesn't  want to hear it right now.  

 

As to not being told the risks of c-section, in my state we have to sign a waiver to consent to a c-section in which we are informed of the risks of c-section.  No such information is provided for in the consideration of a natural birth or the vast number of interventions and injuries that might take place during one.  More to the point:  google natural childbirth and compare the number of times the word "risk" appears in the headings.  It doesn't come up for me even once.

 

It's my own impression that there is a bias at work which implies that something is OK if it's natural and less than ideal if medicalized.  Birth is inherently dangerous and many women like myself often start out very naive as to its risks either way.  This creates a missing piece of the puzzle in educating women about childbirth.  

 

Being made to sign a consent form and actually having the risks thoroughly explained to you, in an unhurried manner, where you feel comfortable asking questions, are two completely different things. You don't have to sign a consent form for a natural birth for the same reason you don't have to sign a consent form for eating a meal or having a bowel movement. It's not a medical event. That doesn't mean there are no risks, or that you can't injure yourself.

 

I would also argue that if doctors felt natural birth were particularly risky, they would tell mothers about it. And some doctors do, in fact, tell mothers what they perceive as the negatives of a vaginal birth. (I think we're muddling 'natural' vs 'vaginal' birth in this thread, but that's a different point.) The fact that many doctors do not, to me, is a testimony that they do not consider it to be particularly risky.

 

I do agree that some NCB educators and advocates gloss over the risks of some birth choices, and that does bother me. However, (and I may be way off base here), it seems from your posts that you had a particularly physically traumatizing vaginal birth, and are generalizing your experience to all vaginal births, as if most mothers have the same outcome as you did, which I don't think is true. I would be interested to see some actual numbers as far as what you perceive the risks of vaginal birth to be, and what your sources are for those perceptions. And I mean that with respect. I feel like we are having a somewhat vague conversation that could be helped by being more concrete.

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#28 of 143 Old 08-12-2013, 11:45 AM - Thread Starter
 
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Being made to sign a consent form and actually having the risks thoroughly explained to you, in an unhurried manner, where you feel comfortable asking questions, are two completely different things. You don't have to sign a consent form for a natural birth for the same reason you don't have to sign a consent form for eating a meal or having a bowel movement. It's not a medical event. That doesn't mean there are no risks, or that you can't injure yourself.

 

I would also argue that if doctors felt natural birth were particularly risky, they would tell mothers about it. And some doctors do, in fact, tell mothers what they perceive as the negatives of a vaginal birth. (I think we're muddling 'natural' vs 'vaginal' birth in this thread, but that's a different point.) The fact that many doctors do not, to me, is a testimony that they do not consider it to be particularly risky.

 

I do agree that some NCB educators and advocates gloss over the risks of some birth choices, and that does bother me. However, (and I may be way off base here), it seems from your posts that you had a particularly physically traumatizing vaginal birth, and are generalizing your experience to all vaginal births, as if most mothers have the same outcome as you did, which I don't think is true. I would be interested to see some actual numbers as far as what you perceive the risks of vaginal birth to be, and what your sources are for those perceptions. And I mean that with respect. I feel like we are having a somewhat vague conversation that could be helped by being more concrete.

 

I didn't say the consent form was ideal, but it does outline some major risks.  Whether or not doctors should be held responsible for more is a matter of debate I won't argue; they should on all levels infomr us more and they should on some levels be far more informed themselves.

 

However, giving birth is much different than eating a meal or having a bowel movement and this is my point: for many women and babies birth is dangerous and that is why they need medical intervention.  The way that births take place in hospitals is a HIGHLY medical event but we all seem to still want to remain in denial of that fact or hope it won't happen to us when the fact is birth is a medical event for the majority of women.  Whether it should be is beside the point.  

 

You are not making any sense whatsoever by saying doctors don't consider vaginal birth particularly risky.  If they didn't, there would be vast numbers of them approving home births and supporting it as a whole.  The vast majority of doctors perceive birth as a medical event with inherent risks.  

 

My intention with the thread is not to argue over statistics and sources nor have my personal experience and how I perceive it to be analyzed.   The goal is to understand why so many people are disiniterested in or uncomfortable with the ideas presented on a deeper level.  And in turn, I mean that with all due respect and appreciate your replies:-) 

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#29 of 143 Old 08-12-2013, 11:58 AM - Thread Starter
 
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Talking about medical treatment/surgery for an illness or abnormality isn't what you referred to in your original post, though. I thoroughly agree that a c-section is a much better option than a natural delivery for a mother with a complete previa, for example. What you appear to be saying is that because c-section is better in that case, it's better in all cases. That doesn't make sense. Dialysis is also an awesome modern medical innovation. But it's only for people with kidney problems. There is no reason for someone with healthy kidneys to opt to have their kidneys removed and be on dialysis for the rest of their life. I absolutely agree that modern medicine does wonderful things. But I have a hard time believing that modern medical intervention in a process that would otherwise occur naturally is a good idea, absent of specific problems or indications of risk.

   

You haven't explained why, though.  A process that occurs naturally is not always the best process for the people involved.  It seems like this argument is not really based on something concrete, because you and others keep talking about belief.  

 

The bottom line is science and medicine step in where mother nature fails.  As there are inherent risks in human beings giving birth, to suppose that medicine has or could in fact become advanced enough to do a better job is not even remotely far-fetched.  I was using the point of other medical interventions that have shown effective; whether or not the original issue was intended for one of disease or perfectly natural occurence is really beside the point.  Maybe you don't think it should, but that is quite different from acknowledging that it could or maybe even does in some instances.  And all I wanted was to ask but what if it did?

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#30 of 143 Old 08-12-2013, 12:10 PM
 
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You can't practice medicine on a 'best for everyone' basis. Isn't that your beef with Natural Birth ideology?

Birth also has benefits for a woman's body, we can't just write off those. Cesarean is a LOT closer to safe for every baby than it is to being safe or without seqelae for every mother. And that simply can never be enough justification for a policy of routine cesarean @ 39 weeks. It would have to be safer in the short AND long term for the *mother* & it would also have to be low in morbidity.

It all again comes down to 'a good mama throws her body under the bus for any microscopic increase in neonatal safety!' I don't accept I can't have both. Statistics show that setting & provider is a larger predictor of Cesaean rate than any single health indication. With the reveloution in microbiological understanding & cesaean's inevitable need for antibiotics (not to mention opiates!) the microbiome has to be considered too.
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