What is your opinion on the # of csections being done here in the us? - Mothering Forums
Forum Jump: 
Reply
 
Thread Tools
#1 of 64 Old 12-29-2004, 09:12 AM - Thread Starter
 
edamommy's Avatar
 
Join Date: Apr 2004
Posts: 3,097
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My dh and I just learned that yet another friend has undergone a csection to remove her "big baby" (10lbs). Since having my own son via emergency csection we know of 15 other births. All but TWO being csections!! Is this crazy or what? Now, our personal conversation was long and dragged out and flighty, if you will. But the main point (of mine- my husband is less paranoid! lol) being that that making csections common is taking power away from women. I'm not a feminist really, but I feel this SO STRONGLY! It seems that with each section another woman loses her control over her body and her baby. Who is behind this surge of sections? The docs? The hospitals? The insurance companies? The gov't? And can we go back to regular births being the "norm" or is that time over? How does one speak up against csections without insulting other moms? My emergency csection really negativly affected me as a woman and I'm still (21 ms later) recovering from the emotional damage of it. BUT my son WOULD HAVE died had I not had it... but at the same time (the cord was wrapped around his neck and leg, doubled) I still feel the hospital caused the situation to begin with as I was induced at 33weeks due to low amniotic fluid,e tc. I was on pitocin for 3 days and cervedel too. I was so stressed- couldn't these things have led to him getting wrapped up in the cord? ? Anyway, I'm intrested in hearing others opinons! I mean, wasn't our body meant to deliver babies- even big ones? And I know that even the most natural-minded mama feels so scared in the birthing situation that one will do what is asked of her from the proffesionals (docs/nurses/etc.). So, going in with the best of nat'l birth intentions can mean nothing when there's a doc in your face saying that your babes life is at risk w/o a csection. And WHY is EVERY DARNED HOSPITAL BIRTH started w/ pitocin these days? Do the docs really not have time to wait out a normal labor? Is this another power-sucking manuever?
Okay, this is an honest post looking for opinions AND a vent. Thanks!
Kimberley
edamommy is offline  
#2 of 64 Old 12-29-2004, 09:25 AM
 
slightly crunchy's Avatar
 
Join Date: Jul 2003
Posts: 1,363
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
You are preaching to the choir here at MDC.

Yes, there are way too many sections. The WHO has said there should be, at the most, 15% I believe, but it is now between 25 and 30%. I think inductions are a big part of it, but just the general climate out there among doctors, and the public. For the doctors, they are afraid of getting sued, because they do get sued, all the time, when the outcome is not perfect. Also because so many of the hospital interventions end up leading to section. For the public, because there is not acceptance of the fact that sometimes things do not go perfectly. Sometimes babies have problems, and it is not always the doctor's fault. But the doctors and hospitals get blamed, anyway. They are less likely to get blamed if the baby is taken out quickly via surgery (even though we all know there can be complications from surgery).

The section rate will not change and may get worse until the anti-VBAC trend is reversed, more women get smart and make different birth choices, and the liability crisis in this country is improved. It will take many more women going to midwives and using/demanding birth centers and forgoing epidurals and elective inductions, etc.
slightly crunchy is offline  
#3 of 64 Old 12-29-2004, 12:35 PM
 
alegna's Avatar
 
Join Date: Jan 2003
Posts: 44,408
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I think it's the setup of the insurance companies and the courts that are causing it. Basically if a Dr. does a section, they can't be sued. If they don't they can. Money talks.

I don't know all of your situation (though WOW, induced at 33 weeks! for low fluid sounds like someone covering their backside... they've gotten way relaxed about preemies) BUT my dd had her cord around her neck twice and shoulder once and it was no big deal at my homebirth. Labor was slow (probably largely for that reason) but everything was perfect. If I had been in a hospital, they would have done a section.

-Angela
alegna is offline  
#4 of 64 Old 12-29-2004, 03:29 PM
 
luvmylittleman's Avatar
 
Join Date: Jun 2004
Posts: 62
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Why is c-section rate so high?
1. Doctors (or other providers) who have not seen enough all natural labors (no interventions).
2. Doctors who fear law suits.
3. Doctors who do not listen to the patients and do not really give true informed consent.
4. The general birth tone in your area of the country.
5. Inducing labor.
6. Keeping moms stuck in bed for labor.
7. Forced pushing during the second stage of labor.
8. Providers that put too much stock in technology. (fetal monitors, ultrasounds, etc.)
9. Overuse or not selectively using medications in labor (this is the providers responsibilty and the mothers).
10. Just accepting the status quo as the best way (the general tone in the country).
11. Hospitals which enforce policies on every woman reguardless of their individual situation.
11. Many more!!!!!

So what can be done!!! What will change it???
- if health care providers were made to publically post c-section rates, induction rates, etc... (then women could make more informed choices before selecting doctors or midwives)
- public information
- lawsuits on "unnecessary inductions, unnecessary c-sections, and uninformed consent" (which may not help either)
- completely revamping the obstetrical care of the US to reflect such countries as Holland, Japan, etc.
- Making it manditory for docs and midwives to have to attend many natural births.

Either the doctors will drive the c-section rate up to very, very high numbers. They will drive themselves right out of business (by pushing malpractice insurance higher and higher). Or they will change. Probably the first choice.
(Or babies will be removed from their moms body at 3 weeks gestation and grown in a bubble, because a moms bodies are not safe for pregnancy and birth.-sorry I felt snarky- not all doctors, OB's, etc. are bad)

IMO- inducing at 33 weeks for low amniotic fluid is terrible practice, because if it was so necessary at that point, a c-section would have been done then.
luvmylittleman is offline  
#5 of 64 Old 12-29-2004, 04:29 PM
 
ilovebeingamom's Avatar
 
Join Date: Dec 2001
Location: Michigan
Posts: 566
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I agree with you that it does seem like a women's rights issue. It is another way to make women feel that they are inferior, and can't do anything without a man there to aid them.

Bull****!

Another disgusting fact is that the president of ACOG was recently quoted ( I tried to find it but couldn't quickly) as saying that he feels EVERY women should have a c/s, and that it would cut down on such problems as incontience and pelvic floor damage. :

I get depressed thinking about it. But I think we need to return to midwife care. Dr.'s have only been taught the medical model, which looks at birth as a disaster waiting to happen, rather than what midwives believe, in that it is a natural normal event.
ilovebeingamom is offline  
#6 of 64 Old 12-29-2004, 06:36 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,747
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I've gone to reply to this thread several times and stopped.

I believe that a csection rate of 26% if too high, that the US average should be between 10-15%, that being said I am not completely ready to lay complete blame on insurance companies and doctors or even "male obstetrics". I believe that this problem lies among women themselves and a society at large that allows others to lead them and wanting to rush life as we know it. Every few weeks/months this conversation comes up, and there seems to be no middle ground about certain things. I am going to go through some of the things touched on here and comment on them.

While I will agree that some interventions can lead to csections, I have read several studies that have concluded that the use of epidurals given to a patient at 4-5cm is not an increased risk for a csection. In fact, on many occassions, giving an epidural actually helped labour, not hinder it, because the mother relaxed, etc. I have to say from personal experience with friends, this was the case. I believe from my research that the increased need for csections come about when labor is induced or augmented by pitocin -- which often leads to early epidurals.
With fetal monitoring, it can be used as a tool just like anything else. I do not think this should be the sole reason for putting someone in OR, but is it really the evil that it is made out to be. Is there not some good that has come from its use?

Next, patients sue. We live in a society that wants to place blame and lay responsibility at someone elses feet other than ourselves. I think you might be surprised to learn that some of the lawsuits that have affected OBs come from VBAC patients themselves. Unfortunately there are women who should not VBAC and should be counseled not too. In this very forum, mothers who have risk factors not just for rupture, but other risk factors are encouraged to VBAC and sometimes to HBAC. I personally as of this date know three women who have attempted VBACs that ended horrifically all because they were trying to prove something, even though OBs counseled them not too. However, they took advice from message boards and reading the Silent Knife to conclude their doctors wrong. The thing is, not all OBs are out to get you and cut you up, they have a set of facts in front of them and they are giving often times an educated opinion. One of these women is sueing the OB who delivered her stillborn baby -- because get this, they agreed to support her in her VBAC efforts. This woman claims she was not told all the risks.
I think women in general are not making informed decisions about their healthcare or demanding more from the doctors who treat us. When you have drug companies running trials for drugs designed for women on men, you should be having some serious outrage! I was fortunate to come from strong stock that taught me to stand up for myself and advocate for myself, but not all women or even men have the opportunity to educate themselves.
We can blame doctors for misinformation and bad education, but the facts are, many people fail to listen or even read a prescription label. I think sometimes doctors do play down risks to their patients, not because they want stupid patients, but because people are fearful. Some women want their hands held and led like lambs. Unless this attitude changes, then there is going to be problems with women's healthcare in general.

I have more to say but my kids want to go outfront to play!
OnTheFence is offline  
#7 of 64 Old 12-29-2004, 08:20 PM
 
love2all's Avatar
 
Join Date: Dec 2003
Location: planet earth...mostly
Posts: 1,524
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I agree the %is way to high-
many points already made-
doctors time pressures
insurance
money
big business here in the us
love2all is offline  
#8 of 64 Old 12-29-2004, 11:38 PM
 
TurboClaudia's Avatar
 
Join Date: Nov 2003
Location: in a yellow house
Posts: 7,363
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
briefly, the number of births via cesarean in the U.S. is high, higher than what evidence-based medicine would indicate.

as for why, there are too many confounding factors to pinpoint just one or even a few things. if time was taken to trace each potential reason, i believe a root philosophical "scientific" ideology of the human body as machine would appear. although the human body functions like a machine in many situations, the human mind is in a continuum with the human body and demonstrates a subtle yet strong influence over the body. there is no scientific or technological basis for this and that is very hard for many people to grasp or even want to grasp.

for more on the technocracy of birth, read robbie davis-floyd www.davis-floyd.com

warmly,
claudia
TurboClaudia is offline  
#9 of 64 Old 12-30-2004, 01:34 AM
 
luvmylittleman's Avatar
 
Join Date: Jun 2004
Posts: 62
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I am not attacking anyone or anyone's opinion, just offering my opinion and questions.
Quote:
I believe that this problem lies among women themselves and a society at large that allows others to lead them and wanting to rush life as we know it.
I do agree.

Quote:
While I will agree that some interventions can lead to csections, I have read several studies that have concluded that the use of epidurals given to a patient at 4-5cm is not an increased risk for a csection. In fact, on many occassions, giving an epidural actually helped labour, not hinder it, because the mother relaxed, etc. I have to say from personal experience with friends, this was the case. I believe from my research that the increased need for csections come about when labor is induced or augmented by pitocin -- which often leads to early epidurals.
I know that there are studies that support the idea that (late) epidurals do not increase c-section rates,but epidurals can make pushing more difficult and can slow the pushing stage. If the healthcare provider is set on the 2 hour limit for the second stage (pushing), then how does this not increase your c-section chances. Pitocin is used many times with epidurals, so do you increase your c-section risk because the pitocin is also running. Do you increase your c-section odds because of prolonged purple pushing (commonly used when epidurals are in place) resulting in fetal heartrate changes? Probably. That being said, epidurals can help women relax and progress faster (but there are side effects to consider).

Quote:
With fetal monitoring, it can be used as a tool just like anything else. I do not think this should be the sole reason for putting someone in OR, but is it really the evil that it is made out to be. Is there not some good that has come from its use?
Yes, it should be a tool (electronic fetal monitoring). I have seen it used too many times to put the mom in the OR. Some doctors see a little blip on the monitor and rush to the OR. I know of doctors who put every single woman on an internal fetal monitor as soon as possible. Is this for the baby's well being or for the doctor's well being (something written on paper to prevent lawsuits)? Yes there is some good from its use, but is it overused?

Quote:
Unfortunately there are women who should not VBAC and should be counseled not too. In this very forum, mothers who have risk factors not just for rupture, but other risk factors are encouraged to VBAC and sometimes to HBAC. I personally as of this date know three women who have attempted VBACs that ended horrifically all because they were trying to prove something, even though OBs counseled them not too. However, they took advice from message boards and reading the Silent Knife to conclude their doctors wrong. The thing is, not all OBs are out to get you and cut you up, they have a set of facts in front of them and they are giving often times an educated opinion. One of these women is sueing the OB who delivered her stillborn baby -- because get this, they agreed to support her in her VBAC efforts. This woman claims she was not told all the risks.
Women do truely need to inform themselves. Not all women should VBAC. Are we going to solve the problems by eliminating all VBAC's? Informed consent involves much more than a two second explanation. (seen this many times) I have seen doctors in different specialties give 7 page consent forms for elective procedures (including national statistics and statistics from their practices). Why can't women be given something similar during an office visit before an induction or VBAC? Also, I have seen consent forms where women can opt out of informed consent and rely on the doctor's orders. Not all OB are out with the knife, but it can be very hard for women to find out which doctors are knife happy.
luvmylittleman is offline  
#10 of 64 Old 12-30-2004, 02:58 AM
 
Unoppressed MAMA Q's Avatar
 
Join Date: Jun 2004
Location: Exactly Where I'm At
Posts: 1,942
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
personally, i walked away from the system entirely well before i became mom.
i try to be a light for others who may wish to do the same, to whatever extent.

that is all *I* can do.
Unoppressed MAMA Q is offline  
#11 of 64 Old 12-30-2004, 03:14 AM
 
Tanibani's Avatar
 
Join Date: Nov 2002
Location: Southern California
Posts: 3,052
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Unoppressed MAMA Q
personally, i walked away from the system entirely well before i became mom.
i try to be a light for others who may wish to do the same, to whatever extent.

that is all *I* can do.
I really like that.

I agree with everyone here... I don't think it's necessarily a way to "keep women down" it's just sadly the way the medical system is set up (monitors, cover their ass, impatience with nature, desire to rush in and medicate or induce, when it's not necessary, etc...)

I came pretty close to a Csec the first time "failure to progress" : but I made it. I had a great 18 hour labor (painfree thanks to HypnoBirthing) and there was no way in heck I was going to accept a Csec after all that good work. So I * asked * for the Pitocin in order to get the contractions back. Two hours of hard pushing on my part, and my baby was born.

I had a homebirth the 2nd time to avoid the hospital hassle. DH's family was very concerned and worried about me. Homebirth was totally fine.

The other problem is that * everyone * is convinced that hospitals are the "safest" places to give birth. Not necessarily... it's the place where a woman is most likely to have a medically managed birth... which will most likely lead her to a Csec. :

You might want to read Naomi Wolf's book, Misconceptions. Not the best book ever written, but it's still an interesting read.

10 - boy
5.5 - girl
Tanibani is offline  
#12 of 64 Old 12-30-2004, 11:44 AM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,747
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
[QUOTE=TanibaniThe other problem is that * everyone * is convinced that hospitals are the "safest" places to give birth. Not necessarily... it's the place where a woman is most likely to have a medically managed birth... which will most likely lead her to a Csec. :

[/QUOTE]

The above statement is false. You are making it sound as if going to a hospital to have a baby will most likely lead you to have a Csec. Most likely??? Ok, lets break it down here realisticly and not use over dramatization here --I am sure you hate it when people classify homebirth in such a way. The majority of births are vaginal births. Now if we had a csection rate of 74% then yes, I could see how your statement could be realistic, but its not. Also in the 26% there are lots of factors to consider -- women choosing to have repeat csections. VBAC rates are low, so I imagine that part of the 26% is repeat csections. Then lets break it down further -- birth defects, PE, and other problems in pregnancy that could indicate a csection is safer.
Yes there are unnnecessary csections performed every day. You do have doctors who want to go to golf games or make dinner, but I think they are a minority. Most the stuff I see about Obstetrics on Mothering is just hearsay and ancedotal. (sp) While some it may be right on, some if it is not based in hard evidence or facts.
If women are concerned about having a hospital birth then they need to ask the policy of their OB. How long do you allow pushing? Will I have to stay in the bed? so on and so on. Again its about the woman. If you choose an OB that heavily manages a birth, then why complain? why moan and groan about the establishment? And if you were a doctor would you not be concerned about being sued? I know I would! Because we are a society of blame, who expect perfect outcomes. Ask questions, advocate for yourself -- know if you choose to give birth in a hospital with a 35% csection rate that that could be you, vs one with a 12% rate. Its really quite simple in the big scheme of things.
OnTheFence is offline  
#13 of 64 Old 12-30-2004, 01:01 PM
 
Tanibani's Avatar
 
Join Date: Nov 2002
Location: Southern California
Posts: 3,052
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Kim, you are right, I am being overly dramatic. I think my statement should have said, "most likely lead her to have an unnecessary Csec."

I think for first time mothers, yeah, your chances ARE way higher of having an unnecessary Csection.

And I don't think being pumped/offered every available medication (without good reason) on a routine basis is "healthy." That's why we are moaning and groaning about the establishment.

Quote:
Originally Posted by OnTheFence
Again its about the woman. If you choose an OB that heavily manages a birth, then why complain?
The problem is (Naomi Wolf illustrated this) the whole hospital/medical model leans towards heavily managing birth. Most women (first timers) do not realize the extent OR exactly how it will affect their outcome. People are pretty naive the first time and end up learning the hard way (when things don't work out the way they envisioned.) They come out angry, sad, traumatized. Sometimes the baby feels that way too.

DH and I interviewed our first OB and asked him about his Csec rate. He couldn't (wouldn't) give us a percentage. So I chose another OB who was more "natural friendly." He let me be during labor and would only intervene/act if something was "wrong." I doubt most OBs are like that. Most want to help move things along. They are uncomfortable standing still and doing "nothing." (Liability fears no doubt.) I don't think it's because they want to leave earlier either.

Quote:
Originally Posted by OnTheFence
Why moan and groan about the establishment?
Yeah, the establishment is the problem. It would be nice if it was spelled out in the front door. It's not.

Why moan and groan? Because not every woman is happy about having major abdominal surgery for every subsequent birth when they didn't "need one" in the first place. Now that VBACs are outlawed, women have no choice (unless they go underground.)

10 - boy
5.5 - girl
Tanibani is offline  
#14 of 64 Old 12-30-2004, 01:24 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,747
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Last I checked VBACs are NOT outlawed. I go to a practice that currently does VBACs and I live in backwards Alabama. The csection rate for the area I live in is fairly high (over 35% I believe). However we also have a high number of birth defects in our state, and high maternal/fetal mortality rates. Living in a port city too plays a part, but thats a whole other topic.
VBACs are being discouraged. As I said in another post, the very people who wanted VBACs who had unsatisfactory outcomes, actually have played a part by sueing. There is always going to be a swing in obstetrics to go one way or the other when it comes to VBAC. Just 10-15 years ago INSURANCE COMPANIES would not pay for csections or allow doctors to do them unless there was a trial of labor. In 1996, my SIL wanted a repeat csection but was told she could not, that she had to have a trial of labor and try to deliver vaginally. She did have a successful VBAC but was quite pissed she did not get a choice. Now the tide has changed. Again, there is no middle ground.

Also, I am for women having choices. If they want epidurals and know the risks, then they should have them. They want Nubain to help them relax, fine, they should have it. Not everyone is going to be drinking herbs and eating placentas, nor should I believe that should be the standard of care. Everyone takes risks, some are educated, calculated ones and some are not.

And BTW, I have read Naomi's book. I agree with portions of it, I disagree with others. And I am sure you know she had a failed VBAC, even after all her knowledge.
OnTheFence is offline  
#15 of 64 Old 12-30-2004, 01:44 PM
 
heldt123's Avatar
 
Join Date: Aug 2004
Location: Is crazy a location?
Posts: 2,775
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Whoh...not sure if I want to get into this discussion! I do agree that doctors often jump too quick and opt for a C-section, but I think it is out of fear most of the time. Have you heard about the declining rate of OB's because of the extreme cost of malpractice insurance? I do think that there is some power struggle between the doctors and the women, but things have improved in the past couple decades. I think some of the problems have been brought on by women. As others have mentioned, the frivilous lawsuits force the doctors to take extra percautions because they don't want to be sued. In other words, women are taking the power out of thier own hands and thrusting it in the doctors by sueing them for every little thing. Of course not all the lawsuits are unecessary, but people do need to learn to accept the fact that sometimes things do happen. There should also be some sort of permission thing that if a woman wishes to delay having a C section, she can not sue the doctor for not doing it anyway. In other words, a woman should not be able to sue if she asks the doctor to do something a certain way. A lawsuit should only be for outright doctor error or neglect (I know this is a tough one to decifer.).

Here is a story on the flip side of this discussion. I had a friend in college who was allowed to labor for hours and hours and hours in the hospital before they found out that her body structure was too small to vaginally deliver a baby. Someone finally measured her pelvic outlet and found that it was physically impossible for her to deliver without either braking her pelvis or having a C-section. Her story is worse than that, but I'll be brief. That was a case where the hospital was not cautious enough.

About big babies, my cousin has delivered two 10lb+ babies vaginally in the hospital. The first time they were going to do a C section, but she wouldn't let them. Everything went well, although it was a long labor. So I guess that some large babies are delivered vaginally.

Mom to two boys, ages 8 and 11, and one blessing due May 8th.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 baby.gif 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40

heldt123 is offline  
#16 of 64 Old 12-30-2004, 03:37 PM
 
Tanibani's Avatar
 
Join Date: Nov 2002
Location: Southern California
Posts: 3,052
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Banned. Outlawed. Same thing.

You are right, VBACs are discouraged, and you have to search high and low to find a hospital/OB that still want to perform them. That's going to be harder and harder for women : due to liability.

I was thinking of homebirth VBAC is now banned, which recently happened in the last 2 years here in SoCal. It is still allowed in some area hospitals, but that may change.

Quote:
With more than 300 hospitals in the United States banning normal/vaginal birth after cesarean (VBAC), a new study shows VBAC is safe and repeat cesarean poses serious risks, according to the National Institute of Child Health and Human Development. The study, published Dec. 16 in the New England Journal of Medicine, is the broadest and most comprehensive to date and confirms that VBAC is a safe and reasonable choice for women.
http://www.ican-online.org/

Quote:
Originally Posted by OnTheFence
Also, I am for women having choices. If they want epidurals and know the risks, then they should have them. They want Nubain to help them relax, fine, they should have it.
I completely agree. If a woman goes in wanting everything they offer fine. What I object to is things being heavily managed/pushed onto a woman, "here are 'the rules'..." So much for women having choices (which was Naomi's point, right?) The only way to get around it (if your heart is set on a natural birth in a hospital) is to find an OB who is "pro-natural."

Quote:
Originally Posted by OnTheFence
Not everyone is going to be drinking herbs and eating placentas, nor should I believe that should be the standard of care.
:LOL That's funny. Herbs? meds? you say tomato, I say tomatoe, I don't do either (I don't want Pitocin (just a chemical form of oxytocin/placenta anyway) after birth or eat my own placenta, thank you very much), so it doesn't matter to me. Then the whole other thread, if you care to start it, is what the standard of care should be.

Quote:
Originally Posted by onethefence
And BTW, I have read Naomi's book. I agree with portions of it, I disagree with others. And I am sure you know she had a failed VBAC, even after all her knowledge.
I had the same reaction to the book. Though again, her "failed VBAC" (poor woman, everyone telling her she's a failure) could have been due to any # of reasons (location of birth, her own anxiety, behavior of staff, presentation of baby, yada, yada, yada...)

Sorry for going I'll shut up now.

10 - boy
5.5 - girl
Tanibani is offline  
#17 of 64 Old 12-30-2004, 04:32 PM
 
crazy_eights's Avatar
 
Join Date: Nov 2001
Location: Nisht ahir un nish aher
Posts: 6,837
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by OnTheFence
While I will agree that some interventions can lead to csections, I have read several studies that have concluded that the use of epidurals given to a patient at 4-5cm is not an increased risk for a csection. In fact, on many occassions, giving an epidural actually helped labour, not hinder it, because the mother relaxed, etc. I have to say from personal experience with friends, this was the case. I believe from my research that the increased need for csections come about when labor is induced or augmented by pitocin -- which often leads to early epidurals.
Yes, but if you read those studies (and I haven't in a while), you have to accept that a 25% c/sec rate is NORMAL!!!! There are a few studies taht show that epidurals don't increase c/sec rates (there were I belive 4 studies that came to this conclusion and many others that did no) and they were poorly designed in the first place. AND THEY ALL HAD A HIGH C/SEC RATE! But the women in the non-epidural arm of the study had high rates as well.

They will admit that even when taken at 4 cms, ESP. IF IT IS YOUR FIRST BABY, epidurals increase vacuum and forcep deliveries and malpresentations. Well, having worked as an L&D nurse in several hospitals where epidurals are the norm (98-99% of all deliveries) I can tell you that malpresentation often equals c/sec. I tell people all the time, 'I don't think an epidural causes a problem if you in spontaneous labor with a second baby of average size in a good position for delivery at the time of epidural placement.' But how often is that not the case?

That being said, I think it is the whole 'OB package' that is causing the c/sec epidemic. The inductions, the routine interventions that have not been shown to have benefit, the epidurals. I'm in the hospital day in and out seeing it and I just have to shake my head in disbelief that this is considered 'normal' childbirth in America.
crazy_eights is offline  
#18 of 64 Old 12-30-2004, 04:37 PM
 
crazy_eights's Avatar
 
Join Date: Nov 2001
Location: Nisht ahir un nish aher
Posts: 6,837
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by heldt123
Here is a story on the flip side of this discussion. I had a friend in college who was allowed to labor for hours and hours and hours in the hospital before they found out that her body structure was too small to vaginally deliver a baby. Someone finally measured her pelvic outlet and found that it was physically impossible for her to deliver without either braking her pelvis or having a C-section. Her story is worse than that, but I'll be brief. That was a case where the hospital was not cautious enough.
I'm sorry, but your friend got fed a line. There IS NO accurate measurement that can determine what size a woman's pelvis is and what can pass through it! The pelvis is joined by cartiledge in a number of places that allows it to expand in labor. That is why there is an obstetric expression, 'The best pelivimeter is a baby's head' meaning there is no way to tell what will fit through a pelvis except a trial of labor. That is why pelvimetry (measuring a woman's pelvis) is rarely taught anymore, b/c essentially it is meaningless.
Quote:
Originally Posted by heldt123
About big babies, my cousin has delivered two 10lb+ babies vaginally in the hospital. The first time they were going to do a C section, but she wouldn't let them. Everything went well, although it was a long labor. So I guess that some large babies are delivered vaginally.
You bet they are, but rarely in the hospital. Often b/c larger babies are sometimes slow labors which 'fall of the labor curve' and OB's are afraid of delivering large babies, so they often convince them to c/sec at any sign of delay. Couple that with the epidural, pushing flat on your back bit and nope, most of them won't come out in the hospital. However, ask any homebirth midwife about the size of most babies they deliver. A 7-8 lb'er is generally SMALL for a homebirth MW and 10 and 11 lbs. babies not unusual.
crazy_eights is offline  
#19 of 64 Old 12-30-2004, 05:02 PM
 
natashaccat's Avatar
 
Join Date: Apr 2003
Location: -40 F
Posts: 3,335
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Tanibani
Kim, you are right, I am being overly dramatic. I think my statement should have said, "most likely lead her to have an unnecessary Csec."

I think for first time mothers, yeah, your chances ARE way higher of having an unnecessary Csection.

And I don't think being pumped/offered every available medication (without good reason) on a routine basis is "healthy." That's why we are moaning and groaning about the establishment.

The problem is (Naomi Wolf illustrated this) the whole hospital/medical model leans towards heavily managing birth. Most women (first timers) do not realize the extent OR exactly how it will affect their outcome. People are pretty naive the first time and end up learning the hard way (when things don't work out the way they envisioned.) They come out angry, sad, traumatized. Sometimes the baby feels that way too.

DH and I interviewed our first OB and asked him about his Csec rate. He couldn't (wouldn't) give us a percentage. So I chose another OB who was more "natural friendly." He let me be during labor and would only intervene/act if something was "wrong." I doubt most OBs are like that. Most want to help move things along. They are uncomfortable standing still and doing "nothing." (Liability fears no doubt.) I don't think it's because they want to leave earlier either.


Yeah, the establishment is the problem. It would be nice if it was spelled out in the front door. It's not.

My thoughts exactly....few first time moms have the education and experience to even know what questions to ask of an OB. As a first timer I thought that "conservative" and "closely monitored" were good things, like they would enhance my baby's safety. We all need to teach each other to value natural childbirth and find ways to educate first timers in how to have a successful natural birth.

IMO the medical community isn't going to change until we demand change. We need hospital birthing to take the best of MW care and put it into practice so that women aren't having to choose between having natural births and the safety net of immediate availability of emergency care in the rare case that it might be needed.
natashaccat is offline  
#20 of 64 Old 12-30-2004, 05:25 PM
 
Simply Nurtured's Avatar
 
Join Date: Nov 2004
Location: Massachusetts
Posts: 737
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I believe that only 2% of all births should end in c-section. If you read back through the history of pregnancy and birth, you will know that c-section was originally a method to save a live baby when a mother was dead or dying. It was not an alternative BIRTH choice.

Electronic Fetal Monitoring - external and internal, does not affect fetal outcome, however, it does drastically affect maternal outcome - much greater chance of a c-section.

Do I think some c-sections are necessary? ABSOLUTELY.

Do I think a rate of 30% is high? ABSOLUTELY.

The c-section rate increased after OBs seeing an opportunity for WEALTH, convinced the public that midwives were incompetent, and they should put themselves in the hands of the OBs.

Please read Gentle Birth Choices and watch the Gentle Birth Choices video to further educate yourselves and all who seek to learn the truth...
Simply Nurtured is offline  
#21 of 64 Old 12-30-2004, 05:48 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,747
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Tanibani
Banned. Outlawed. Same thing.

VBACs are not banned. Outlawed and banned do not mean the same things. I think you are being way over dramatic and I think its very unwise to spread these things and blow them out of proportion.
Right now there is a climate that does not support VBAC. This does not mean banned. At some hospitals, you can not have a VBAC. I wouldn't call this a ban. There is a catholic hospital here that doesnt do abortions or give patients birthcontrol and a few other things -- its not a ban, its just something they do not do.
Some hospitals do not do VBACs because of liability reasons. Like having the proper staff available for one. Plus there are lawsuits. Hospitals, while the majority do not turn profits, do try to protect their financial interests. If they don't, the cost is passed on to consumers.
Its not illegal to have a VBAC. Its not banned. It may be hard in the current climate of obstetrics to get one, but with determination it is still possible.
OnTheFence is offline  
#22 of 64 Old 12-30-2004, 06:01 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,747
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Simply Nurtured
I believe that only 2% of all births should end in c-section. If you read back through the history of pregnancy and birth, you will know that c-section was originally a method to save a live baby when a mother was dead or dying. It was not an alternative BIRTH choice.

Electronic Fetal Monitoring - external and internal, does not affect fetal outcome, however, it does drastically affect maternal outcome - much greater chance of a c-section.

Do I think some c-sections are necessary? ABSOLUTELY.

Do I think a rate of 30% is high? ABSOLUTELY.

The c-section rate increased after OBs seeing an opportunity for WEALTH, convinced the public that midwives were incompetent, and they should put themselves in the hands of the OBs.

Please read Gentle Birth Choices and watch the Gentle Birth Choices video to further educate yourselves and all who seek to learn the truth...
You will never convince me that the csection rate should be 2%. Never. In fact I think its ludicrous to suggest it. With the amount of birth defects we have each year, PE, and other health related problems for indication of a csection, you would be well over 2%. (and breech presentation is one -- and yes I have read all about Ina May and breech vaginal births)
I hope it never returns to the days of old when a woman had to be dead to get her belly cut to save her child. I wouldnt have my children if it weren't for csections. They would die first or we both would after my uterus ruptured.
You are never going to convince me that OBs see csections as a sign of wealth and that is why they have increased. There is nothing factual to support this. I think its a more educated guess, based on the current "sue sue sue" mentality that has created higher rates of csections.

Its amazing too how someone will say seek the truth seek the truth -- well I have read things from both sides of the fence, I fall somewhere in the middle of those beliefs. I do know that part of the problem is that those who are too far too the left are not easy to listen too when they over dramatize and misconstrue something into something its not. Stick to the facts. The ones that can be backed up, not conjecture.
OnTheFence is offline  
#23 of 64 Old 12-30-2004, 06:42 PM
 
crazy_eights's Avatar
 
Join Date: Nov 2001
Location: Nisht ahir un nish aher
Posts: 6,837
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by OnTheFence
VBACs are not banned.
Actually, in a large number of hospitals they are. Banned by hospital protocol in many places or the fact that the OB will be dropped from his malpractice insurance carrier if he provides for women to labor after a prior c/sec. Not an option is not an option regardless of how it comes about.

I have read that 5% is a realistic target for c/sec rate and that seems to be resonable based on my experience of what percentage are 'high risk' and what percentage are either 'Failure to Progress' or 'elective'. I believe that the Farm has an under 2% rate.

Oh, and I don't even believe that most c/sec's are b/c of a 'sue sue sue' mentality, but are a product of OB training. They rarely see 'normal' birth as in 'spontaneous, unmanaged labor', so they haven't a clue how that would be accomplished, they generally see their interventions as benign, and they are trained 'when x happens = c/sec' rather than trying other things.
crazy_eights is offline  
#24 of 64 Old 12-30-2004, 07:32 PM
 
Simply Nurtured's Avatar
 
Join Date: Nov 2004
Location: Massachusetts
Posts: 737
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Kim,

I am sorry if what I wrote upset you, it was not my intention, I would never want to do that.



I am so glad that you have your babies and that you are ok. I had hospital births without interventions, and I know I am very fortunate. I also have friends who had to have a necessary c-section to save their life, and I am so very glad for the surgery to be used in this way.

I would never suggest going back to using c-section for it's original purpose.

What I am trying to help change is the unnecessary ones, the ones that are being caused by what is called the "cascade effect".

I have studied extensively about this subject. Before 1970, the c-section rate in North America was 5% or less.

As Marsden Wagner has said, we have the highly trained obstetricians for complications, "Thank God" (he said this in Gentle Birth Choices) but the problem is that we have lost the balance, and healthy pregnancies are treated the same as the ones with complications.

This part of why I wanted to serve birthing women and their families, so that they would have support for THEIR choices. So many birthing women are not allowed their own voice......

Please accept my sincere apology if I upset you.....


I have included some links, I hope they help. They give all of the information that I spoke of.

http://www.todaysparent.com/askus/ar...sp?content=903

http://www.midwiferytoday.com/articl...nformation.asp

http://www.midwiferytoday.com/articl...ogyinbirth.asp

http://www.amazon.com/exec/obidos/tg...76027?v=glance

http://www.abqjournal.com/paperboy/i...-03-04.htm?rrc

http://www.midwiferytoday.com/articles/vbacprimer.asp

http://www.amazon.com/exec/obidos/tg...76027?v=glance

You can find most of the history in the book Silent Knife.
Simply Nurtured is offline  
#25 of 64 Old 12-30-2004, 07:56 PM
 
luvmylittleman's Avatar
 
Join Date: Jun 2004
Posts: 62
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
It does help to find a pro- natural OB, but sometimes women get lip sevice until the end of pregnancy. So how do women get information?

I do think a majority of OB's sincerely have the best interest of the patient in mind. I do not think a majority of OB's decide on c-sections based on money either. (It may figure into a hospital's bottom line though) Also, many believe what has been accepted practice for a long time but not all practice is supported by facts (studies). How do women know what is best for the baby or themselves? I do not know of a lot of women that will pour through medical research.

Just a little story- knew of MD who had very high c-section rate, induced almost all patients, and preferred small babies (under 7lbs). Some babies wound up in neonatal ICU, but a large majority of moms loved the MD. They mostly felt that this doc saved the babies.


Here are some interesting websites (no, not mine), very interesting info on FDA and OB drugs, checking the background of docs,what informed consent is:
http://www.nwhalliance.org/improving_patient_safety.htm
http://www.nwhalliance.org/pregnancy.htm
luvmylittleman is offline  
#26 of 64 Old 12-30-2004, 08:04 PM
 
Simply Nurtured's Avatar
 
Join Date: Nov 2004
Location: Massachusetts
Posts: 737
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
That is good info, luvmylittleman.

http://www.motherfriendly.org/

Another good link~

And it is true, many people don't get enough support, or the doctors tell them what they want to hear, right up to the end.

I cannot discuss it on here, but I personally know doctors who do exactly that........

I know one doctor who has a c-section of 75-80%, he starts convincing his "patients" to induce at 34 weeks, pressuring them, convincing them that the baby will be too big, then once they have been induced he convinces them that their body is incapable of birthing their baby and he must rescue them. He takes a lot of welfare patients who have little choice but to go along with him. It is so shameful.....
Simply Nurtured is offline  
#27 of 64 Old 12-30-2004, 08:42 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,747
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Simply Nurtured
I know one doctor who has a c-section of 75-80%, he starts convincing his "patients" to induce at 34 weeks, pressuring them, convincing them that the baby will be too big, then once they have been induced he convinces them that their body is incapable of birthing their baby and he must rescue them. He takes a lot of welfare patients who have little choice but to go along with him. It is so shameful.....
I find this really shocking since the two most recent OBs I have seen have told me that they cannot do inductions until 39 weeks per their malpractice insurance guidelines unless there is clear documentation of a medical problem. I had a uterine anomaly and it wasn't "good enough" to schedule a csection at 38 weeks. It wasn't until I developed PE that she was allowed to do one before the 39 week mark. When I asked about how this had come about, she said from lawsuits for delivering babies to early that died or had breathing complications.
OnTheFence is offline  
#28 of 64 Old 12-30-2004, 08:45 PM
 
Simply Nurtured's Avatar
 
Join Date: Nov 2004
Location: Massachusetts
Posts: 737
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
It was shocking to me too, when we all started to see a pattern with him.......

Things are not always as they seem, and I have had my eyes opened more than once. Unfortunately. I did not want to know. I wanted to look the other way. He has lost privilages at several hospitals once they started seeing the pattern.
Simply Nurtured is offline  
#29 of 64 Old 12-30-2004, 09:27 PM
 
flminivanmama's Avatar
 
Join Date: Nov 2001
Location: Sunny South Florida
Posts: 7,090
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by OnTheFence

The above statement is false. You are making it sound as if going to a hospital to have a baby will most likely lead you to have a Csec. Most likely??? Ok, lets break it down here realisticly and not use over dramatization here --I am sure you hate it when people classify homebirth in such a way. The majority of births are vaginal births. Now if we had a csection rate of 74% then yes, I could see how your statement could be realistic, but its not.

Here in Florida there are quite a few hospitals whose c-section rates are over 50%.
Jackson Memorial in Miami is 54% and Lawnwood Regional which is by me on the treasure coast (where the hurricanes hit this summer LOL) is 53% - just to name two. So that's what I would consider a majority LOL

In my county and the surrounding area one can absolutely NOT find a doctor who will preform a VBAC. they all refuse. I am not making a generalization, I am making a statement of fact.

In the south part of the state there are some but they are few and far between.

There are two homebirth midwives in my area - one will not do VBACs and one will only do a VBAC if you already had one previously.

still reading the thread but I just wanted to comment on the "majority ofbirth by c-section thing"

not saying it's the majoritybut it's surely getting there... heck in NJ the c-section rate was 30% last year

I'm Andrea - I have three boys - 12 year old twins & an 11 year old

flminivanmama is offline  
#30 of 64 Old 12-30-2004, 09:44 PM
 
flminivanmama's Avatar
 
Join Date: Nov 2001
Location: Sunny South Florida
Posts: 7,090
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Simply Nurtured
I believe that only 2% of all births should end in c-section. If you read back through the history of pregnancy and birth, you will know that c-section was originally a method to save a live baby when a mother was dead or dying. It was not an alternative BIRTH choice.
well I hope we never go back to THAT either LOL. I wasn't dead or dying when I had my c-section - but if I hadn't had one my 29 week double footling breech twin B would have either been born dead or mentally retarded as a result of being severly O2 deprived... so I'm glad for MY c-section.

what bothers ME personally is the fact that one c-section in this birthing atmosphere we have means you are virtually guarenteed another - especially if you use an OB and a hospital. and if you do want a VBAC you have to fight tooth and nail to have one.

people I know here near me that want VBACs have basically 3 choices - unassisted birth, wait to go in till the baby is crowning LOL, or go down to south florida to have their baby at a birth center there (good 2 hour drive). Those don't really all sound like great choices to me - well maybe UC LOL... but seriously - if you are doing UC b/c you have no other options? how is that right?

I'm Andrea - I have three boys - 12 year old twins & an 11 year old

flminivanmama is offline  
Reply

Quick Reply
Message:
Drag and Drop File Upload
Drag files here to attach!
Upload Progress: 0
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off