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What did they do before c-sections?

18K views 103 replies 40 participants last post by  Drummer's Wife 
#1 ·
A friend and I were talking today. She didn't progress with her first child and had a c-section. THe dr told her that her pelvis is too small. And she asked me what would they have done before c-sections. Would she have just died. I don't know the answer to that.

What about breech babies? Why do dr's not want to deliver breech babies? Even my midwife goes to the hospital for a section for breeches. If I were to have another baby I wouldn't want to have a c-section just because the baby is breech.

So what did they used to do? Anyone know?
 
#77 ·
off topic a little, but I once got in an argument, er. . .discussion, on some mainstream boards and when I said that 90% of women can have normal pregnancies/births one woman responded with "That's not true because I have complicated pregnancies"
I was so thrown off by her lack of logic I failed to respond.
 
#78 ·
Quote:

Originally Posted by Synchro246
The world health organization says that 90% of deliveries can happen normally at home and have good outcomes. I don't know if they mean that the remaining 10% require surgery or just medical care of some kind.
I'm not sure how they can make that calculation, when so many births in Western countries receive medical intervention whether it is needed or not. We have no way of knowing how many of those births would have required medical help. It sounds likely to be true, on an instinctual level, but I personally doubt the statistical validity of it.
 
#79 ·
When pregnant I read one of Ina May Gaskins' books, don't remember the exact title but it spoke a lot about "The Farm"...There (a place with talented midwives where women would come from nation-wide and around the world to get the natural births they wanted) they had something crazy like a .2% section rate (could have been 2%, but I really think it was .2...)

I highly recomend the read if anyone's interested.
 
#81 ·
It's true that almost none of those women have preeclampsia or gestational diabetes, but that's partly due to the care they receive. They follow a good diet. When's the last time you heard of an OB giving good nutritional advice? I suggest that just by going to an OB a woman is increasing her risk of developing such complications. Getting good care keeps 90% of women in the normal category.

They have breech babies and twins vaginally on the farm.

I think the WHO has access to all kinds of data. They tell how they gather the data. They even look at the rates of certain "causes" for cesarean- like preeclampsia. They use the discrepency to evaluate what an acheivable rate of such diseases could be and they calculate those into their estimation. Some rates of certain abnormalities are fairly consistant the world over- although some must be controled for race for the consistancy to be seen. I think estimating the acheiveable rate of normal pregnancy is quite possible with the right data and the right minds doing the work. It wouldn't be easy, and there would be a good margin of error (esp. since there is no way to implement good sources of food and care everywhere), but it's possible.

Here is a link to some relavant http://www.who.int/reproductive-health/MNBH/index.htm WHO stuff. Browse around- you can read their methodology for yourself. Here is another pertinant link http://www.who.int/reproductive-heal...mortality.html
 
#82 ·
Quote:

Originally Posted by Synchro246
I think the WHO has access to all kinds of data. They tell how they gather the data. They even look at the rates of certain "causes" for cesarean- like preeclampsia. They use the discrepency to evaluate what an acheivable rate of such diseases could be and they calculate those into their estimation. Some rates of certain abnormalities are fairly consistant the world over- although some must be controled for race for the consistancy to be seen. I think estimating the acheiveable rate of normal pregnancy is quite possible with the right data and the right minds doing the work. It wouldn't be easy, and there would be a good margin of error (esp. since there is no way to implement good sources of food and care everywhere), but it's possible.
It would probably be far more accurate if doctors were honest about the causes of cesarean. In both my cases, my docs just had to pick something to write down--they had no real diagnosis for why my babies didn't come out. I gather this is quite common. Besides which, diagnoses like CPD and FTP are often just plain bull-hockey. I've got to think that skews the statistics.

As a side note, can you imagine if they were honest about the causes of c-sections? They'd sometimes be writing down things like "golf date" and "doctor incompetence."


Quote:
Here is a link to some relavant http://www.who.int/reproductive-health/MNBH/index.htm WHO stuff. Browse around- you can read their methodology for yourself. Here is another pertinant link http://www.who.int/reproductive-heal...mortality.html
Thanks! I'll check it out.
 
#83 ·
From WHO- underlines are mine
"According to ICD-10, maternal deaths should be divided into two groups:

Direct obstetric deaths are those resulting from obstetric complications of the pregnant state (pregnancy, labour and the puerperium), from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the above.

Indirect obstetric deaths are those resulting from previous existing disease or disease that developed during pregnancy and which was not due to direct obstetric causes, but was aggravated by physiologic effects of pregnancy.

The drawback of this definition is that maternal deaths can escape being so classified because the precise cause of death cannot be given even though the fact of the woman having been pregnant is known. Such under-registration is frequent in both developing and developed countries."

I think it's sad/funny that WHO acknowledges it. Direct obstetric deaths
 
#85 ·
I think one of the biggest issues in the c-section epidemic today (that did not exist way back when) is the approx. 85% of all laboring women who get epidurals/narcotics and therefore are choosing to labor in bed on their backs. It never ceases to amaze me that ANY baby can descend while mom is flat on her back for most of the labor.

NOTE: I am usually a thread-killer.
 
#87 ·
Quote:

Originally Posted by erin_brycesmom
eirual, keep in mind that the woman who want to give birth at the farm do not have known high risk problems. So that would skew normal c-section rates.
Actually, that's not exactly true. Firstly, they give prenatal care to all the women who live at the farm. They also have a lot of Amish women that get care with them, first time moms and for a long time they had a program where they would take in women off the street to have their babies. Anyone who got prenatal care with them is included in their stats whether they are refered to the hospital or MD care.
 
#88 ·
Quote:

Originally Posted by mom2seven
Actually, that's not exactly true. Firstly, they give prenatal care to all the women who live at the farm. They also have a lot of Amish women that get care with them, first time moms and for a long time they had a program where they would take in women off the street to have their babies. Anyone who got prenatal care with them is included in their stats whether they are refered to the hospital or MD care.
Yes, but not entirely true. they also except women last minute who have breech babies. I was given the choice with dd of flying out there, but it wasn't feasable.
 
#89 ·
Quote:

Originally Posted by Leilalu
Yes, but not entirely true. they also except women last minute who have breech babies.
Are you saying they except those women, as in leave them out of the statistics? ('cause that would be false.)

Or do you mean that they accept these women despite/because of knowing baby is breech?

I'm promise I'm not being snarky or part of the grammar police, just trying to understand what you mean. Thanks.
 
#90 ·
Quote:

Originally Posted by erin_brycesmom
eirual, keep in mind that the woman who want to give birth at the farm do not have known high risk problems. So that would skew normal c-section rates.
I'm sure it would skew them to some extent...but not near enough to account for the difference between 0.2% and 30%!

I wish I'd known about and had a way to get to the Farm when I was pregnant with ds1 back in '93...of course, I didn't know he was going to turn breech when I went into labour, so I don't think I'd have gone that route. My doctor (not an OB) certainly didn't have any concerns about my ability to give birth vaginally.
 
#91 ·
Quote:

Originally Posted by Rico'sAlice
Are you saying they except those women, as in leave them out of the statistics? ('cause that would be false.)

Or do you mean that they accept these women despite/because of knowing baby is breech?

I'm promise I'm not being snarky or part of the grammar police, just trying to understand what you mean. Thanks.
oops, sorry!
I need a nap!
I meant ACCEPT
 
#92 ·
mom2seven - What I mean is who is going to go to the Farm with a known serious high risk pregnancy? Sure there are going to also be some people who start at the Farm end up risking out, but there are many women who are already aware from a previous situation that they are high risk and would know they couldn't go to the Farm to start with.

I'm sure it would skew them to some extent...but not near enough to account for the difference between 0.2% and 30%!

Storm Bride, I agree fully! I just wanted to point out that the Farm isn't exactly a true representative of all situations that may require c-section. Of course you have a much better chance of not "needing" a c-section when you are at the Farm or even anywhere out of a hospital. The c-sec rates in the US make me sick to my stomach.

I seriously considered trying to go to the Farm when ds#2 was breech at 39 weeks but thankfully diligence with my chiro for Webster paid off and he flipped.
 
#94 ·
Quote:

Originally Posted by caned & able
NO one has mentioned the 1978 study done in Northern CA
You mean the Mehl study? I can't find it linked anywhere, but here is a summary:

Quote:
Mehl, L., Peterson, G., Shaw, N.S., Creavy, D. (1978) "Outcomes of 1146 elective home births: a series of 1146 cases." J Repro Med.
19:281-90
Neonatal Outcomes:

* In the hospital, 3.7 times as many babies required resuscitation.
* Infection rates of newborns were 4 times higher in the hospital.
* There was 2.5 times as many cases of meconium aspiration pneumonia in the hospital group.
* There were 6 cases of neonatal lungwater syndrome in the hospital and none at home.
* There were 30 birth injuries (mostly due to forceps) in the hospital group, and none at home.
* The incidence of respiratory distress among newborns was 17 times greater in the hospital than in the home.
* While neonatal and perinatal death rates were statistically the same for both groups, Apgar scores (a measure of physical well being of the newborn) were significantly worse in the hospital.
 
#96 ·
There was a more recent study (which of course I can't find the citation for -- somewhere in my syllabus from the last conference) that looked at planned home birth in Washington and planned hospital births and found equivalent outcomes, with decreased infant mortality for the home birth group.
 
#97 ·
Quote:

Originally Posted by maxmama
There was a more recent study (which of course I can't find the citation for -- somewhere in my syllabus from the last conference) that looked at planned home birth in Washington and planned hospital births and found equivalent outcomes, with decreased infant mortality for the home birth group.
I think you mean the CPM study that was written up in the BMJ. However, mortality was the same as similar groups of babies born to low-risk hospital women, but morbidity (injury) was much lower in both mother and baby.
 
#98 ·
Quote:

Originally Posted by erin_brycesmom
I seriously considered trying to go to the Farm when ds#2 was breech at 39 weeks but thankfully diligence with my chiro for Webster paid off and he flipped.
I wish I'd known about the farm...or the Webster technique...when dd was breech at 39 weeks. I don't think my first c-section was necessary, but looking back, I'm still not sure how I could have avoided it...
 
#99 ·
Quote:

Originally Posted by mom2seven
I think you mean the CPM study that was written up in the BMJ. However, mortality was the same as similar groups of babies born to low-risk hospital women, but morbidity (injury) was much lower in both mother and baby.
Wooooo Hoooo CPM2000! I heard a group of midwives in a state where midwifery is alegal/illegal went to the legislators saying "the safety of homebirth is established. . . what are you going to do about it" essentially. No more arguing that homebirth is safer(with random people), it just is. I can't believe in a free country that there are states where midwifery is still illegal. There's no excuse now. I might have to go start an activism thread.
 
#100 ·
After reading this thread, I got out my copy of "Ina May's Guide to Childbirth" and went to the stats page. I don't have it in front of me, so I can't directly quote. But the C-section rate for The Farm, between 1970 & 2000, is only 1.4%.

At the bottom of the page, she writes something like (again, not an exact quote): Our statistics are different from birth centers, because birth centers normally "risk out" twins, breech births, ect. Our statistics reflect every woman who received prenatal care at The Farm, regardless whether they planned a birth at The Farm with a midwife, or with a doctor at the hospital near The Farm.
 
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