What did they do before c-sections? - Mothering Forums

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#1 of 104 Old 04-25-2006, 07:05 PM - Thread Starter
 
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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?

Serenity LDS mommy to 4 rambunctious kidlets
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#2 of 104 Old 04-25-2006, 07:13 PM
 
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Breech babies were delivered vaginally. Often, breech wasn't diagnosed until baby's feet or buttocks appeared. Though vaginal breech birth has risks, the risks for cesearean section are much greater.

Before c-sections, there also weren't epidurals or inductions, so many women went into labor when they were ready and were able to be mobile so as to facilitate rather than hinder birth.

That being said, sometimes mothers did die in childbirth. Sometimes mothers still die in childbirth.
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#3 of 104 Old 04-25-2006, 07:18 PM
 
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Well, her doctor was most likely lying. CPD is very very very rare. And yes, in those REAL cases, the mother died. Breech babies were born vaginally (like they should be). Babies died, but it had more to do with nutrional problems, bad sanitation, too young of women having babies, and messed up bones (corsetting).

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#4 of 104 Old 04-25-2006, 08:28 PM
 
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Kmom gives revealing definitions of failure to progress & CPD at her site PlusSizePregnancy:

Failure to Progress (FTP) - also known as labor dystocia. This occurs when labor deviates from a normal or average pattern of labor, but is strongly subjective and differs greatly from one provider to the next. Midwives often call this "Failure to Wait" by the physician, since it can result from an impatient doctor or one who does not recognize that labors that deviate from the 'normal' labor are not necessarily pathological. Just what constitutes a normal labor and an abnormal labor that needs intervention is highly controversial and will differ significantly from provider to provider. True FTP can occur, of course, but it is difficult to separate out the cases that are caused by obstetric mismanagement vs. naturally-occuring cases. Common in induced labors.

Cephalopelvic Disproportion (CPD)- a baby that is 'too big' for the mother's pelvis. This is a catch-all phrase that doesn't have a lot of meaning; the baby's presentation and position usually has more to do with CPD than the actual size of the baby. An 8 lb. baby that is malpresenting, for example, is likely to get stuck, whereas a 9+ lb. baby that is perfectly positioned and where the mother gets to use optimal delivery positions is likely to come right out. Many women who are given a c-section for CPD and told that their pelvises are 'too small' actually go on to later deliver a baby vaginally that is much bigger. The presentation/lie of the baby, maternal positioning, and forcing labor unnaturally are the keys in many cases. True CPD can occur, but is usually seen in mothers who have had pelvic injury or disease, had rickets, or who were chronically malnourished as children, although it is possible occasionally in normal circumstances too. CPD is most often actually a case of cephalopelvic malpresentation or 'failure to wait' by the physician, but this is often overlooked as a cause.


In the old days there was no "active management of labor" i.e. time limits. There was no one waiting for you to pass the allowed time limit with a scalpel in hand telling you your body couldn't birth.
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#5 of 104 Old 04-25-2006, 08:34 PM
 
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Quote:
Originally Posted by velcromom
Kmom gives a definition of failure to progress & CPD at her site PlusSizePregnancy:

Failure to Progress (FTP) - also known as labor dystocia. This occurs when labor deviates from a normal or average pattern of labor, but is strongly subjective and differs greatly from one provider to the next. Midwives often call this "Failure to Wait" by the physician, since it can result from an impatient doctor or one who does not recognize that labors that deviate from the 'normal' labor are not necessarily pathological. Just what constitutes a normal labor and an abnormal labor that needs intervention is highly controversial and will differ significantly from provider to provider. True FTP can occur, of course, but it is difficult to separate out the cases that are caused by obstetric mismanagement vs. naturally-occuring cases. Common in induced labors.

Cephalopelvic Disproportion (CPD)- a baby that is 'too big' for the mother's pelvis. This is a catch-all phrase that doesn't have a lot of meaning; the baby's presentation and position usually has more to do with CPD than the actual size of the baby. An 8 lb. baby that is malpresenting, for example, is likely to get stuck, whereas a 9+ lb. baby that is perfectly positioned and where the mother gets to use optimal delivery positions is likely to come right out. Many women who are given a c-section for CPD and told that their pelvises are 'too small' actually go on to later deliver a baby vaginally that is much bigger. The presentation/lie of the baby, maternal positioning, and forcing labor unnaturally are the keys in many cases. True CPD can occur, but is usually seen in mothers who have had pelvic injury or disease, had rickets, or who were chronically malnourished as children, although it is possible occasionally in normal circumstances too. CPD is most often actually a case of cephalopelvic malpresentation or 'failure to wait' by the physician, but this is often overlooked as a cause.
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#6 of 104 Old 04-25-2006, 08:34 PM
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First of all, getting off of your back and onto a squatting position will open up the pelvic area 42% larger than being on your back. So, "too small" depends on which position you are in.

In the extremely rare case of ACTUALLY being too small, the baby might die (after two or three days of labor) and then could be passed......because dead babies are smaller than live babies.

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#7 of 104 Old 04-25-2006, 09:35 PM
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Why are dead babies smaller than live ones?

I know that in some cases, doctors used to section fetuses (cut them apart with a scalpel) when labor failed to progress for a very, very long time. This killed the baby, if it hadn't died already, and was very dangerous for the mother. This is one of the reasons that women were extremely unwilling to allow doctors into the delivery room in the 18th century, even though some doctors offered laudanum for pain relief. WOmen associated the presence of a doctor during labor with almost-certain death. Doctors weren't welcome until some time after the invention of forceps (I can't remember the date for that).
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#8 of 104 Old 04-25-2006, 10:57 PM
 
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Quote:
Originally Posted by velcromom
Midwives often call this "Failure to Wait" by the physician, since it can result from an impatient doctor or one who does not recognize that labors that deviate from the 'normal' labor are not necessarily pathological. Just what constitutes a normal labor and an abnormal labor that needs intervention is highly controversial and will differ significantly from provider to provider. True FTP can occur, of course, but it is difficult to separate out the cases that are caused by obstetric mismanagement vs. naturally-occuring cases. Common in induced labors.
My first instinct was to laugh, but actually this is not funny at all. If anything results in a c-section more often than an impatient OB, I don't know what it is.
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#9 of 104 Old 04-25-2006, 11:51 PM
 
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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.
Nope, she wouldn't have died....she probably would have delivered vaginally. Check out the statistics. If you have a birth in a hospital with an OB you are way more likely to have a c-section. And most likely the dr is going to tell you there was a some reason for it afterwards...to cover his own behind. Women who birth at home with a midwife rarely have this problem.

Also for breech, the really really sad thing is that we have grown to rely on technology to solve the problem. Yes many were delivered breech, but there is a greater risk there. Still very possible in many cases though. BUT...there is a really really highly successful way to turn a breech baby that is not advocated enough...WEBSTER through a chiro. My OB was totally ingorant to this techinque when my ds was breech at 37 weeks. SO many people are unaware. Sorry to rant...just taking this opportunity to spread the word as much as I can.
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#10 of 104 Old 04-26-2006, 06:27 PM
 
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Well i didnt read every bit of this thread, but no, she most likely wounldnt have died. In almost all cases of that the baby and or mom are having positioning problems. Most cases you can get baby to turn and have a problem free vag delivery. In the extreamly rare case that baby really didnt fit, one or both probably would have died.

breach babies were delivered normally, most situations ended just fine. Of coarse there are sometimes situations that do require a c/s for a healthy outcome, we cant deny that and in those cases death would have been likely, many cases of true placenta previa would be one of those times.

Death rates of both mom and baby were higher before c/s but there are many other factors that most likely played a part in that as well.

I dont know of all the offical numbers and statistics, mostly because you have to be really careful where you get that kind of info and who cam e up with it, but I know in my state from the info I have gathered, about 1 percent of c/s PERFORMED are nessasary. And we have about a 34 percent c/s rate statewide. So that comes to be about 1 in 300 births should end in c/s not 1 in 3!!!!

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#11 of 104 Old 04-26-2006, 07:04 PM
 
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Safety of breech birth has more to do with caregiver competence rather than breech birth being inherently dangerous. I have given birth to a breech baby, I spent 10 weeks preparing for her birth. There are cases where turning the babe is not an option (pm me for long version).

There are no guarantees that your friend would/wouldn't have died in her circumstances. Definitely a certain percentage of births will benefit from cesarean birth, unfortunately birth politics and $$ seem to get in the way of true statistics.

Education and support go a long way toward having a normal labor/birth. Unfortunately we live in a society that depends on experts to tell us what to think and do. Yet when the experts make a mistake our courts fill with lawsuits from the very people that didn't take responsibility in the first place.
I am fortunate that I was raised to question experts and research my decisions. I am prepared to take full responsibility for my decisions.

You may want to gently introduce your friend to books/websites that will educate and inform her for future childbirth choices.

Best wishes,
Sarah
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#12 of 104 Old 04-26-2006, 10:11 PM
 
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That "pelvis too small" thing really grates my nerves!
I actually DO have a small pelvis. I have pituitary dwarfism and puberty had to be chemically induced when I was 14 years old when it was discovered that I had stopped all growth and development at around 8 years old. Because of this completely unnaturally puberty, I ended up with weird growth patterns and a lot of hormonal problems. For one, I never developed hips. My pelvis literally didn't change shape. I started my period and my breasts started growing but otherwise I had no puberty-related growth. Not even my facial bones changed shape (normal for puberty) so I tend to have this very child-like look to me and get mistaken for a very young teenager.

Can I deliver vaginally?
HELL YES!

And I have. I will again, too.
Your pelvis opens during delivery, different positions change its size and shape, and there are all sorts of variables.

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#13 of 104 Old 04-26-2006, 10:32 PM
 
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I think its a misnomer to think that all breech babies were born vaginally and alive. Some did die, some died being born vaginally, and some got hung and the mother got her bottom butchered. Its easy in a an era of time where we do have medical intervention to say how wrong it is.

I had a transverse breech baby, I can tell you for certain that I would have never delivered my baby vaginally. What would have happened is my baby would have died probably due to a failing placenta or had my water broke, died from prolapse cord. I would have probably died too, because my uterus is deformed and there is no way a baby was coming out unless it was grossly premature.

I just hope women don't use the past as a judgement on what is happening to women in the future. I don't believe we have real accurate statistics or outcomes for what really did happen. Also, we have less skilled professionals when it comes to delivering breech babies vaginally today.
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There is more risk in vaginal breech birth- not only with how the legs are positioned (can increase or decrease risk of prolapse cord), but with the positioning of the head too. Thankfully, MOST breech babies are in relativly good positions for vaginal birth. I wouldn't think the ratio of positioning has changed that much over the past 1000 years. Although, I did have a prof. of A&P who insisted that before chairs and things of that kind humans had much better movement and posture, which would have at least a little to do with positioning.
Most breech babies were delivered vaginally right up to the 1970's- this was long after the advent of the Cesarean section.

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#15 of 104 Old 04-26-2006, 11:59 PM
 
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Well, for me, I will never really know if I could've delivered vaginally or not.

dd had not started labor AT ALL, at 44 weeks. Yes, the dates were correct. Nothing done to my body started labor. And I did everything! Many times!

So, who knows what would have happened. Yes, I know the statistics, asnd I know homebirth is the way to go. I guess I am just happy we have medical intevention avilable for the real cases in which it can really be helpful.

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#16 of 104 Old 04-27-2006, 12:01 AM
 
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Both my mother and my uncle were vaginal frank breeches. One full term, one preemie. Back then no one considered doing it any other way, nor did they even talk about "how risky" it was and how the baby "could die".

But when I had a frank breech?
"Do you want your baby to die? Do you, do you!? Have a c-section!"

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#17 of 104 Old 04-27-2006, 12:02 AM
 
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Originally Posted by Leilalu
Well, for me, I will never really know if I could've delivered vaginally or not.

dd had not started labor AT ALL, at 44 weeks. Yes, the dates were correct. Nothing done to my body started labor. And I did everything! Many times!

So, who knows what would have happened. Yes, I know the statistics, asnd I know homebirth is the way to go. I guess I am just happy we have medical intevention avilable for the real cases in which it can really be helpful.
A friend of mine just went 45.5 weeks UC. She had absolutely zero labour symptoms at 44 weeks, too. That's just how long her baby needed to be in there.

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#18 of 104 Old 04-27-2006, 12:03 AM
 
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Well, I would've surely died. I was breech and had the cord wraped around my neck at birth, several times. my mom did not die, and I did not die.

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My mom had me at just past 44 weeks

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#20 of 104 Old 04-27-2006, 12:04 AM
 
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Originally Posted by littleteapot
A friend of mine just went 45.5 weeks UC. She had absolutely zero labour symptoms at 44 weeks, too. That's just how long her baby needed to be in there.
iI can understand that. but I am talking about my personal situation. I had a choice to make, adn it was a scary one.

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#21 of 104 Old 04-27-2006, 12:10 AM
 
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Originally Posted by Leilalu
Well, I would've surely died. I was breech and had the cord wraped around my neck at birth, several times. my mom did not die, and I did not die.
Cord around the neck does not strangle a baby, it's a very safe place for the cord, and is incredibly common. I had my own cord around my neck twice and my entire body (crotch to shoulder) once. My daughter had hers around her neck, too. In fact almost everyone I know had a cord around the neck... is the only reason for death the breech thing?

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#22 of 104 Old 04-27-2006, 12:37 AM
 
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My mom was in HARD labor at least 2 days. I was NOT coming out. Why so quick to judge? I have done my reasearch, I know all about the statistics, etc etc. No, breech is/was not the only concern

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#23 of 104 Old 04-27-2006, 12:39 AM
 
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Quote:
Originally Posted by Leilalu
My mom was in HARD labor at least 2 days. I was NOT coming out. Why so quick to judge? I have done my reasearch, I know all about the statistics, etc etc. No, breech is/was not the only concern
I'm not judging, I'm asking... because that's confusing to me. Cord around the neck isn't deadly, so I couldn't figure out why it meant you would have died. Although lots of women mistakenly do believe that it is deadly because they think of fetal necks the same way as adult necks.
(For the record, I'm not speaking out of ignorance or lack of experience either. I was in hard labour for 44 hours as well)

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#24 of 104 Old 04-27-2006, 01:56 AM
 
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Originally Posted by littleteapot
I'm not judging, I'm asking... because that's confusing to me. Cord around the neck isn't deadly, so I couldn't figure out why it meant you would have died. Although lots of women mistakenly do believe that it is deadly because they think of fetal necks the same way as adult necks.
(For the record, I'm not speaking out of ignorance or lack of experience either. I was in hard labour for 44 hours as well)
Well, I guess I should really say I am not sure. That's just the thing with birth, it is mysterious and wild. One never knows what will happen. But to say that someone cannot die from the cord being wrapped around, well, that is just not for you to say. At the hands of an unskilled country doctor, maybe death was immenant.All throughout history select women have died in childbirth for one reason or another, or their children. Some women are not so lucky.My grandmother died in childbirth with her 15th child, because of a strawberry tumor on her brain. Totally irrelevant to the situation.

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#25 of 104 Old 04-27-2006, 08:59 AM
 
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The thing about a modern c-section is that it's a birth choice. What I mean by that is that, a c-section is the choice when the risks of vaginal birth are too great--either from the mom's perspective, or (more often, sadly) from the doctor's. I think this accounts for nearly all the c-sections that occur. Yes--it is possible to birth breech babies vaginally in many cases. But for some women, the risk of things going wrong is too great. It comes down to the balance between the risk of each choice.

I'll elaborate: My grandmother, who was a tiny little woman, under 5 feet and less than 100 pounds when she was first pregnant, labored for three days to get my mother out--finally was able to while straddling her father's lap. Two doctors were called in during the labor--unheard-of in rural Appalachia in 1929--and they estimated my mother to weigh over 11 pounds. They had to resuscitate my mother and my grandmother took weeks to recover and was horribly torn (and their sewing job was so Frankenstein-esque that she never had sex without pain again). Now, when I went into labor, both times I was in good positions and pushed for many hours, and the baby didn't go past my un-flexing pelvic bones. So I wonder: Was my grandmother's problem the same? Would I have had to push for days to get my babies out? Probably. But that was too much of a risk for me. Yes, it might have been possible, but it nearly killed both my grandmother and my mother. It was entirely possible my mother could have been dead at the end of that process. So it's not worth trying and trying and trying for an exceptionally difficult vaginal birth--a c-section is the better risk to me.

Now, as to the OP's question, I agree that "too small" is a ridiculous assessment in most cases. But there are cases where moms would die if not for c-sec, as OnTheFence pointed out. I for one am quite grateful we have the option in these modern times. I just wish it wasn't used quite so frequently and cavalierly by both docs and moms.
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#26 of 104 Old 04-27-2006, 10:27 AM - Thread Starter
 
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Originally Posted by chumani

You may want to gently introduce your friend to books/websites that will educate and inform her for future childbirth choices.

Best wishes,
Sarah
I don't really think there is much point in that. I would do that if she hadn't just had her fourth c-section. I think at this point it would be more risky for her to try to have a vaginal delivery.

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#27 of 104 Old 04-27-2006, 12:53 PM
 
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The last time we went to India I met a man whose wife died in childbirth because the baby got stuck and couldn't come out. They were in a small village and had no access to medical care. They had a midwife but they still couldn't save her or the baby.

Dh's mother and aunt were delivered by csection in India in the 50's. They were breech and would not come out, so they drove them to the hospital and took them out.

Even in my great-grandma's day they had csections. They were done at home in extreme emergencies, without anethesia. They also would, in some cases, cut the baby out piece by piece to save the mother.

In the old days death from childbirth was very high-- I think 1 in 3?

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Or one could always crush the baby's skull.
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#29 of 104 Old 04-27-2006, 01:53 PM
 
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#30 of 104 Old 04-27-2006, 02:04 PM
 
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Quote:
Originally Posted by USAmma
In the old days death from childbirth was very high-- I think 1 in 3?
I don't think that all of history has had a maternal death rate that high, would have to research to say for sure, but there have definitely been times when it rose for different reasons. Malnutrition being high on the list, and of course the era when OB management of birth began w/o knowledge of how bacteria caused infection. I think that's the root of our current cultural attitude that birth is hideously, tremendously dangerous and needs to be managed into submission or all women could die... our great grandmothers who saw the effects of that era would surely have been very frightened by them, and probably added their voices to the OB claims that birth is terribly dangerous, and handed down that belief to their daughters.
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