C sect mothers right - Page 2 - Mothering Forums

Forum Jump: 
Reply
 
Thread Tools
#31 of 60 Old 07-12-2006, 12:23 AM
 
Storm Bride's Avatar
 
Join Date: Mar 2005
Location: Vancouver, BC
Posts: 27,300
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by wifeandmom
If a woman is willing to take on the risk of birthing her child without anyone present to assist in a medical emergency...
Every single woman who ever got pregnant takes that risk. This is part of what our entire cultural mindset about birth completely overlooks.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

Storm Bride is offline  
#32 of 60 Old 07-12-2006, 12:27 AM
 
rmzbm's Avatar
 
Join Date: Jul 2005
Location: NC
Posts: 16,378
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Storm Bride
I think if she's that uncomfortable with vaginal birth, avoiding pregnancy in the first place might be a good idea.
Wow. Are you serious? Because, as I have posted many times, normal birth terrifies me. Really...to the point I think it may be an actual phobia. I have 4 kids...is what you're saying that I shouldn't of had them? :
There's so much more to being a parent than how you birthed, and there's so much more to life than how you were born!

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
rmzbm is offline  
#33 of 60 Old 07-12-2006, 01:22 AM
 
maxmama's Avatar
 
Join Date: May 2006
Location: Ann Arbor/Ypsilanti
Posts: 2,454
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Storm Bride
I agree. However, I also think OBs have largely put themselves in the position they're in. Women used to know and understand that birth was risky and that things can go wrong. OBs gloss over that and try to make it go away. "Be a good girl, do what I tell you, and you'll be holding your healthy baby in no time." When you deliberately try to put yourself on a pedestal, you've got nobody to blame but yourself when it gets uncomfortable up there.
I don't agree. I think the consumerist mentality of society has a lot to do with the expectations of a perfect baby and birth. The prevailing attitude seems to be that you've paid for a perfect baby, and you damn better well get one. There are lawsiuts where families say they weren't urged strongly enough to have prenatal screening, where preemies are saved and the hospitals sued for their disabilities. At what point do Americans accept that risk cannot be removed from life and that they are not entitled to compensation for everything? Frankly, sometimes shit happens.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
maxmama is offline  
#34 of 60 Old 07-12-2006, 01:50 AM - Thread Starter
 
AppleOrangePear's Avatar
 
Join Date: Apr 2004
Posts: 1,224
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I think many that choose the Csect because to post to push ( someone like britney spears) they are NOT thinking about their child. There are many beneficial things a baby gets squeezed by contractions, coming out of the birth canal, receiving the mothers natural oxytocin. This is what I DONT understand. It isnt as simple as saying "oh vaginal c sect same thing... baby in the end" ONCE AGAIN HOWEVER I am NOT talking about true emergency csections..

michele
AppleOrangePear is offline  
#35 of 60 Old 07-12-2006, 10:26 AM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,742
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by kstsmith
MRCS is a woman's *choice*, but it is still an elective surgery. Homebirth is just the normal physiological process of birth, only at home. Yes, at the end of both a baby is the end result, but they are night and day as far as cost goes. Like the pp said, it comes down to the insurance company's bottom line. This choice is more expensive for them, and without a medical reason, they should have the right to deny it. Homebirth has equivalent outcomes and fewer interventions than hospital birth overall, and is the norm throughout most of the world. If an insurance company will pay for a hospital vaginal birth, then they should pay for a homebirth. But to compare that choice with elective surgery is like comparing apples and oranges. I don't think my insurance premiums should increase because someone chooses any kind of elective surgery.
I disagree, should a homebirth go wrong and it has to transfer it becomes incredibly expensive. Some problems could have been managed, treated and resolved in a hospital setting early on at less expense. So I don't think its like comparing apples and oranges. With birth comes an unknown, with an elective csection, the risks are spelled out, its fast, and the results are pretty much known. While it may cost than a natural vaginal birth initially, it probably is less expensive than a homebirth transfer. (actually I know it is)
If insurance were to pay for homebirth, don't think premiums wouldn't rise, they would. Because in the long run, should something go wrong, the cost is much higher. Also the insurance industry wouldn't be able to gage who were transfers from home or not because in many states, people lie when they transfer as to not get their midwives in trouble. (like here in AL)
OnTheFence is offline  
#36 of 60 Old 07-12-2006, 11:26 AM
 
maxmama's Avatar
 
Join Date: May 2006
Location: Ann Arbor/Ypsilanti
Posts: 2,454
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by OnTheFence
I disagree, should a homebirth go wrong and it has to transfer it becomes incredibly expensive. Some problems could have been managed, treated and resolved in a hospital setting early on at less expense. So I don't think its like comparing apples and oranges. With birth comes an unknown, with an elective csection, the risks are spelled out, its fast, and the results are pretty much known. While it may cost than a natural vaginal birth initially, it probably is less expensive than a homebirth transfer. (actually I know it is)
If insurance were to pay for homebirth, don't think premiums wouldn't rise, they would. Because in the long run, should something go wrong, the cost is much higher. Also the insurance industry wouldn't be able to gage who were transfers from home or not because in many states, people lie when they transfer as to not get their midwives in trouble. (like here in AL)
Most insurance in WA does cover homebirth, and our premiums sure aren't any lower.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
maxmama is offline  
#37 of 60 Old 07-12-2006, 11:35 AM
 
TanyaS's Avatar
 
Join Date: Jun 2003
Location: in a people house
Posts: 3,439
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
Quote:
Originally Posted by OnTheFence
I disagree, should a homebirth go wrong and it has to transfer it becomes incredibly expensive. Some problems could have been managed, treated and resolved in a hospital setting early on at less expense. So I don't think its like comparing apples and oranges. With birth comes an unknown, with an elective csection, the risks are spelled out, its fast, and the results are pretty much known. While it may cost than a natural vaginal birth initially, it probably is less expensive than a homebirth transfer. (actually I know it is)
If insurance were to pay for homebirth, don't think premiums wouldn't rise, they would. Because in the long run, should something go wrong, the cost is much higher. Also the insurance industry wouldn't be able to gage who were transfers from home or not because in many states, people lie when they transfer as to not get their midwives in trouble. (like here in AL)
Ugh...MDC ate my reply, so I'm trying again.

You are correct that birth is an unknown. But elective c/s is not as simple as knowing the risks. Are women told of their risk of infection? It's the most common risk and results in a longer hospital stay, more treatment, and on occasion reopening the surgical wound for cleaning and then remaining open for weeks for wound treatment. What about iatrogenic prematurity? Are parents really aware that their baby stands a good chance of being in the NICU as a result of a c/s for prematurity or breathing difficulties? What about the babies who are cut by a scalpel...happens more often than we hear about. What about all the other things that can go wrong with anesthesia as a direct result of the c/s? Insurance companies will pay for c/s knowing that complications can arise from them, making them even more costly than they already are. The same is true of vaginal birth. A vaginal birth in the hospital could have complications resulting in more cost to the insurance company, so how is homebirth any different?

Midwives have a lesser rate of costly interventions, including c/s. Because of this, the homebirth transfer rate is a very small percentage of all homebirths. And not all transfers are automatic c/s. Some go in for pain relief so labor can progress, or medications like antibiotics for a fever and have the baby vaginally. Insurance already pays for a more expensive hospital vaginal birth and accepts the risk that it could be more costly because of the unknown. How is homebirth any different? Insurance already pays for vaginal birth, so in reality, they are not being asked to pay for something extra by covering homebirth. They are simply being asked to allow women to choose the midwifery model of care or the medical model of care.
TanyaS is offline  
#38 of 60 Old 07-12-2006, 12:05 PM - Thread Starter
 
AppleOrangePear's Avatar
 
Join Date: Apr 2004
Posts: 1,224
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
All I have to say is OBGYN DO have a higher intervention rate. With DS1 I showed our MW ( medwife ) my birthplan and consulted her on what ifs... She gave answers that I thought she would. However when I met the Dr one time I had asked him the SAME exact question. lets just say he wrap things up quickly with

fluids ARE needed through iv during labor
episiodomy is done so no trouble getting the baby out and quickly
After the baby delivers I would give pitocin for the placenta
if baby stays breech we will just do a csect ( dont ya love how easily this can be said :irk

and sooo on.. thank goodness i didnt have to see him again

AND when he heard i delievered naturally he gave me this big huge congrats like i just did something totally unheard of and unpossible.. Some may think im odd but i dont think giving birth naturally needed a congrats!

Michele
AppleOrangePear is offline  
#39 of 60 Old 07-12-2006, 12:17 PM
 
georgia's Avatar
 
Join Date: Jan 2003
Location: tl;dr
Posts: 25,918
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
If insurance were to pay for homebirth, don't think premiums wouldn't rise, they would. Because in the long run, should something go wrong, the cost is much higher.
I don't understand why you are saying premiums would rise? In a majority of HBs, there aren't transfers. In a hospital setting the risks are SO much higher that "something would go wrong" just by the virtue of the medical model of interventions/timelines/etc. The Miehl study risks come to mind. It's really frightening to see even old stats of how much risk is involved birthing in a hospital.

The mw I used transfers to the hospital about 10% of her clients....w/a rate of around 3% who actually have cesarean. The local hospital where her back-up has privileges (sp?) has a c-s rate of over 35%. So, I don't get why premiums would rise. Thanks for helping me understand the reasoning

I have retired from administration work, so if you have a question about anything MDC-related, please contact Cynthia Mosher. Thanks!
 
georgia is offline  
#40 of 60 Old 07-12-2006, 02:10 PM
 
Storm Bride's Avatar
 
Join Date: Mar 2005
Location: Vancouver, BC
Posts: 27,300
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by rmzbm
Wow. Are you serious? Because, as I have posted many times, normal birth terrifies me. Really...to the point I think it may be an actual phobia. I have 4 kids...is what you're saying that I shouldn't of had them? :
There's so much more to being a parent than how you birthed, and there's so much more to life than how you were born!
I never said there wasn't more to being a parent. I think I'm a decent mom and I never gave birth to any of my children. (I'm not interested in debating this...if your c-sections were births for you, that's fine. They absolutely were not births for me.)

What I was pointing out is that vaginal birth is the normal, natural result of getting pregnant. You had four c-sections, but any one of those could have easily ended up being preterm labour, with you ending up having a vaginal birth somewhere. You were lucky (considering your feelings) that you made it to a hospital and OR in time to avoid a vaginal birth. But, there is no guarantee that that will happen. What my post meant was the only way to be sure you can avoid a vaginal birth is to avoid getting pregnant in the first place. A baby can be vaginally born anywhere (we had one arrive in our complex parking lot on June 27th)...but a c-section requires an OR. The only way a woman can be sure to avoid a vaginal birth is to spend the last half of her pregnancy (roughly) at the hospital so she can be immediately transferred to OR if everything gets going early.

So, no - I'm not saying that you shouldn't have had your children - not at all. What I'm saying is that, considering your fear of normal birth, you were taking a big chance. I think you're very, very brave.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

Storm Bride is offline  
#41 of 60 Old 07-12-2006, 02:13 PM
 
Storm Bride's Avatar
 
Join Date: Mar 2005
Location: Vancouver, BC
Posts: 27,300
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by kstsmith
You are correct that birth is an unknown. But elective c/s is not as simple as knowing the risks. Are women told of their risk of infection? It's the most common risk and results in a longer hospital stay, more treatment, and on occasion reopening the surgical wound for cleaning and then remaining open for weeks for wound treatment. What about iatrogenic prematurity? Are parents really aware that their baby stands a good chance of being in the NICU as a result of a c/s for prematurity or breathing difficulties? What about the babies who are cut by a scalpel...happens more often than we hear about. What about all the other things that can go wrong with anesthesia as a direct result of the c/s?
What about all the things that don't show up in the statistics, because they don't show up in the doctor's records? After my third section last July, I lost all bladder sensation. DS2 will be a year old on the 26th, and I still can't tell when I have to use the bathroom. I mentioned this to my doctor once back in September. She said, "oh, I'm sure that has nothing to do with the surgery". So...it's not on record anywhere as a complication of my last c-section. I'm very sure that nobody is warning women of the possibility when they're discussing the option of an elective primary c-section.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

Storm Bride is offline  
#42 of 60 Old 07-12-2006, 02:21 PM
 
Storm Bride's Avatar
 
Join Date: Mar 2005
Location: Vancouver, BC
Posts: 27,300
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by maxmama
I don't agree. I think the consumerist mentality of society has a lot to do with the expectations of a perfect baby and birth. The prevailing attitude seems to be that you've paid for a perfect baby, and you damn better well get one. There are lawsiuts where families say they weren't urged strongly enough to have prenatal screening, where preemies are saved and the hospitals sued for their disabilities. At what point do Americans accept that risk cannot be removed from life and that they are not entitled to compensation for everything? Frankly, sometimes shit happens.
Of course shit happens. I know that. However...I was bullied into a c-section last time. Before he pulled out his big gun (threatening to leave me with no care provider when I was in prodomal labour and 41w,4d pregnant), my OB's favourite tactic was to tell me over and over that I should have the c-section because I was "late", and there was a study on post-dates pregnancies where two babies died using "expectant management". Those two babies died, so I needed to have a c-section. Did he ever actually flat out say "there's no possibility that you or your baby will die if we operate"? No - but he might as well have. His entire stance was that I could avoid problems by doing what I was told.

Fine - he's the "expert". But, when you profess to know more than you do, and it blows up in your face, don't come crying to me about it. Would I have been insanely pissed off if my son had been harmed (eg. a scalpel cut) during the surgery? Ooohhh, yeah! I probably wouldn't have sued, because that's not my style in any way. But, I'd have been pissed....not because "shit happens", but because my OB had spent weeks trying to bully me with his insistence that I should to the "safe" thing and have surgery. I didn't believe him, so...different for me than for many women. But, he is the one who chooses to present himself to women as being able to "save" their babies. Maybe he should make it clear that he can do a lot under certain circumstances, but he doesn't have all the answers. Until he and his colleagues choose to take that approach, they're going to have to expect some flack when the perfect baby doesn't appear.

And, no - I don't support suing a doctor when a VBAC goes wrong. I just despise the way they want to be treated as the all-knowing expert who can save women and their babies, but don't want to accept the crap that flies when they're wrong.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

Storm Bride is offline  
#43 of 60 Old 07-12-2006, 03:01 PM
 
rmzbm's Avatar
 
Join Date: Jul 2005
Location: NC
Posts: 16,378
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Storm Bride
I never said there wasn't more to being a parent. I think I'm a decent mom and I never gave birth to any of my children. (I'm not interested in debating this...if your c-sections were births for you, that's fine. They absolutely were not births for me.)

What I was pointing out is that vaginal birth is the normal, natural result of getting pregnant. You had four c-sections, but any one of those could have easily ended up being preterm labour, with you ending up having a vaginal birth somewhere. You were lucky (considering your feelings) that you made it to a hospital and OR in time to avoid a vaginal birth. But, there is no guarantee that that will happen. What my post meant was the only way to be sure you can avoid a vaginal birth is to avoid getting pregnant in the first place. A baby can be vaginally born anywhere (we had one arrive in our complex parking lot on June 27th)...but a c-section requires an OR. The only way a woman can be sure to avoid a vaginal birth is to spend the last half of her pregnancy (roughly) at the hospital so she can be immediately transferred to OR if everything gets going early.

So, no - I'm not saying that you shouldn't have had your children - not at all. What I'm saying is that, considering your fear of normal birth, you were taking a big chance. I think you're very, very brave.
Thank you. I really appreciate the clarification. FWIW, I DID labor with the first two. They should have all been vaginal births but I listened to a Dr. who happened to be brain dead. But I also SHOULD have been at home where my labors likely would have been normal, as it was they were not. I am 100% for normal birth as well as non-medicalized birth. But I am also terrified beyond words of it. That's my reality. And before I conceive another child I will get it all worked away in my head so that, God willing, I CAN birth normally.

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
rmzbm is offline  
#44 of 60 Old 07-12-2006, 03:45 PM
 
grumpyshoegirl's Avatar
 
Join Date: Mar 2006
Location: South Shore, MA
Posts: 962
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My thoughts? (on the original question...)

A lot of corporate types use the word "choice" when they really mean promote the option that's best for THEM, not the average consumer. Here in MA, we've been having issues with hospitals handing out formula-sponsored goodie bags that they have the audacity to call "breastfeeding bags" (with a huge can of formula in them?!?), and the governor thinks it should be allowed so as to give new moms "choice" in how to feed their babies. Last time I checked, not getting free samples didn't actually undermine anyone's choice to formula feed, but there you have it.

I think the crap about "respecting patient choice" is conveniently trotted out when the patient wants a c-section, or any other intervention, but not when we make the CHOICE to opt out of that intervention. My choice not to be induced at 41 weeks wasn't respected at all; I was repeatedly told how the chances of stillbirth went way up after 41 weeks to scare me into going in more frequently. My choice not to get cytotec after the cervical ripening gel didn't work was complied with, but not treated with respect. My choice not to supplement with formula when my daughter had jaundice was met with an outright fight.

Choice won't be true choice until care providers give us honest, unbiased information about risks and benefits of a procedure. That means not just reciting the risks of UR in VBAC, but the risks associated with ECS.
grumpyshoegirl is offline  
#45 of 60 Old 07-12-2006, 03:58 PM
 
grumpyshoegirl's Avatar
 
Join Date: Mar 2006
Location: South Shore, MA
Posts: 962
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by wifeandmom
I also believe that a woman who CHOOSES to have an elective section should understand that it may very well be impossible to find someone willing to attend any future attempts at vaginal birth. That's part of the package deal of asking for an elective section IMO and should be explained and discussed fully prior to surgery. It should also be discussed that some women' can only 'handle' a limited number of sections, so if she wants a half dozen kids, elective primary c-section isn't a very good plan overall. To me, those are part of the risks associated with elective primary c-section and should be covered under informed consent.
But see, the problem is that this is simply NOT explained prior to signing the consent form in the majority of cases. When I had my c/s, I got the risks of future bladder and bowel problems, the risk of needing a hysterectomy, the death rate (for me not the baby), and the possibility of VBAC the next time around in terms of a percentage of moms who were able to. Nothing else-- nothing about a permanent numb spot on my abdomen, the risks of repeat cesareans, the risks the baby faced, or the hospital protocol for VBAC moms which severely compromises successful VBAC. I also got information about incision type and suturing protocol because I knew to ask about them. And I had nowhere to turn for the other information-- I was in the hospital! How is a mom facing a primary c/s supposed to know WHICH questions to ask to ensure that she is giving truly informed consent? It pretty much boils down to what the OB thinks she should be told.
grumpyshoegirl is offline  
#46 of 60 Old 07-12-2006, 11:45 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,742
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by kstsmith
Ugh...MDC ate my reply, so I'm trying again.

You are correct that birth is an unknown. But elective c/s is not as simple as knowing the risks. Are women told of their risk of infection? It's the most common risk and results in a longer hospital stay, more treatment, and on occasion reopening the surgical wound for cleaning and then remaining open for weeks for wound treatment. What about iatrogenic prematurity? Are parents really aware that their baby stands a good chance of being in the NICU as a result of a c/s for prematurity or breathing difficulties? What about the babies who are cut by a scalpel...happens more often than we hear about. What about all the other things that can go wrong with anesthesia as a direct result of the c/s? Insurance companies will pay for c/s knowing that complications can arise from them, making them even more costly than they already are. The same is true of vaginal birth. A vaginal birth in the hospital could have complications resulting in more cost to the insurance company, so how is homebirth any different?
First I want to say that we don't actually know the percentage of homebirth transfers because 1) people lie and 2) midwives skew their own statistics. There is a lot more room to "play" with the numbers when there is no one to answer too.

As for your questions. Yes, women who are having csections know there is an increased risk for infection. Just like women are told that they are at an increased risk of infection if they do not birth within 24 hours of their water breaking. However this percentage is SMALL. And there are things that can be done to decrease infection.
Also the risk of a baby being born prematurily by csection is becoming smaller and smaller, mainly because pregnancy is being detected earlier, the use of ultrasounds, and tests prior to surgery. Most csection done prior to 39 weeks have to be done for a valid medical reason, other wise is does not fall within the guidelines of most malpractice policies -- I know this because with my past two births, both before 39 weeks, there had to be clear, documented evidence given for my cesareans.
The chance of a baby being cut by a scalpel is about as equal as a baby having a vaginal birth injury. The risk is about the same.
There are risks to anest. You are told the risks. Mine actually FAILED and I felt an entire csection and was the table for 75 minutes. Of course this was an emergency and I did not have much choice in the matter -- I did have choices for my other two. I think a lot of research and thought needs to be made in this area. But you are told the risks. Its not like going into a blind -- just like anyone having a vaginal birth knows pain is going to be involved.
OnTheFence is offline  
#47 of 60 Old 07-12-2006, 11:56 PM
 
OnTheFence's Avatar
 
Join Date: Feb 2003
Location: Alabama
Posts: 3,742
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by georgia
I don't understand why you are saying premiums would rise? In a majority of HBs, there aren't transfers. In a hospital setting the risks are SO much higher that "something would go wrong" just by the virtue of the medical model of interventions/timelines/etc. The Miehl study risks come to mind. It's really frightening to see even old stats of how much risk is involved birthing in a hospital.

The mw I used transfers to the hospital about 10% of her clients....w/a rate of around 3% who actually have cesarean. The local hospital where her back-up has privileges (sp?) has a c-s rate of over 35%. So, I don't get why premiums would rise. Thanks for helping me understand the reasoning
First there is no way to determine how many homebirth or UCs transfer. That would be calculated as a risk by the insurance company.
Homebirth transfers are more costly because often more care and expense is needed for the patient and her baby. Period. For one, the majority do end up as csections or their are complications that include a lot of medical intervention. Just reading this forum about those brave enough to even post their stories, gives a clear indication of this. Doctors who take on this risk are going to have higher premiums (if its known) when dealing with patients in this category. One of the reasons my own OB will not back up local midwives is because she says she got F-ed over too many times in transfer situations, where babies died or baby and mother were ill. She tells people straight up that she has a 30+% csection rate and that her main objective is healthy live babies and that is her objective, if they don't like it she can refer them to someone else.
OnTheFence is offline  
#48 of 60 Old 07-13-2006, 12:30 AM
 
Storm Bride's Avatar
 
Join Date: Mar 2005
Location: Vancouver, BC
Posts: 27,300
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by OnTheFence
Yes, women who are having csections know there is an increased risk for infection.
Nobody has ever mentioned the risk of an infection to me...except my last maternity ward nurse with ds3. That's four of my doctors (two FPs and two OBs), plus assorted "on staff" doctors, plus I don't know howm many nurses who haven't bothered to mention it.

Quote:
Most csection done prior to 39 weeks have to be done for a valid medical reason, other wise is does not fall within the guidelines of most malpractice policies -- I know this because with my past two births, both before 39 weeks, there had to be clear, documented evidence given for my cesareans.
This could be true, but at 39 weeks, my dd was discovered to be breech, and my section was scheduled for the earliest possible slot in the OR. My doctors (FP & OB) were both absolutely freaking out about having to "wait" so long. They would have much preferred to do the surgery sooner. Maybe some people consider a breech to be a valid medical reason for a pre-term section, but it's not black and white.

Quote:
There are risks to anest. You are told the risks.
No. You were told the risks. I have never had a single medical professional - before, during or after my sections - mention any risk involved in anesthesia. I've been instructed not to eat before surgery, but I've never been told that it had anything to do with anesthesia. What I know about these things is all from online research I've done myself. My doctors have never mentioned any risk involved with having a cesarean - not one...not infection, not scalpel cuts, not damage to other organs, not anesthesia risks, not nerve damage - nothing.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

Storm Bride is offline  
#49 of 60 Old 07-13-2006, 01:06 AM
 
TanyaS's Avatar
 
Join Date: Jun 2003
Location: in a people house
Posts: 3,439
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
Quote:
Originally Posted by OnTheFence
First I want to say that we don't actually know the percentage of homebirth transfers because 1) people lie and 2) midwives skew their own statistics. There is a lot more room to "play" with the numbers when there is no one to answer too.
Homebirth accounts for 1% of all births in this country. Do you really think that there is a huge discrepancy in this number when the known homebirths are such a small percentage of all births? Homebirth and UC are just not that mainstream to wildly skew statistics.

And OBs don't skew their own statistics? I know of many women who obtain their records and are angry to find that it states "maternal request" for the reason for the surgery. I guess there's not a box to check that states coerced, lied to, used scare tactics, and other extreme measures to get mother to agree to surgery. You're right. There is room to play with the numbers when there is no one to answer to.

Quote:
Yes, women who are having csections know there is an increased risk for infection.
I was told nothing about the risks, only that it needed to be done after dilating to 10 cm and pushing only a short time. Fetal distress from the pitocin that they gave me. Also something I knew nothing about until I educated myself later. I was also under general anesthesia for my c/s. I was not informed of any risks. As a matter of fact, many things I heard from the doctor later. She told the nurse, "lets start some pit" and then came to talk to me about it. She told the people in the room "I may have to section her" before she even told me what was going on or why she felt surgery was necessary.

Many women have already talked about the numbness, lack of bladder control and other side effects of c/s. They are quite numerous. There's also adhesions, a risk of any surgery. I've only recently learned what they are.

Quote:
And there are things that can be done to decrease infection.
When I'm under general anesthesia how exactly was I supposed to decrease my risk of infection?

Quote:
Also the risk of a baby being born prematurily by csection is becoming smaller and smaller, mainly because pregnancy is being detected earlier, the use of ultrasounds, and tests prior to surgery.
Ultrasounds are notorious for being inaccurate for dating a pregnancy. The medical model does not take into account women who have cycles outside of the average 28 days. Doctors routinely convince women to have a c/s because u/s says the baby will be 'too big.' Only to have the baby be smaller than they predicted because they took the baby out too early. If you've seen some research studies on a decrease in iatrogenic prematurity because of tests, then I'd be interested in reading it.

Quote:
There are risks to anest. You are told the risks. Mine actually FAILED and I felt an entire csection and was the table for 75 minutes.
I'm sorry you had to go through this. I cannot imagine the horror you went through, and whenever I hear of women who have felt the surgery I am humbly thankful for not remembering a thing because of the GA. Again, of which I was told no risks about.

Quote:
But you are told the risks. Its not like going into a blind -- just like anyone having a vaginal birth knows pain is going to be involved.
Again, I have to disagree. I don't think any mother is told to expect incision pain for many months afterwards. I certainly wasn't. Everytime I brought up pain to the doctor I was told "It's just ______" like it was not a big deal at all.
TanyaS is offline  
#50 of 60 Old 07-13-2006, 12:17 PM
 
TanyaS's Avatar
 
Join Date: Jun 2003
Location: in a people house
Posts: 3,439
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
Here is some interesting info I found on iatrogenic prematurity (bold emphasis mine):

http://www.transitiontoparenthood.co...datespaper.htm
Quote:
Iatrogenic Prematurity. In cases of elective cesarean section or medically-indicated induction, a serious risk is iatrogenic prematurity: a baby that is premature because the interventions were performed too early due to error in determining gestational age. This could be prematurity in the more typical sense: if the estimated date of conception (based on LMP) is significantly wrong, then the baby would be delivered prior to 38 weeks of age. It could also be any infant who had not reached full maturity, regardless of weeks of development. “Thus a preterm birth can occur even at the 42nd week just as a postterm birth is possible even at the 38th week.” (Klimek)

Incidence: It has been estimated that 10% of the time the gestational age based on LMP is significantly inaccurate. In some studies, as many as 10% of admissions to neonatal intensive care are due to inadvertent iatrogenic prematurity. (Clewell) Shreiner et al. examined a sample of 47 infants that developed respiratory distress syndrome following elective abdominal delivery “at term.” The mean difference between the gestational age determined pre-natally (by methods such as LMP or ultrasound) and post-natally (by clinical exam) was 2.6 weeks, +/- 1.6 weeks.

Ways to reduce risk: some hospitals and groups (e.g. ACOG, College of Physicians and Surgeons of Manitoba) have established protocols to determine fetal maturity before elective cesarean. These require clear documentation of gestational age based on multiple indicators such as: clear menstrual history, prenatal exam records, Doppler record of fetal heart tone for 30 weeks, more than 36 weeks since a positive urine pregnancy test, and ultrasound estimates of gestational age performed before 20 weeks. If these data are not available, then they recommend amniocentesis: amniotic fluid analysis of the lecithin-to-sphingomyelin (L/S) ratio and phosphatidylglycerol to provide evidence of fetal lung maturity.

Allowing the woman to go into spontaneous labor before c-section would also markedly reduce the risk: The risks of iatrogenic prematurity and lung disease for those infants delivered by elective cesarean before labor are 30 percent versus those born by cesarean after labor begins (11 percent). (PCRM)
These numbers are interesting considering they are making use of all the tests, u/s, and EDD calculations available today, yet 30% of c/s babies are born too early.
TanyaS is offline  
#51 of 60 Old 07-14-2006, 06:09 AM
 
AllisonR's Avatar
 
Join Date: May 2006
Posts: 3,137
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by ArlyShellandKai
It concerns me to think that more choose csect for the reason of avoiding pain. They are choosing a major surgery over a normal physiological response.
This is not correct. Women do not normally choose cesarean, just to avoid "a little " pain, or to conveniently choose their babes birthday. In Denmark, most women (93%) who chose an elective cesarean with no medical indication do so because of a previous, traumatic birth experience. 93%! This may be different in the USA, but I wouldn't think the number will be vastly different.

This "previous, traumatic experience" could be because of a previous stillbirth, previous traumatic emergency cesarean, previous sexual abuse brought up during the birth, a painfully long birth with cascade of interventions that caused PTSD or PPD....

These women have good reason, and this should be respected. A woman has a right to homebirth, as does her sister have a right to a planned cesarean. All choices should be respected, even if you disagree.
AllisonR is offline  
#52 of 60 Old 07-14-2006, 06:23 AM
 
AllisonR's Avatar
 
Join Date: May 2006
Posts: 3,137
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Breech position in week 39 is a medical emergency??? Breech can turn! Why not wait until onset of labor. If it's two weeks later, the baby may have turned, or it can turn even right before labor! At least try moving it! And if babe is still breech, schedule a calm, reasonably planned section within the next few hours? (OK, don't answer that. Doc wants to preschedule, during the afternoon, before his/her weekend...)

PS - someone asked about limiting infection during cesarean. I read that if the uterus is taken outside your body for checking, cleaning.... it is more convenient for the doc, but increases the risk of infection 23%. How often is this done?
AllisonR is offline  
#53 of 60 Old 07-14-2006, 10:51 AM
 
TanyaS's Avatar
 
Join Date: Jun 2003
Location: in a people house
Posts: 3,439
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
Quote:
Originally Posted by AllisonR
PS - someone asked about limiting infection during cesarean. I read that if the uterus is taken outside your body for checking, cleaning.... it is more convenient for the doc, but increases the risk of infection 23%. How often is this done?
I don't know how often it's done, but I used to watch a lot of those baby shows when pregnant with my first, and all the ones I saw were with the uterus outside the body. There was a discussion about this on another list I frequent and, IIRC, it depends on how the physician was trained, so they may not even know how to sew a patient back up without taking out the uterus. Reminds me I need to get my records so I can find out how mine was done.

Here's a link with things patient's can do to decrease their chance of infection in the hospital:

http://www.hospitalinfection.org/protectyourself.shtml
TanyaS is offline  
#54 of 60 Old 07-14-2006, 04:49 PM
 
Storm Bride's Avatar
 
Join Date: Mar 2005
Location: Vancouver, BC
Posts: 27,300
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by AllisonR
Breech position in week 39 is a medical emergency??? Breech can turn! Why not wait until onset of labor. If it's two weeks later, the baby may have turned, or it can turn even right before labor! At least try moving it! And if babe is still breech, schedule a calm, reasonably planned section within the next few hours?
That's what I wanted to do, but I'm afraid my emotional state when I found out the baby was breech was...bad. I didn't do very well at resisting the pressure from my doctors when I was told that there was "no way" the baby could turn, because she was too big. I couldn't summon any articulate arguments, and really wish I'd just said, "no - I don't want it" and left it at that. When my arguments had all been shot down, I just caved. (My first was sectioned for breech, and he turned during labour, but he wasn't a "big baby". ARRGH.)

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

Storm Bride is offline  
#55 of 60 Old 07-14-2006, 07:30 PM
 
lurve's Avatar
 
Join Date: May 2006
Location: Phoenix
Posts: 869
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Storm Bride
I agree. However, I also think OBs have largely put themselves in the position they're in. Women used to know and understand that birth was risky and that things can go wrong. OBs gloss over that and try to make it go away. "Be a good girl, do what I tell you, and you'll be holding your healthy baby in no time." When you deliberately try to put yourself on a pedestal, you've got nobody to blame but yourself when it gets uncomfortable up there.
I completely agree to this! The one thing that made me feel so comfortable with my midwife was when she explained that death is a part of birth. It is rare, but it happens. She did not try to sugar coat it. I respected her for saying that.

I also think that if a woman wants an elective c-section, then it should be like any other elective surgery - she has to pay for it, not the insurance company. Want a nose job? Well insurance will pay if its medically necessary like with a deviated septum, but for beauty you pay. I don't see why it is not the same with c-sections.

Just my two cents after my insurance company refused to pay for my midwife/homebirth (which would cost them 1/3 of what a hospital vaginal birth would be!).

Legal Mama to TWO homebirthed, unschooled, unvaxed, cloth diapered, mei tei loving, still breastfeeding baby girl 1/14/07 and an intact 8 pound 10 ouncer baby boy 4/5/10.
lurve is offline  
#56 of 60 Old 07-15-2006, 09:21 AM
Banned
 
Join Date: Aug 2005
Posts: 3,484
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Stopped reading at page two...

My take is every women has the right to a fully INFORMED choice. Babies can die either way, women can die either way, (I've only heard of people becoming amputees through section, so can't add that in) and every parent should have the right to an informed choice based on thier assesment of the actual risks.

People choosing section to avoid pain make me sick, I've been in pain for two years because of mine and it looks like it will stay the rest of my life. Again, informed choice should include all the info.
pumpkinsmama is offline  
#57 of 60 Old 07-15-2006, 09:34 AM
 
tash11's Avatar
 
Join Date: Mar 2006
Location: OH
Posts: 744
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by ArlyShellandKai
...I remember when i was prego with DS#1 and i told family i was NOT having an epi my sis said Everyone has them and my mom added that she was drugged....

Michele
my friends mom belives that everyone has to have one for the baby to fit.

and an old co-worker of mine said that something that big going through something that small would definatly tear me a lot. I told him he was gay and what did he know about how streachy that part is

I had a homebirth and I didnt even tear.
tash11 is offline  
#58 of 60 Old 07-20-2006, 08:31 PM
 
mamabeth's Avatar
 
Join Date: Jul 2003
Location: RUNNING errands
Posts: 3,031
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My 2nd c/s was considered elective. I am glad I had the "right" to choose, because my dh and I carefully considered all the risks and benefits, both from the docs (who we mostly ignored because they were freaking out), from a HB midwife who we consulted, and from our own research on PubMed. We chose a c/s at almost 43 weeks gestation because that was our own personal comfort level. Yes, we could have waited longer for a VBAC and had prepared for it, and yes, I could have homebirthed or UC'ed.

But I was glad to have the choice of a c/s, as well as all the rest of the birthing choices. I felt blessed and privileged to have all those choices, and it allowed me to have little regret about my son's birth, which, yes, statistically, was an ERCS.

I do agree with whoever said that women who choose a primary elective c/s should be informed that it will impact the rest of their birthing choices for life. That would be truly informed consent.
mamabeth is offline  
#59 of 60 Old 07-20-2006, 10:34 PM
 
sapphire_chan's Avatar
 
Join Date: May 2005
Posts: 27,769
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by OnTheFence
And why should anyone care how one particular women gives birth? Why do we must always assume that if a woman chooses homebirth she is naive and ignorant and then say the same for a woman who chooses an elective cesarean?
$$$
C-sections cost more than other forms of birth. If insurance companies have to pay for a lot of them, they'll drive rates up for everyone else.

Then there are the potential health problems of a baby born before he/she is ready, the problems caused by *not* squeezing through the birth canal, increased reluctance to help mothers *avoid* c-section, greater difficulties in bonding from lack of the appropriate hormones. Actually, c-section is sort of like formula feeding, a life-saving miracle of the modern age when it's needed.
sapphire_chan is offline  
#60 of 60 Old 07-23-2006, 04:57 AM
 
flapjack's Avatar
 
Join Date: Mar 2005
Location: England, easily locatable by Google
Posts: 13,642
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I feel everyone has the right to choose an elective c-section. My kids stepmom is being bullied into one for fairly spurious reasons, and I'm not cool with that - the hospital has a 15% elective c-section rate, which seems a tad excessive.
I'm not cool with the NHS paying out for an elective c-section for a first-time mum with no medical indicators. That's what we have private maternity hospitals over here for- I'd much rather my taxes were spent where they're needed.
I'm not cool with elective c-sections being performed before 39 weeks. There's a lot of evidence out there to suggest that 39 weeks is really the earliest you want to be considering c-section, yet a lot of doctors aren't listening.
I'm also not cool with it being easier to get an elective c-section than a homebirth in almost every part of the country.

Helen mum to five and mistress of mess and mayhem, making merry and mischief til the sun goes down.
flapjack 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