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  Topic Review (Newest First)
04-07-2011 06:58 AM
Fluga

I just want to point out that any surgery that is not a matter of life and death is classified as elective.  

04-04-2011 09:30 PM
jwoodbri

I had to sign an "elective" c-section form at my hospital. I looked at my OB-GYN as said if it's elective there's another option right... Not if you want to deliver here or with me. So I had to sign the elective form even though I had no other option. And there weren't any other options anywhere in a few hour drive that I could find. My last c-section I tried to make more natural but it's the first time our hospital had tried anything like it. But this video went even further. I might try to get my OB to watch it. It would be great if I can do more of these things this next time. (I wish it weren't true but this will be my fourth c-section. Baby #1 was breech, baby#2 I should have found a midwife but I didn't know better, baby#3 I wanted to try to VBAC but no midwife would touch me and baby was breech and low amniotic fluid, and this one again no one anywhere around would let me VBAC and I'm not comfortable doing it on my own. Not at all what I would have chosen but it is what it is. So all I can do is do the best I can given the circumstances. And advocating for myself does improve things and helps to personalize the birth. With my first two I didn't even think I could write a birth plan with a c-section but it was my last one that I decided I could have some control over how things were done and they actually listened to many of my requests.


 

 

 

 

 

03-18-2011 11:41 AM
MeepyCat

T-dunahoo, for a "crash" section, mom is often knocked out because general anesthesia is faster to administer.  If a situation proceeds to crash status on a mother who has an epidural already in place, it may be possible to crank the epidural to a sufficient level for surgery, or use spinal anesthesia (which, technically, is anesthesia in a different layer of the spine). 

 

A crash section is a really scary situation.  It means that a patient is at imminent risk of dying.  It's possible for a situation to be a real emergency and still to not be quite that bad.
 

Quote:
Originally Posted by Tdunahoo View Post

I've always been told that TRUE birth emergencies that require a c/s the mom is knocked out. Many moms are told that they need to have an "emergency section" and it can be anywhere from 30-60 minutes before she is rolled into the OR for surgery. I believe, and I could be wrong. that is what imalittleteapot is talking about. A true emergency mom gets knocked out, non-emergent mom is kept awake even if it is a "necessary" c/s
 



 



 

03-18-2011 11:03 AM
jr'smom

Quote:
Originally Posted by lil_stinkyfeet View Post



I agree "elective" doesn't mean it was the Mother's choice..

Both local hosptial's here have VBAC bans so you either choose your elective C-section or you drive almost 2hrs away. It's quite the "choice" that is offered, you get to have your hands tied to birth locally while practically being threatened with stories of you uterus rupturing.



So true.  I have absolutely no one who will support a VBA3C in IL.  It would be much longer than a two hour drive to find anyone who would deliver--don't even know where.  I'm 99% sure I'm heading toward another C/S.  Given the history of the reasons for my past C/S (all planned homebirths, 2 with more than 24 hrs of labor before transfer), I'm not comfortable with an unassisted birth.  I wouldn't call my upcoming C/S "elective."  I have no realistic choice.

 

I don't know why we're beating each other up over semantics here.  The way I see it is, when possible it would be great to have a C/S like the one in the video versus the way they're typically done. Personally having a "natural c/s" (stupid terminology) still would not entice me to choose a C/S.  Most people "naturally" minded would still fight like heck to have a vaginal birth.

 

03-18-2011 10:45 AM
Tdunahoo

I've always been told that TRUE birth emergencies that require a c/s the mom is knocked out. Many moms are told that they need to have an "emergency section" and it can be anywhere from 30-60 minutes before she is rolled into the OR for surgery. I believe, and I could be wrong. that is what imalittleteapot is talking about. A true emergency mom gets knocked out, non-emergent mom is kept awake even if it is a "necessary" c/s
 

Quote:
Originally Posted by lovebeingamomma View Post

uum did you completely miss my post about the fact that emergency sections are done like this in my state?  By two OB's who believe this is what is BEST for mom & baby, not for the frills.  And if this isn't about proving which c-sections are necessary, why are you going ahead and trying to disprove the c-section that I mentioned?  I don't really care about the strange attitude you have towards all of this but please just stop saying this will not be an option for emergency c-sections because it's not true, it's not a matter of your opinion.
 



 



 

03-18-2011 10:30 AM
Tdunahoo

Quote:
Originally Posted by Cutie Patootie View Post

I think this is incredible and was really moved by the film...until the end when the doctor said something about changing the way elective c-sections are done.  I'm thoroughly against elective c-sections, but for mothers who have no other choice but c/s, this is so amazing.


I think that many c/s moms that are more "main-stream" (because lets face it, none of us here are mainstream) feel like they don't have a choice when it comes to having a 2nd, 3rd etc C/S. So while they are elective, the mom feels like they don't have an option. I know in IA its hard to find an OB who will perform a VBAC, which makes me so sad, but those moms are still classified as "elective" kwim?

 

I cried while watching this, what a beautiful way for c/s moms to experience childbirth. 

 

03-15-2011 11:22 AM
lil_stinkyfeet



I agree "elective" doesn't mean it was the Mother's choice..

Both local hosptial's here have VBAC bans so you either choose your elective C-section or you drive almost 2hrs away. It's quite the "choice" that is offered, you get to have your hands tied to birth locally while practically being threatened with stories of you uterus rupturing.

03-15-2011 11:03 AM
Storm Bride

Quote:
Originally Posted by littleteapot View Post


There isn't "always a choice"...  in theory or in practice. I didn't have one. I was forced against my will. Lots of women are. Sometimes it's not as obvious as my case is/was, but being forced by way of lies, manipulation, coercion, blackmail, threat of legal action, threat of CPS or lack of support all count as losing your choice. Before I had my experience I also thought it was as easy as simply saying "no", and then I was knocked unconscious while begging for a vaginal birth and realized it's not always so black and white.  :( Check out some of the stories coming out of Florida, they're ATROCIOUS!! Women jailed and their other children taken away by CPS because they refused an unnecessary cesarean when faced with threats and lies. It's horrific.

 

I'm the one who said there's always a choice, theoretically. I said "theoretically" quite deliberately, as I was knocked out for my first cesarean while I was refusing consent. When I commented on the choice issue, I was more commenting on the complete lack of meaning behind the term "elective" where c-sections are concerned. It doesn't mean it was chosen. It means it wasn't an emergency. It shouldn't mean that. The way they use the term "elective" makes me furious. But, they do use it that way, and it has nothing to do with choice.

 


Also, and I'm not trying to be a prat, but simply CYAing:

 

"Elective Cesarean" :

[1], "Caesarean delivery on maternal request (CDMR), is medically unnecessary caesarean section, where the conduct of a childbirth via a caesarean section (CS, or c-section) is requested by the pregnant patient."  (emphasis mine)

[2], "...After all, the word "elective" simply means there is no medical justification"  (emphasis mine)

This is the primary definition for the term, which is the context in which I was using it.

 

That might be the primary definition, but that's not how it's used in most circumstances. I've had three "elective" c-sections and every one of them was done for medical indicators (supposedly). Where did you get those definitions? They're very interesting, because that's what elective should mean, imo...but it's not what it means in practice.



 

03-15-2011 12:25 AM
littleteapot

I want to repeat that I never said that skin to skin contact and all that wonderful stuff was somehow bad, in fact that would be awesome if it could be done more often (which is what I said originally as well). Reducing trauma for both mother and baby is amazing, let's do more of that. ... but this won't be possible in emergencies, which was my point. This is a technique designed to cater to a market of 99% elective, non-emergency, not necessary cesareans. I'm not looking to "punish women to prove a point" (seriously??!), I'd be the last person in the room saying, "No I think the mom actually SHOULDN'T touch her baby for the next 10 hours. That would be best for everyone... evil laugh!". What I'm talking about is on a much larger scale of simply not making elective, dangerous, life threatening surgery glamorous. Please note the key word "elective" in this. Remember, as I said, I am a mom who had a cesarean. Having more time and contact (read: ANY time or contact) with my son while he was still alive would have literally made the difference in the severity and depth of my grief to this day, but that is an entirely different world than what they're talking about up there.

For whatever dumb reason, they decided at that hospital that I didn't have that option. Was it true? Heck no. It was simply bad policy: their policy was to never, ever, ever deliver a breech vaginally. Was it based on facts and life saving research? Nope. Does that matter? Unfortunately not. By law at that time, a labouring woman was "not of their right mind" and they could overrule my decisions, my choices, and my rights to body integrity with a sweep of the hand. Which brings me to my next point...

There isn't "always a choice"...  in theory or in practice. I didn't have one. I was forced against my will. Lots of women are. Sometimes it's not as obvious as my case is/was, but being forced by way of lies, manipulation, coercion, blackmail, threat of legal action, threat of CPS or lack of support all count as losing your choice. Before I had my experience I also thought it was as easy as simply saying "no", and then I was knocked unconscious while begging for a vaginal birth and realized it's not always so black and white.  :( Check out some of the stories coming out of Florida, they're ATROCIOUS!! Women jailed and their other children taken away by CPS because they refused an unnecessary cesarean when faced with threats and lies. It's horrific.

 

And no, other poster whose name I've forgotten who asked if I missed their post, I didn't - I just think you've misunderstood what "emergency" means in the context that I'm using it. And in this context it means you don't have the luxury of taking 15+ extra minutes, therefore these kinds of "natural cesareans" or "woman centered cesareans" (you're not the only one who bristles at that term) would be a life threatening waste of precious, precious moments.

 

Also, and I'm not trying to be a prat, but simply CYAing:

 

"Elective Cesarean" :

[1], "Caesarean delivery on maternal request (CDMR), is medically unnecessary caesarean section, where the conduct of a childbirth via a caesarean section (CS, or c-section) is requested by the pregnant patient."  (emphasis mine)

[2], "...After all, the word "elective" simply means there is no medical justification"  (emphasis mine)

This is the primary definition for the term, which is the context in which I was using it.

 

03-14-2011 04:37 PM
nktigger99


So wouldn't you want to improve those 8-10 women's experience....or would you rather just punish them for having to have a c-section even though they had no other choice.  Just to prove a point!!!!!!!!!!!!!!!!!   Condem those women who have no other choice but to chose a surgical birth...just because our country and other's are screwed up.

 

I am carrying twins...if both are breech I may end up with a c-section...Where I live no midwives will do a home birth for twins...and no OB will do a double breech deliver...I was lucky to find an OB willing to do a vaginal birth if the second baby was breech.  You have to play the hand that has been dealt you...I got blessed with twins so I will do what I need to do to bring them into this world safely.

 


 

Quote:
Originally Posted by littleteapot View Post

 

If you're standing in a room full of 100 women who all had "necessary" cesareans, chances are only about 8-10 needed them. This is the sad truth about the cesarean epidemic.

 

03-14-2011 04:06 PM
MeepyCat

There's a big difference, too, between an "emergent" section (we have a medical and urgent reason to do surgery), and a "crash" section (decision to incision in less than 2 minutes).  There's a fair bit of flexibility in those emergent cases, but when we say "emergency", we tend to think of the crash situation.

03-14-2011 04:04 PM
clutterbug

Quote:
Originally Posted by Storm Bride View Post

I hate the term "natural cesarean" with every fiber of my being.


True, it's a ridiculous term.  "Mitigative" or something like that might be a better descriptor...something to recognize that efforts are being made to reduce the negative impact a c-section has on all kinds of natural processes.

 

03-14-2011 03:05 PM
Storm Bride

I hate the term "natural cesarean" with every fiber of my being. There are no words to describe how strong my reaction is to hearing this term. That said, my last c-section had some elements of this, and it was less traumatic than any of the previous four. I don't consider it to have been "prettied up". It was simply less traumatic. I have no desire whatsoever to have the drape lowered to see the baby emerging, though. Yuck.

 

There are lots of emergent and/or medically advisable cesareans that aren't true emergencies, and where the time could be taken to make it a less brutal experience for the mom. I'm all in faovur of that.

03-14-2011 03:03 PM
Storm Bride

Quote:
Originally Posted by littleteapot View Post

But the word "Elective" has a very specific meaning, and it is for cesareans where a choice was present.



Since when? This is one of my pet peeves about cesareans. "Elective" is used to code any c-section that isn't an out and out emergency, even when there's medical need. This has been seen many, many times. My third one was only done because my OB threatened to withdraw from my case if I didn't go in (and how i wish I'd let him, but that's just one more in a long list of regrets). It was supposedly necessary (due to having two prior cesareans, and an "overdue" - GAK! - baby). It was still considered "elective".

 

There's always a choice, theoretically. A woman could be in immediate danger of both herself and her baby dying and still refuse surgery.

03-14-2011 03:02 PM
lovebeingamomma

It's something that I will have in my birth plan for an emergency situation.  I can't really think of an emergency situation that wouldn't permit skin to skin contact right away (unless I'm under general anesthesia)  Me holding the baby or a nurse holding the baby makes no difference when determining apgar score, in a full term pregnancy of course.
 

Quote:
Originally Posted by dayiscoming2006 View Post

That's really neat. It'd be even neater if it could almost always be like that for any emergency C/S. I'm assuming that it's only relevant for something they know before hand, rather than an on the spot emergency?
 



 



 

03-14-2011 02:52 PM
dayiscoming2006

That's really neat. It'd be even neater if it could almost always be like that for any emergency C/S. I'm assuming that it's only relevant for something they know before hand, rather than an on the spot emergency?
 

Quote:
Originally Posted by lovebeingamomma View Post

...emergency sections are done like this in my state?  By two OB's who believe this is what is BEST for mom & baby, not for the frills.  

 



 

03-14-2011 02:38 PM
lovebeingamomma

uum did you completely miss my post about the fact that emergency sections are done like this in my state?  By two OB's who believe this is what is BEST for mom & baby, not for the frills.  And if this isn't about proving which c-sections are necessary, why are you going ahead and trying to disprove the c-section that I mentioned?  I don't really care about the strange attitude you have towards all of this but please just stop saying this will not be an option for emergency c-sections because it's not true, it's not a matter of your opinion.
 

Quote:
Originally Posted by littleteapot View Post

Really, I agree with the fact that cesareans should be done with a lot more care... less traumatizing is the way to go. Having baby up on your chest would be great. Skin to skin would be great. Minimal separation would be great. Ideal. Perfect! But the word "Elective" has a very specific meaning, and it is for cesareans where a choice was present. And I stand by my original point: the number of women who would be truly eligible for this (including in the above examples) is very, very slim. This will not be an option for emergent cesareans. Period. Which, if we're trying to get down to a safe and healthy number of cesareans, is what we're aiming to save the surgery for.

 

Emergency cesarean sections are done to save a mother and baby's life, which is why the doctor specifically said these can only be done for electives. He mentions repeatedly that while the surgical procedure doesn't differ, extra time is involved. You do not have that time in an emergent situation... because it is an emergency. You do not have the luxury for skin to skin and all that stuff because mom and baby are in dire need. That's why the surgery was done. Originally this is why we had cesareans, but this is no longer the case unfortunately.

Labours that are "too long" or have failure to progress are very, very, very often iatrogenic. By several days in it's unlikely it will change, but changes to policy in the beginning would have created a very different situation. The times when failure to progress is a serious issue are very slim, and you're usually talking about situations wherein CPD is true (less than 1% of diagnosed CPD is true CPD caused by a defect in the baby's head or mother's pelvis). Persistent transverse lie in late labour is also very rare. It happens, but it's extremely extremely rare (and is often exacerbated by having your membranes artificially ruptured, as if often the case with cord prolapse as well). As for the herpes outbreak one... well, please do a lot of research on the topic. I don't want this thread to turn into a, "let me prove to everyone why MY cesarean was necessary"-a-thon because that's pointless and painful, but please remember that very few are medically required... that's why we have a problem. If you're standing in a room full of 100 women who all had "necessary" cesareans, chances are only about 8-10 needed them. This is the sad truth about the cesarean epidemic.

 

PS. On the hospital record thing. Sometimes they write that to cover their a$$. My records also say "Elected to have a cesarean" after being "calmly explained the pros and cons"... when in reality my baby was crowning when the doctor realized he was frank breech (the safest and best way to deliver a vaginal breech) and reached in and shoved him forcibly back into my uterus while I screamed in pain, told me my baby would die if I didn't agree with him, and then took me to the OR (without moving his hand from inside my uterus the entire time) and knocked me unconscious while I screamed, "No I want a vaginal birth. I want a vaginal birth". Ironically he ended up dying anyway for something totally unrelated and unseen... you'd hope that doc would feel like a tool for having used the dead baby card and actually having it happen, but no...

 

Not much elective about that. I was told my cesarean was "emergency", but in my records it's classed as BOTH elective and emergent... however, neither are true. It wasn't an emergency, and it wasn't elective: it was just bad policy. The next day the surgeon came in and said, "If I'd known your baby was going to die anyway I might have allowed you to have a vaginal birth", shook my hand and left. Bad policy, impatience and fear is what drives most cesareans... the institution needs to change. Birth on a whole needs to be healthier and safer for mom and baby, and imho we're not going to get there by focusing all our energy on making elective cesareans prettier.



 

03-14-2011 02:37 PM
dayiscoming2006

Quote:
Originally Posted by littleteapot View Post

PS. On the hospital record thing. Sometimes they write that to cover their a$$. My records also say "Elected to have a cesarean" after being "calmly explained the pros and cons"... when in reality my baby was crowning when the doctor realized he was frank breech (the safest and best way to deliver a vaginal breech) and reached in and shoved him forcibly back into my uterus while I screamed in pain, told me my baby would die if I didn't agree with him, and then took me to the OR (without moving his hand from inside my uterus the entire time) and knocked me unconscious while I screamed, "No I want a vaginal birth. I want a vaginal birth". Ironically he ended up dying anyway for something totally unrelated and unseen... you'd hope that doc would feel like a tool for having used the dead baby card and actually having it happen, but no...

 

Not much elective about that. I was told my cesarean was "emergency", but in my records it's classed as BOTH elective and emergent... however, neither are true. It wasn't an emergency, and it wasn't elective: it was just bad policy. The next day the surgeon came in and said, "If I'd known your baby was going to die anyway I might have allowed you to have a vaginal birth", shook my hand and left. Bad policy, impatience and fear is what drives most cesareans... the institution needs to change. Birth on a whole needs to be healthier and safer for mom and baby, and imho we're not going to get there by focusing all our energy on making elective cesareans prettier.


What your doc did is insane! The baby was coming out, that should have been considered too late. It's obvious he had never had to deal with that before and panicked. How horrible! If your baby wasn't going to die anyway, they may have had some serious injuries from what your doc did.

Just another thing to add to the list of why I'm UCing. 

 

I honestly know very little about C/S except that they are done way too often and the fact that you had a previous one doesn't mean you should have another. I tried to convince my sister to try for a VBAC with her second, as her first was an emergency C/S for pre-e at 31 wks gestation, but she wouldn't do it though I gave her all the info. She actually said she didn't like the idea of a vaginal birth. I found that sad but I guess her only experience with a vaginal birth was how my first went (she was there) and the way typical hospital vaginal births go is also rather scary. I'm sure the whole thing really freaked her out. 

 

I will say anyway, that I think littleteapot could be right, that this type of surgery is only available when the situation isn't considered emergent and that is troubling. Maybe I'm wrong, but I can't imagine docs who thought the situation was an emergency doing things so nice from my previous experiences.

 

 

03-14-2011 01:52 PM
MeepyCat


 

Quote:
Originally Posted by littleteapot View Post

Emergency cesarean sections are done to save a mother and baby's life, which is why the doctor specifically said these can only be done for electives. He mentions repeatedly that while the surgical procedure doesn't differ, extra time is involved. You do not have that time in an emergent situation... because it is an emergency. You do not have the luxury for skin to skin and all that stuff because mom and baby are in dire need.



Again, I disagree. 

 

If a surgical delivery is done to address a crisis which ends with birth, then there is no reason why, crisis past, skin to skin contact can't be initiated immediately.  So long as I'm not puking into my oxygen mask, is there any reason why the nurse assigned to make sure I'm not showing signs of distress can't lower a curtain at the right moment?  There is no reason why a basically healthy set of parents can't nuzzle a basically healthy baby on one side of the blue curtain while suturing goes on on the other.  In a lot of cases, c-sections are preventive medicine:  poor fetal heart tones might indicate a serious problem, but might be nothing - if I'm getting bad fetal heart tones, I want surgery and if, once out of my body, my baby is pink and screaming, we can all slow down and indulge in a small luxury like nursing on the table. 

 

My "elective" section (they really do not need to cover their butts when sectioning for previa) included a moment where a nurse brought me my baby and held her where I could kiss her cheek.  They still got her to the NICU really fast, and surgical recovery was arranged so that my mom and my DH could come in and report to me on how she was doing.  Why on earth does everyone not get that?

 

We don't have to attack only one problem in maternity care at a time.  We can have nicer c-sections AND work to reduce the overall percentage of c-sections.  Collectively, we have the resources to do both. 

03-14-2011 12:58 PM
littleteapot

Really, I agree with the fact that cesareans should be done with a lot more care... less traumatizing is the way to go. Having baby up on your chest would be great. Skin to skin would be great. Minimal separation would be great. Ideal. Perfect! But the word "Elective" has a very specific meaning, and it is for cesareans where a choice was present. And I stand by my original point: the number of women who would be truly eligible for this (including in the above examples) is very, very slim. This will not be an option for emergent cesareans. Period. Which, if we're trying to get down to a safe and healthy number of cesareans, is what we're aiming to save the surgery for.

 

Emergency cesarean sections are done to save a mother and baby's life, which is why the doctor specifically said these can only be done for electives. He mentions repeatedly that while the surgical procedure doesn't differ, extra time is involved. You do not have that time in an emergent situation... because it is an emergency. You do not have the luxury for skin to skin and all that stuff because mom and baby are in dire need. That's why the surgery was done. Originally this is why we had cesareans, but this is no longer the case unfortunately.

Labours that are "too long" or have failure to progress are very, very, very often iatrogenic. By several days in it's unlikely it will change, but changes to policy in the beginning would have created a very different situation. The times when failure to progress is a serious issue are very slim, and you're usually talking about situations wherein CPD is true (less than 1% of diagnosed CPD is true CPD caused by a defect in the baby's head or mother's pelvis). Persistent transverse lie in late labour is also very rare. It happens, but it's extremely extremely rare (and is often exacerbated by having your membranes artificially ruptured, as if often the case with cord prolapse as well). As for the herpes outbreak one... well, please do a lot of research on the topic. I don't want this thread to turn into a, "let me prove to everyone why MY cesarean was necessary"-a-thon because that's pointless and painful, but please remember that very few are medically required... that's why we have a problem. If you're standing in a room full of 100 women who all had "necessary" cesareans, chances are only about 8-10 needed them. This is the sad truth about the cesarean epidemic.

 

PS. On the hospital record thing. Sometimes they write that to cover their a$$. My records also say "Elected to have a cesarean" after being "calmly explained the pros and cons"... when in reality my baby was crowning when the doctor realized he was frank breech (the safest and best way to deliver a vaginal breech) and reached in and shoved him forcibly back into my uterus while I screamed in pain, told me my baby would die if I didn't agree with him, and then took me to the OR (without moving his hand from inside my uterus the entire time) and knocked me unconscious while I screamed, "No I want a vaginal birth. I want a vaginal birth". Ironically he ended up dying anyway for something totally unrelated and unseen... you'd hope that doc would feel like a tool for having used the dead baby card and actually having it happen, but no...

 

Not much elective about that. I was told my cesarean was "emergency", but in my records it's classed as BOTH elective and emergent... however, neither are true. It wasn't an emergency, and it wasn't elective: it was just bad policy. The next day the surgeon came in and said, "If I'd known your baby was going to die anyway I might have allowed you to have a vaginal birth", shook my hand and left. Bad policy, impatience and fear is what drives most cesareans... the institution needs to change. Birth on a whole needs to be healthier and safer for mom and baby, and imho we're not going to get there by focusing all our energy on making elective cesareans prettier.

03-14-2011 09:14 AM
lovebeingamomma

Two doctors in my state perform c-sections like this, and I know for a fact they do emergency c-sections like this.  In fact I just spoke to an ICAN leader the other day about her c-section (yes, truly necessary, after days of laboring), that was beautiful and gentle like in this video.  Better for mom better for baby.
 

Quote:
Originally Posted by littleteapot View Post

10:29-10:37

 

"And I don't see any reason why this shouldn't be the way in which cesarean section- elective cesarean sections - are generally performed across the country".

 

Emphasis may be mine in text, but it's his as well; listen to his voice. This is an option only for elective sections. Those which are NOT medically necessary, NOT an emergency, where vaginal birth WAS an option.



 

03-14-2011 08:55 AM
clutterbug

Quote:
Originally Posted by MeepyCat View Post None of these things requires that obstetrical surgery must suck for everyone who has it. 

 

I agree - it's not necessarily about prettying it up, it's about making the best out of a less-than-ideal situation for the sake of each mother-baby pair.  And it doesn't mean we can't continue to strive for a 15% c-section rate instead of 30%; those 15% of necessary sections would be at least a slightly better experience for those mothers and babies.
 


Maybe that's naive?  I have been fortunate not to have had institutionally-approached births (my first was in hospital, but with a family physician, not an OB), so maybe I just see the world through rose-coloured glasses ;)

03-14-2011 07:52 AM
MeepyCat

Littleteapot, may I say how much I disagree?

 

My DD was born by c/s for unstable hemorrhage resulting from a grade III placenta previa.  The surgery is coded as "elective" in my records.  I have no idea how many of the surgeries described as elective in hospital records and statistics resemble mine in that no one who wasn't a hospital administrator would consider them optional.

 

Now, honestly, I would not have wanted this kind of surgery:  by the time my DD was born, I was completely freaked by the sight of blood and DH was worse.  I am immensely grateful that they cleaned her up before they brought her to me (which was about 60 seconds before they brought her to the NICU).  But we had some time before the surgery - not a lot, but a few minutes - to discuss our desires with the OB, to consult with anesthesiology, neonatology, and the surgical team, and I see no reason why we should have been denied this option.

 

Your argument seems to be that c-sections are popular enough, we shouldn't make them nicer.  But that implies that making the c/s nicer is just a frill, and I don't think it is.  If facilitating mother/infant contact makes the situation prettier, so be it - we don't do it because it's prettier, we do it because it's good for moms and babies.

 

I would love to change the way hospitals operate.  I would love for unrestricted malpractice insurance to be affordable to all OBs, and for every hospital to be able to staff the L&D unit at levels that make VBAC safe and available for all women.  I don't think that anyone but me and my doctor should have input into the question of whether or not I have a surgical delivery.  None of these things requires that obstetrical surgery must suck for everyone who has it. 

 

 

Quote:
Originally Posted by littleteapot View Post

A few things I want to say:

1. yes you can ask for a cesarean and get it. LOTS of people do. This is a large part of why iatrogenic prematurity is such a huge, huge, huge problem in the states.

2. In times when a cesarean is medically necessary, most are emergencies... they won't have time or the luxury to make things all flowers and sunshine. It is going to be 99% the "non emergent" cesareans that are capable of being done like this, which means that it's mostly elective and repeats, which are neither medically necessary nor should be encouraged. I think the general idea here is that if you have the option to have a "woman centered cesarean" (what a misleading title!), you probably didn't need a cesarean at all. There will be exceptions, but it'll be pretty rare.

3. Before anyone jumps on me for not knowing what I'm talking about, I'm a cesarean mom and an ICAN co-leader.

 

Being safe and happy with your birth are paramount, and in the best interest of mother and baby health (as well as bonding, long term side effects, breastfeeding, and a MILLION other reasons) cesareans should not be prettied up imho. They're already popular enough... I think we can all agree the last thing the cesarean industry needs is more excitement on why it's awesome to get one. Cesareans are major abdominal surgery, and carry very serious risks to both mother and baby. I don't know that I think this kind of surgery should be promoted considering the amount of women who would be ideal candidates for it (IE. ones that cannot, cannot, cannot have a vaginal birth and that reason does not mean an increase in medical monitoring or care due to being in a high risk situation) are going to be very few. VERY few.



 

03-14-2011 07:23 AM
clutterbug

What about something medically indicated but not emergent...like transverse position, herpes outbreak, etc.  I would never, ever, ever elect to have a c-section, but if I were in a position where I was having to plan one, it would be nice to know that options like this are available.  And what about a failure to progress c-section - one could argue that those are unnecessary, but they don't tend to be a whisk-you-off-fast situation.  If the routine practice could move to incorporate at least some of this stuff, as much as possible in different circumstances, it would make a big difference for people's experiences. 

 

There is a video in our LLL library about the 10 stages a brand-new baby goes through to latch for the first time, and it has a section in it aimed at health care providers, to show how they can alter their standard way of doing things to help facilitate this process in c-section birth.  Little things like lowering a curtain are not particularly difficult or time consuming to do, it's just a routine/cultural shift and then it becomes part of the norm.  And if baby is breathing well at birth, there shouldn't be a reason to separate from mom, even if there was a rush to get baby out.  Making changes at the non-emergent level could, eventually, affect how emergent situations unfold, even just a little bit.  You make something just a part of the routine and it becomes easier to incorporate more and more often.

03-14-2011 07:03 AM
dayiscoming2006

Yuck. :( 
 

Quote:
Originally Posted by littleteapot View Post

10:29-10:37

 

"And I don't see any reason why this shouldn't be the way in which cesarean section- elective cesarean sections - are generally performed across the country".

 

Emphasis may be mine in text, but it's his as well; listen to his voice. This is an option only for elective sections. Those which are NOT medically necessary, NOT an emergency, where vaginal birth WAS an option.



 

03-14-2011 12:31 AM
Cutie Patootie

I think this is incredible and was really moved by the film...until the end when the doctor said something about changing the way elective c-sections are done.  I'm thoroughly against elective c-sections, but for mothers who have no other choice but c/s, this is so amazing.

03-14-2011 12:25 AM
littleteapot

10:29-10:37

 

"And I don't see any reason why this shouldn't be the way in which cesarean section- elective cesarean sections - are generally performed across the country".

 

Emphasis may be mine in text, but it's his as well; listen to his voice. This is an option only for elective sections. Those which are NOT medically necessary, NOT an emergency, where vaginal birth WAS an option.

03-14-2011 12:11 AM
littleteapot

A few things I want to say:

1. yes you can ask for a cesarean and get it. LOTS of people do. This is a large part of why iatrogenic prematurity is such a huge, huge, huge problem in the states.

2. In times when a cesarean is medically necessary, most are emergencies... they won't have time or the luxury to make things all flowers and sunshine. It is going to be 99% the "non emergent" cesareans that are capable of being done like this, which means that it's mostly elective and repeats, which are neither medically necessary nor should be encouraged. I think the general idea here is that if you have the option to have a "woman centered cesarean" (what a misleading title!), you probably didn't need a cesarean at all. There will be exceptions, but it'll be pretty rare.

3. Before anyone jumps on me for not knowing what I'm talking about, I'm a cesarean mom and an ICAN co-leader.

 

Being safe and happy with your birth are paramount, and in the best interest of mother and baby health (as well as bonding, long term side effects, breastfeeding, and a MILLION other reasons) cesareans should not be prettied up imho. They're already popular enough... I think we can all agree the last thing the cesarean industry needs is more excitement on why it's awesome to get one. Cesareans are major abdominal surgery, and carry very serious risks to both mother and baby. I don't know that I think this kind of surgery should be promoted considering the amount of women who would be ideal candidates for it (IE. ones that cannot, cannot, cannot have a vaginal birth and that reason does not mean an increase in medical monitoring or care due to being in a high risk situation) are going to be very few. VERY few.

03-11-2011 01:24 PM
ceriserenee

As most of you know, I am trying for a VBAC here is Peru, and am working with a wonderful midwife. She is the only Doctor (She is actually and OBGYN that acts as a midwife here) in all of Lima that will work with you to have VBAC. I am grateful to have found her and am really hoping for a great experience. I also can understand those who don't want to watch this, or wish they hadn't...C-sections can be so traumatic...I am sending lots of healing energy to you all.

03-10-2011 10:52 PM
maotmsmi

*

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