Mothering Forum banner

1 - 20 of 35 Posts

·
Registered
Joined
·
2,969 Posts
Discussion Starter · #1 ·
Hi! I'm hoping this wont be an issue, but I've read of a few people who had elective cesareans with their preemies because its supposed to help minimize damage? Or brain bleeds? Something like that...<br><br>
Anywho, I wanted to see if anyone knew of this, if this is from a study and if so, which, any info that might be pertinant would be helpful. Is there a specific gestation this was recommended for? I'm just wondering, thanks.
 

·
Registered
Joined
·
538 Posts
I don't have any info other than my own personal experience.<br>
My twins were delivered by c/s at 25w4d. I was in labor and my midwife asked me to consent to a c/s because it reduces the risk of brain bleeds by avoiding the pressure of the birth canal.<br>
Neither of my twins developed a brain bleed. We just talked with their nicu doctor today who told us that the chances of them developing a bleed now (minus a major medical catastrophe happening) are almost 0. He also said that preemies as early as mine were, to not have any level of brain bleeds, is very rare.
 

·
Registered
Joined
·
279 Posts
I didn't have a elective C/S because we were both very sick, but there was a study done that said that 26% of all babies born vaginally have minor brain bleeds. <a href="http://www.emaxhealth.com/84/9266.html" target="_blank">This isn't the study, but an article writen about it</a>. I don't know of any others.<br><br>
HTH
 

·
Registered
Joined
·
378 Posts
I gave birth to my 25 1/2 weeker (I usually just say 26 weeks) vaginally and he had many complications but NO brain bleeds. Actually his lungs were terrible and lungs are helped by vaginal delivery, so if I had opted for a c/s I would have felt guilty. The Neonatologists told me that they don't know exactly what causes brain bleeds and that pressure during delivery being one reason is just a theory at this point.
 

·
Registered
Joined
·
1,900 Posts
I'm not trying to be snarky or defensive, I wear. But I'm not quite sure how any cesarean can truly be considered elective when you're talking about a preemie. I suppose I could've asked for a c-section from the start when I was at 6cm and was told there was nothing else they could do to keep me from having babies. But I still don't know that I'd consider that "elective" though I guess by the strict definition, it's elective if you could have birthed them vaginally instead, somehow.<br><br>
Anyway, I have only anecdotal evidence to offer, which is that neither my vaginally-birthed twin A nor my c-section-birthed twin B had a brain bleed at 29 weeks, though my c-section-birthed twin had much more significant respiratory distress syndrome and required oxygen until she was nearly 6 months old.
 

·
Registered
Joined
·
279 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>OGirlieMama</strong> <a href="/community/forum/post/11621515"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I'm not trying to be snarky or defensive, I wear. But I'm not quite sure how any cesarean can truly be considered elective when you're talking about a preemie. I suppose I could've asked for a c-section from the start when I was at 6cm and was told there was nothing else they could do to keep me from having babies. But I still don't know that I'd consider that "elective" though I guess by the strict definition, it's elective if you could have birthed them vaginally instead, somehow.</div>
</td>
</tr></table></div>
Yes, this. There needs to be a third definition for women who have a medically necessary c/s which isn't classed as emergency but nor is it "elective".
 

·
Premium Member
Joined
·
2,270 Posts
My cesarian was classified as "elective" but that's because it was scheduled. Nothing else about it was elective. Mother's don't "elect" to have sick babies at 34 weeks.<br><br>
I was told a CS could spare her brain damage. That coupled with the placental problems had me agreeing. My cs was medically needed and saved her life.
 

·
Registered
Joined
·
1,789 Posts
I'm pretty sure I heard of a recent study stating that preemies lungs fare better when birthed vaginally.<br><br>
My ds was born via c-section due to breech presentation (@ 30 weeks) and had really shoddy lungs.
 

·
Registered
Joined
·
1,789 Posts
Of course, that totally doesn't answer your question about brain bleeds.
 

·
Registered
Joined
·
1,900 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>Le Bec</strong> <a href="/community/forum/post/11621541"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Yes, this. There needs to be a third definition for women who have a medically necessary c/s which isn't classed as emergency but nor is it "elective".</div>
</td>
</tr></table></div>
<br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>intorainbowz</strong> <a href="/community/forum/post/11621579"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">My cesarian was classified as "elective" but that's because it was scheduled. Nothing else about it was elective. Mother's don't "elect" to have sick babies at 34 weeks.<br><br>
I was told a CS could spare her brain damage. That coupled with the placental problems had me agreeing. My cs was medically needed and saved her life.</div>
</td>
</tr></table></div>
Exactly. Kate was born via c-section because after her sister came out, she got into a really bad position. The OBs basically said to me that it wasn't an emergency (although she was experiencing some decels) but she needed to come out via c-section. Could I have argued the point, asked them to wait, see if she changed position? Maybe so. Would she have died while we were waiting? Maybe not, but was anyone willing to take that chance at that point? Not me. Would I ever classify that as "elective"? No UA violation-ing way.<br><br>
I think rather than using the very emotionally-charged phrase "elective c-section" you would be better off saying "Consented to a c-section in hopes that it would spare their baby further complications on top of prematurity" since that is really much closer to what actually happens in those instances. An elective c-section, to most people, is something chosen for timing and convenience, and has nothing to do with the baby's health.
 

·
Premium Member
Joined
·
34,292 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>OGirlieMama</strong> <a href="/community/forum/post/11622344"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;"><br>
I think rather than using the very emotionally-charged phrase "elective c-section" you would be better off saying "Consented to a c-section in hopes that it would spare their baby further complications on top of prematurity" since that is really much closer to what actually happens in those instances. An elective c-section, to most people, is something chosen for timing and convenience, and has nothing to do with the baby's health.</div>
</td>
</tr></table></div>
Just popping in as the moderator because I saw the title, and I whole-heartedly agree with this and the posts that proceeded this. I can't imagine anyone would call a choice to save a baby's life "elective". "Medically-necessary" definitely seems like a better choice in terminology here, and I would hope never to see anyone in this forum referring to a mother's decision to make the healthiest choice for her and her baby as elective. It just seems beyond cruel to pretend that a mother faced with saving her baby life has any real choice in the matter.
 

·
Registered
Joined
·
5,520 Posts
<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/truedat.gif" style="border:0px solid;" title="Truedat">
 

·
Registered
Joined
·
349 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>Le Bec</strong> <a href="/community/forum/post/11621541"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Yes, this. There needs to be a third definition for women who have a medically necessary c/s which isn't classed as emergency but nor is it "elective".</div>
</td>
</tr></table></div>
<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/yeahthat.gif" style="border:0px solid;" title="yeah that">:<br><br>
I had one of those not-emergency, not-elective c/s, due to monoamniotic twins (v. rare - about one in 50,000 births).<br><br>
Or, to take another odd kind of twinning, what about conjoined twins? Most of those would have to be c/s, but it wouldn't be what I'd call "elective" nor what I'd call "emergency". Like momo twins, it's a "they won't make it any other way, but it's not as if we didn't see it coming" c/s. V. different than either "oh, hey, I want to skip labor, just give me surgery" and also v. different from "we have to get this baby out now!"
 

·
Registered
Joined
·
2,969 Posts
Discussion Starter · #14 ·
No, I agree that there is a difference between a medically necessary cesarean and an elective one. However, I do feel that in the context I'm asking in, it is still a choice-at least for me it would be. So for myself, yes, it would be an elective cesarean, as I am chosing to have it. I wouldnt feel guilty about it though, provided I saw the research as showing better outcomes-everyone just wants what is best for their baby. In any case, I'm sorry if I offended anyone.<br><br>
In any case, it kinda sounds like for an older preemie (does that make sense? lol), the lung issues can be more of an issue than brain bleeds? Or something? I'm almost 30w and having some PTL which is why I'm asking-I've never had a preemie before and want to explore this stuff before it happens, if it did.<br><br>
So for a 30 weeker, or just a little under that, what would be ideal? If anything? If I could avoid a cesarean, I'd be happy, no doubt, but if there is more of a risk with vaginal birth, Id go for the cesarean. Also, would he fact that this is my 5th change anything there in your opinion? (ie I've had almost 9 pound babies come through there before, maybe itd make for easier passage for a little tiny babe? lol)<br><br>
And again, I'm sorry if I offended anyone, I wasnt trying to make anyone feel like they should feel bad over a cesarean, whether it was medically indicated or elective or...anything.
 

·
Registered
Joined
·
378 Posts
Well, at one point it was suggested that I may want a c/s to prevent possible (not proven) brain bleeds. The neo (head of the practice) did not recommend it exactly, just mentioned that it MAY prevent brain bleeds. It would have been an elective c/s and I decided against it. There are preemie situations that would not fall under elective to me. But this situation would be an elective c/s. Lots of people get elective c/s because they feel that it is safer. There are docs out there that actually think c/s are safer than vaginal births. So, it is a little murky. To the OP, go with your gut. I am eternally thankful that I did not get a c/s. It would have made a stressful situation so much worse. My baby has been in the NICU 4 months and I just shudder to think what recovering from surgery would have meant for those early stressful days. In your situation (unless there are factors I don't know, which is likely <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> I would NOT want a c/s.
 

·
Registered
Joined
·
378 Posts
Also, stats on brain bleeds and gestational age should be readily available. Talk to the neonatologists at the hospital, we did several times before our baby was born (I was in the hospital for a week while they tried to stop my labor) They should be able to tell you the exact risk for brain bleeds. I think you may be far enough along that brain bleeds are less of an issue. Talk to more than one neo!!
 

·
Registered
Joined
·
1,900 Posts
FWIW, I've been told it's actually harder birthing a preemie than a big FT baby, because the preemie doesn't "help" the process along the way a FT baby does. I have no idea if that's true - my only vaginal birth experience is a 3 pound 29-weeker.<br><br>
I haven't done any research on the topic, but all the preemies I know who had bleeds were born via c-section. That's probably just coincidence. If I were in your position, I would try and find statistics regarding IVH (intraventricular hemorrhage - a brain bleed) by gestational age. I want to say that I've read that the incidence decreases pretty sharply after 30 weeks, but I can't vouch for that since I haven't studied up.<br><br>
And now that I reread your OP, where you said "I'm hoping this won't be an issue..." now I think you meant that the premature birth wouldn't be an issue for you and the question would be moot, whereas at first I thought you were referring to the question of whether a c-section was elective or not. I hope that the first holds true and this becomes an entirely academic question. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> Gestate on!
 

·
Premium Member
Joined
·
2,270 Posts
Have you had the steriod shots for lung development? I had them at 30 weeks, and DD was born breathing at 34. She had HiFlow O2 for about12 hours after birth.
 

·
Registered
Joined
·
3,109 Posts
I had my preemie twins vaginally at 31 weeks. I wanted the benefits that vaginal birth give to babies, but also wanted to avoid recovery from surgery as that would make me unavailable to be with and advocate for my babies for weeks afterwards in any hands on way. My husband is not the medically knowledgeable one in our family and would need to care for my other three children. As it turned out, one daughter died (would have died if born either way) and I would have been in surgery still and unable to hold her while she died as I was able to having given birth vaginally and able to follow her to the NICU.
 

·
Premium Member
Joined
·
2,270 Posts
Every one's recovery from a cs is different. I was in the NICU about 5 hours later. Saw her at least twice daily while she was there, except for when I had a cold sore. I drove a week after. My foot surgery recovery was much more difficult than my cs. I certainly was not incapacitated for weeks.<br><br>
If you are prone to cold sores, consider going on suppressive Valtrex treatment. They won't let you in NICUs with a cold sore.
 
1 - 20 of 35 Posts
Top