C Sections As A Lifestyle Choice?

In My Humble Opinion
1

Not sure where to put this particular thread…I’ll try here, but feel free to move to GD or somewhere else if needed. There is an interesting article in Newsweek

About the trend in many Latin American countries to “schedule” C sections as a routine delivery procedure…mainly to avoid the “pain of delivery”.

Apparently, many women are scheduling them much like one would schedule a hair appointment…even printing up birth announcements before hand…like wedding announcements.

This strikes me as freaky, and somewhat dubious medically. Leaving aside the natural vs. drugs debate in childbirth, is treating childbirth like just another surgery…with all the associated risks and side effects a good idea? Is this a cultural phenomenon that will stay primarily in Latin America?

2

In my personal corporate experience in Colorado, I’ve known at least three women who’ve had planned c-sections to tie in with their business schedules. I would hardly say it’s limited to South America.

I’d never choose unnnecessary surgery myself though. I don’t relate.

3

There should be a difference. My wife had them with our Children. Cases like that should be okay.

Scheduling your kids delivery to extremes, tho… I don’t think that’s a good idea.

4

My opinion-this is not a good idea. A c-section is major abdominal surgery and should be reserved for those few cases where it is necessary to save the life of the mother and/or baby. The thought of people choosing to take that risk for no good reason is just horrifying.

Will it remain a Latin American phenomenon? Probably not. Unfortunately, there are growing numbers of obstetricians in the US who are pushing for this. Already we have the increasing popularity of “social inductions”, where women choose to induce labor because they want to be delivered by a particular doctor or just want to make it more convenient. It’s not that big a step to scheduling a surgery instead.

5

As a mother of three, who has had one vaginal delivery, one emergency c-section and one planned c-section, I have to chime in here.

I can’t believe this article! I can promise you, c-sections are not pain-free. You have the pain after the surgery, not during. I was in labor for 18 hours with my first child, but I can say the procedure was pain-free. I had an epidural, which worked wonders. There was a small bit of pain afterwards, but nowhere near what it was like with a c-section.

It’s interesting, standing up for the first time after surgery, wondering if your guts are going to fall out. Then you have to have more drugs to kill the pain.

Vaginal deliveries do damage “down there?” Not in my case. I enjoyed sex as much after as I did before. :smiley: I enjoy it even more now because I had a tubal.

Our son was a c-section because his heart rate kept decelling. It was a scary situation, but I did get to be awake and Saint Zero was right there with me. Our son had a perfect knot in his umbilical cord. If we hadn’t had the surgery, he might not be here today.

Our daughter was planned. I wanted to go VBAC, since I had a successful vaginal delivery before, but since she was only 13 months after her older brother, the chance of uterine rupture was too high. After talking with my doctor and doing some research on my own, we decided a repeat c-section was the best way to go. It also made it easier for the doctor to do a tubal while he was there.

I wouldn’t recommend surgery as an everyday way of having a baby. It’s great if you need it, but only if you need it. I don’t believe it should be available simply on demand.

Of course, c-sections do make for some serious stories to pass down. For example, after our son was born, they gave me a self-service morphine drip. I could punch the button every so often and get pain relief. I pressed it once. Only once. I got up about 4am to go to the bathroom, and came out and statred dancing with my IV pole, singing, “An IV is a girl’s best friend.” My porr husband was laughing hysterically! To this day, he wishes he would have had a video camera.

I turned down the morphine the next time. My husband was devastated. :smiley:

6

If, by some miracle, I were able to get pregnant, I’d opt for a scheduled C-section, although I’ve got a good medical reason to do this.

Some women are carriers of a bacterium called group B strep that can cause serious harm to or can kill the baby. It’s routinely screened for now, and it’s easy to prevent transmission to the fetus with a couple of very cheap and safe antibiotics. Unfortunately, I’m allergic to one of these antibiotics. And because I’ve lost a child to GBS disease, a C-section is indicated. (Yes, I know there are other drugs, and there’s a vaccine in the works, but it’s a risk I am not willing to take.)

Robin

7

Okay, on one hand, its not something I’d be willing to do. Scheduling induction or a C-section just seems like too much messing with ‘the natural way of things’ unless you have a specific medical need. Social factors and wanting to control every bit of my life just aren’t a good enough reason for me.

However, if they want to do it and are more comfortable with knowing when, where, and how everything is going to occur, by all means let them. Its their pregnancy, their kid, and they are the ones who should be the most comfortable in the situation.

This is why I like midwives personally, in my experiance doctors have procedures that pregnant woment have to conform to, while the midwives I have known are more willing to allow the personal preferances and comforts of the woman to superscede how delivery is ‘supposed’ to be done.

Every one is different and is more or less comfortable with different options available. Its a rough enough experiance without other people telling you how it should be done. So my opinion is pertty much, let it be. Until doctors start mandating C-sections or scheduled inductions, I’m not worried about them being options.

8

This one touches off hot button topic for me. To have any organization decide that some level of C-sections is the ‘right’ percentage drives me up a tree. The only folks who should be making that decision are the woman, her family and her doctor.

My mother had vaginal births. My sister and I had C-sections. Now, some may disagree with the reasons either my sis or I had them. Tough. Your opinions were not requested.

However, for the nimrod who saw fit to talk to my (then) husband shortly after I’d given birth and shaaaaaaaare with him that they thought my C-section was probably unneccessary, and convinced my (then) husband of same (one of the many excellent reasons we’re divorced), well, let me assure you that there is a special place in hell for folks like you…

What may be an excellent reason in my eyes might not be in some one elses. I personally wouldn’t have gone the C section route 'cause “it fit in my schedule better” but, that’s me. (mine was an emergency one scheduled after 17 hours of labor and consultation from 3 doctors). So, for me, I’ll refrain from deciding if these other women had ‘sufficient reason’ for theirs.

9

wring wrote:
So, for me, I’ll refrain from deciding if these other women had ‘sufficient reason’ for theirs.

I, however, have no such compunctions. Abdominal surgery carries with it risks that cannot be completely avoided. It presents a danger to the mother and to the baby. In cases where that danger is less than the danger of attempting a vaginal birth, it makes sense. When a woman chooses it because she doesn’t want to damage herself “down there” (and the doctors are agreeing with this? Kegel, anyone?) or because it is more convenient for her, that is stupid and dangerous. And I’m not afraid to say so.

How many of these women do you think were informed of the actual risks they were taking? The article mentions a doctor who schedules inductions on Wednesdays and Saturdays for those pesky patients who insist on a vaginal birth. Is this being done for the women’s convenience or the doctor’s? Would most of them make the same choices if they were fully educated?

10

Sorry. I will agree that the physicians involved should be giving the comparative risks, however, once that is done, the decision is hers to make. Should some woman desire to undergo a C-section for reasons that I personally would find insufficient, it’s still her decision.

And, my main point, (why should some group decide that there’s an ‘optimum’ percentage of C-sections?) stands. Without a review of each file, it is premature for any of us to decide that there’s too many going on.

11

I couldn’t agree with you more. I am most certainly NOT saying that C-sections in and of themselves are automatically a bad idea. I am pointing out that the article says that there is a culture that is developing in Latin America that is anathema to the notion of vaginal deliveries. It is disturbing that two female birth educators (Poly & Eli) are accused of “planting ideas” in the heads of pregnant women for suggesting that “gasp” vaginal deliveries are possible…and for some women possible without Rx.

From the article “A recent study in the British Medical Journal concluded that 850,000 C-sections are needlessly performed throughout the region each year.”

The word “needlessly” seems relevant to this discusssion…especially in any discussion of surgery.

12

“needlessly” according to whom, please? were the individual files examined? You see, that’s my problem with that position. The jerk off that cornered my ex-husband was just as certain as you seem to be that my C-section was ‘needless’.

And, just as I would not want anyone else sitting in judgement over my decision, **even ** if you agreed with it ultimately, I would not wish to sit in judgement over some one else’s.

13

My main problem with scheduling c-sections is that many OB’s do this routinely at 38 weeks, to lessen the likelyhood that the mom will go into labor beforehand - but if the mom’s dates are not exactly right, they may very well end up delivering a preemie, with all of the risks that entails.

A c/s is not exactly minor surgery, either - I know a couple women who have had their bladders or intestines sliced (and then needed repairs) and some who have had pretty bad postoperative infections as well. The higher level of complications, IMO makes a c/s something that should only be done after consultation, not just because it fits a schedule.

–tygre

14

Well, I’ll chime in too. I had a scheduled C/S, due to a cantaloupe-sized fibroid that was blocking the exit. The procedure was painless. However…the recovery was excruciating for a long time, and walking (and lifting the baby and getting dressed and moving around in bed etc etc etc)was painful for weeks. I was healthy going in and coming out, the baby was healthy, it’s just a long, painful recovery when you have major abdominal surgery.

When my best pal, who was pregnant at the same time, was offered a C-section after 16 hours of labor, she said, “NO!! My friend almost bled to death and couldn’t walk for weeks! Let me rest an hour, and I’ll get this thing out if it KILLS ME!!!” (Note: baby was not in danger.) Four hours later, her daughter was born. The next day, my friend went shopping at the mall with her mother.

My recommendation? If the baby or mother is in danger, cut. If not…well, labor bites, but it bites for a LOT less time than post-surgical recovery.

That said, I do know a large number of women, all at term, who scheduled an induction. (This same friend did, for her second baby.) That is not in any way the same thing as getting surgery…it’s just “getting things started,” as it were. And, it’s up to the doc whether mom/baby are “ready.”

15

Add me to your list! This happened to me (A fairly serious bladder tear, very close to my ureters).

If you have to have a c-section in order to squeeze in a business trip… well, I dunno, at 40 weeks I can’t believe your mind would be more on business than the new arrival. I recall I worked past my due date and I was very concerned about being able to wrap up a project before Cranky Jr. arrived. But I don’t think I would have asked for surgery (presumably at some earlier point) to make that work out right. Then again, my job ain’t exactly high-powered. I’m important, but not crucial. LOL

16

The problem is that “getting things started” doesn’t always work. It is not all that unusual for an induction to fail and become a c-section.

And, in the absence of a medical emergency that requires intervention, the doctor cannot determine whether the mom/baby are ready. The “due date” an expectant mother is given is only a rough approximation, not any sort of deadline. (And the 40 weeks we’re all familiar with isn’t accurate, anyway. A recent study indicates that the average term of pregnancy is actually 41 weeks plus a day.) The onset of labor is determined by many factors, not all of which we fully understand. Dilation and effacement, which doctors love to track as evidence of “progression,” are only indications that labor is occurring, and actually tell you absolutely nothing about when that baby is going to come out. At one extreme, you can be 2cm at an exam and deliver an hour later. You can also walk around for weeks at 5cm.

This concept of scheduling surgery for convenience’s sake is just an outgrowth of the medical model of childbirth, where the doctor attempts to “manage” the process by forcing it into some “normal” pattern. It completely ignores the natural process, which can be quite variable, often for very good reasons. And it ignores how much we don’t understand about what is happening and why. Modern medicine has given us some wonderfully lifesaving interventions. It is sad and frustrating to see them so horribly misused.

17

I don’t think anyone has said it’s not her decision. The question is whether it’s a good decision.If someone tells me she’s having or had a C-section, I’m not going to question her reasons, because it’s not my business. On the other hand, if she tells me she’s planning a c-section because she doesn’t want the timing to interfere with her business or vacation schedule, or because “she doesn’t want pain” , it’s going to cause me to question her judgement and/or priorities.

You couldn’t decide a c-section is unnecessary in a particular case without reviewing the file, but if, for example,22% of all births are by c-section, and 75% of my doctor’s patients have c-sections, I’m going to wonder what’s going on.Looking at an individual doctor, there may be a good reason (restricted practice), but according to the article,private hospitals in Nueva Leon have a c-section rate of 73%. If 73% of births in private hospitals there require c-sections, either a lot are being performed for non-medical reasons, or something has caused the women in that area to require c-sections for medical reasons far more often than in other places (and unlike most medical problems, this one disproportionately affects the wealthy).

18

My wife has had two kids. First natural, without epidural, second c-section because it was a breach birth. She says that the c-section was a lot more painful for a longer time afterwards than the natural birth, and she would much rather deliver the old-fashioned way.

19

[QUOTE]
*Originally posted by doreen *
**

** Again, if you believe that it’s her decision to make, whatever her criteria are, then why do you wish to supplant your own assessments on her decision?

What I am objecting to is the Medical authorities ‘deciding’ that a certain level of C-sections is the right one. Pressure is then brought on the doctors. Now, then what this does is to apply this magical percentage onto a specific group of women, and instead of evaluating each pregnancy on it’s own merits, then the doctor may have this concept overriding.

(warning personal example alert) It used to be thought that if you had a C-section, subsequent pregnacies should also be C-section. But then the AMA came out and decried ‘we’ve got too many C-sections’ and urged doctors to have women attempt a vaginal delivery second time. My friend Lois, had 3 kids. Each and every single one of them was born after several long hours of labor plus a C-section. Her doctor kept urging her to try for a vaginal birth. After my one episode of labor +C-section, I’d never consider risking that again thank you.

I understand your point about women with $$ opting for the surgery vs. vaginal delivery. and agree that it’s likely that the reasons for the huge percentage there are not likely to be medical reasons.

However. To have a decreed percentage of C-sections as ‘acceptable’ applies a percentage to all women. Doctors can be influenced by these things, and perhaps not recommend a C-section in a marginal case because of it.

Nope. I want the decision to be exactly with the individual Doctor and the woman involved, without being subjected to either second guessing by others or condemnation by others 'cause they didn’t think the decision was for ‘sound medical reasons’.

You’re certainly entitled to this:

where we diverge is that I think even if her reasons are insufficient for me, that she should be allowed to make the decision.

20

I have to chime in, also.
I can’t even imagine choosing to have a c-section just for the “convenience.”

Two deliveries here, one vaginal, one c-section. With my daughter, it was a normal vaginal delivery, no complications. I even walked to my room, about 90 minutes after delivery. I was a little sore “down there” but it wasn’t bad.
With my son, however, it was a completely different story. I had placenta previa (placenta covers the cervix) so I knew I would be having a c-section. At about 35 weeks, I started hemmorraging and having contractions, so I had an emergency c-section. Not fun, let me tell you. Major freaking surgery, sliced open from hip to hip, hurts like hell for weeks. I know the doc did something to my bladder…nothing major, but now, even 4 years later, if I have to pee, I HAVE TO PEE! If you are between me and the bathroom, I will knock you over. I used to be able to go for hours without having to go, and could ‘hold it’ for ages. Not anymore. As soon as I get that “need to go” feeling, I go. I also still have a numb spot (about the size of my palm) on my right side where I suspect nerves were cut.
And I won’t even go into the issues of ‘draining’ (the incision) and the staples and trying to stand up and walk after the surgery, and trying to nurse.
I just can’t imagine someone choosing it over a regular vaginal birth.