C Sections As A Lifestyle Choice?

wish to clarify a point. C-Sections are not a fun thing to undergo. (tho’ I’d have to say for me, personally, having labor and a C-section should be considered the worst of both worlds). what I am concerned about, (similar to my position on abortion) is that the decision should be made by the patient and doctor. I do not wish to issue standards by which other people should or should not have this surgery.

Yes, it’s risky. Yes, it’s painful. yes, yes, yes, some people are apparently doing it for reasons that I personally think are flimsy, foolish whatever.

However. Their body. Their decision.

I personally find most plastic surgery (not all) to be taking risks for silly reasons. However, I do not want to be in the position of telling other people that they should only undergo plastic surgery for this list of approved reasons.

does that help?

AMEN, sister! I think women have gotten so out-of-touch with their bodies and their bodies natural processes that anything that can’t be completed managed and predicted is seen as bad.

My sister is carrying twins. Her doctor wants to her to consider a C-section. Now, I don’t know how vaginal delivery with twins differs or what the risks; maybe someone can fill me in. She is all gung-ho about it. I keep trying to tell her that a C-section is cutting muscle and its not going to be this walk in the park she thinks its going to be. She said her doctor told her (and I don’t know if she heard incorrectly or what) that nowadays, they just separate the muscle layers versus cutting them. Huh? I told her I didn’t think this was possible. I mean, You’ve got to cut something (besides skin) to get through the peritoneal layer, right?! I also keep telling her that her recovery isn’t going to be as easy as she thinks (“Oh, 2 or 3 weeks and I’ll be good as new.” Um, right. Sure. If you say so.)

re:twins

Having twins certainly does not mandate a c-section, although some doctors do them routinely. If your sister is interested in having a vaginal delivery, she needs to find a doctor/midwife who has done twin vaginal births. In a natural childbirth, the mother simply puts the first baby to the breast immediately following delivery, which stimulates contractions and encourages the second baby’s birth.

But if I were faced with a twin or breech delivery (both of which are almost always possible, but do carry extra possible risks) and, for some reason, my only option was a doctor who had never seen a vaginal birth of twins or a vaginal breech, I’d probably opt for the surgery. It is a sorry fact that many obstetricians have never even seen an unmedicated birth, much less a vaginal breech or a natural, unhurried twin delivery.

This is where I think that wring and I may be talking at cross purposes, because I do agree that women should be making their own decisions about their own bodies. However, I think that many, if not most, women are making decisons without adequate information. I would not be at all surprised to hear that BunnyGirl’s sister was indeed given some song-and-dance about “separating the muscles” in order to convince her of the ease of a c-section. I would assume that her doctor had decided that all twins should be delivered via surgery and he was doing what he felt was necessary to convince his patients to agree. Reading the comments from the women who have posted here should convince anyone that a c-section is not an easy choice. I am suggesting that doctors are not infallible, that they sometimes do things “the way they were taught” (just as we all do from time to time) and that they way they were taught is not always the best way. I am suggesting that it is unethical for a doctor to do unneccessary abdominal surgery just to fit it into anyone’s schedule.

one example of why I think it is appropriate to question your doctor:

I can quote to you an obstetrician in a medical journal stating that he prefers epidural anesthesia because it doesn’t reach the baby. (I will indeed provide cites on request; for now I will work from memory.) Now this was a fairly recent journal, published well after several studies have proven this false. Anesthesia injected into the spinal fluid can be detected in cord blood and in fetal scalp samples within seconds of administration.

So how can this doctor make this claim? I have a few theories:

  1. He is a caring, well-meaning person who was taught that epidural anesthesia was perfectly safe and he wants to believe it is so. Because he does not feel he has any other options, he has convinced himself that the studies were flawed or in some other way do not show a risk.

  2. He understands that the anesthesia will travel to the unborn baby, but he feels that epidurals are unavoidable, so he downplays the risk when he discusses it with his patients, and may even have partially convinced himself of this “fact” because he has said it out loud so many times.

  3. He knows full well that the anesthesia will cross to the baby and will likely cause at least some respitory distress. But that doesn’t matter, because he has tools and more drugs with which to resucitate that baby. So the mother doesn’t have to be told the truth-she would only worry needlessly. He is in control and knows what is best.

In any case, his patients are being given false information. They are making the choice to accept anesthesia without fully understanding the possible consequences.

Note: I am not bashing all doctors here. There are some wonderful doctors out there. It was our family physician, in fact, who calmly guided me through my son’s very difficult birth. On the other hand, there are also plenty of doctors like the one who attended my first birth, who tried to give me an episiotomy, not because there was any indication I needed one, but because it was his routine to do so. We argued, between contractions, until it became a moot point and I delivered my daughter. Without tearing, I might add. The point I am trying to make is that there are some serious problems with the current model of childbirth. I would like to encourage as many women as I can to educate themselves so that they can take an appropriate role in decisions made regarding their bodies and the health of their children.

Anyone facing any other type of major surgery would surely be advised to seek a second opinion. Why should childbirth be any different?

robin, unfortunately, she’s only interested in the C-section, which I find disappointing. And her doctor is a woman! But, to be fair, I wasn’t there when the doctor gave her the info so I don’t know if she did talk about vaginal delivery or if my sister is just hearing what she wants to hear.

Me, personally, I’m going with a midwife and home delivery, if possible, barring any medical emergencies.

Actually this is not a song and dance. It is known as a “manual retraction”. Prior to birth the abdominal muscles are already spread a little. During the c-section an incision is made in the skin and then the doctor actually takes one side of the abdominal muscles in each hand and “manually” pulls them apart to leave and opening between them large enough to get the baby out so the next incision can be made through the abdominal wall, etc.

My wife had an emergency c-section that used this procedure. It does speed up healing since those muscles don’t have to heal from a cut. The bruising that results to those muscles makes a charley horse feel comfy though.

If there is no medical reason to go through a c-section again we will avoid it at all costs. She was laid up for weeks and was miserable. She wasn’t able to enjoy our daughter nearly as much as she wanted. She couldn’t even hold the baby on her belly for a month and more. She still had lasting effects from this 6 months later. I’m glad it’s there for emergencies but to use this as an alternative to vaginal birth is a terrible disservice to women.

The deal I’ve heard on twins and c-section is that ‘Because we so often have to deliver the second twin by c-section ANYWAY, why have both a vag AND a c-section to recover from? Just go with the c-section from the get-go!’ And the reason the second twin is so often a c-section is what? I wonder how often they allow enough time for the second twin to turn into position, and for labor to resume (there’s often a rest period while the baby gets into place, IIRC). And how often is ‘so often’?

I haven’t had a c-section, but my opinion on this trend is that it is based on the same things that the trend toward medicated birth was based on 50+ years ago… very little education in the mothers about how labor works (or their bodies function), and an acceptance of the female body as negative/backward and science as positive/all-knowing/advanced. Add in a dash of prestige (from being able to AFFORD the medicalized version), and you have a budding trend on your hands.

I also suspect that the state of obstetrics prior to this trend in Latin America has not exactly been to put the women in control, educate them, give them the tools and power to cope well with labor, encourage them to trust their bodies and their capacity to deliver, provide individual support for them during labor, and so forth. A good natural birth experience may well seem like a wild anomaly. Compared to a hellish, out-of-control, agonizing, and anxiety-provoking ‘normal’ delivery, c-sections may indeed seem a godsend, and if you are scheduling one anyway, why not at a convenient time? I’ve heard some doozy stories of hellish deliveries even in the US, and certainly a reasonable c-section sounds better than THAT. This may be part of where the decision-making is coming from, having not had a cycle of positive vaginal labor/delivery experiences in the culture to draw on. Even the OBs may be viewing this as a medical decision, because of the trauma they’ve witnessed when a woman is ‘allowed’ to deliver ‘naturally’ (without the necessary education or support).

Heck, I’ve been told that my general lack of pain in labor was ‘just because I was lucky’ not because I trained, practiced, educated myself, prepared, and then worked my butt off to stay focused and relaxed during three days of labor. Even though I can tell you that when I stopped using my trained coping methods, labor hurt like a son-of-a-bitch, and when I did use those methods, it didn’t ‘hurt’ at all (though it wasn’t at all comfortable, either, it just wasn’t painful, and the general discomfort was certainly within my capacity to deal with)… ‘just lucky’, my ass. But people even in the US (where we have at least a small trend toward trusting our bodies) simply are not willing to believe that a normal person can manage their labor to make it well within their capacity to deal with without trauma. Like, we WANT it to be miserable and agonizing for some reason, we don’t want to beleive that it could possibly be good.

That need for it to be horrible under normal conditions may also be present in the Latin American culture… knowing my step-mom, who is from Equador, I can certainly believe that ‘you are supposed to suffer horribly just because you are a woman’ is part of the culture. C-sections may be a backlash against that, too, a way for women to say, I’m a woman, and I don’t need to suffer, I can choose NOT to suffer. Even though c-sections are painful, choosing to suffer man-made pain rather than God-made pain may be a step up in self-esteem and pride in being a woman. Twisted, but possible.