Elective Caesareans Judged Ethical: Doctors Group Issues Statement on Popular Procedure
It may be ethical, but why on Earth would a woman chose to have majory surgery, have her abdomen and uterus sliced open, rather than natural childbirth? The recovery is much worse with a caesarean. It seems that these women are too lazy to go through labor.
Well, my wife had no choice in the first child. A placenta previa complicated with a breech delivery left no alternative to a caesarian.
Our Doctor though is very good. He made a bikini cut that left no scar, and my wife was back to full activity in 8 weeks.
Nothing appears to be wrong with our second pregnancy, yet we are planning on a caesarian.
While a post caesarian natural delivery is pretty doable, the consequences for a 1-2% chance of a uterine rupture are catastrophic. Anothet emergency c section with a hysterectomy.
The problem with natural childbirth isn’t when everything goes smoothly. The problem occurs after 20hours of labor and no results. The problem occurs when the fetal heartrate drops to disastrous levels while it’s still in the birth canal.
If something goes wrong in a natural delivery the consequences can be very high.
A caesarian these days entails very little risk comparatively speaking.
All that being said, if the first wasn’t caesarian we wouldn’t be going this way with the second.
The trade off is the recovery time.
This from the article cited above.
So it’s not an open acceptance to c-section on demand.
As for your statement:
please tell us about your labor experiences!
QtM, MD
Veteran of over 1000 vaginal deliveries and at least 100 C-sections. Never been in labor personally, though. 
I was chatting to a couple of young pregnant women the other day and they were quite adamant that they would opt for a caesar rather than endure a vaginal birth regardless of medical indications. I was aghast!
Here in Australia there is a virtual epidemic of caesareans, although few people will admit to them being ‘elective’ as such. Of course it is more profitable for medical practitioners to attend a caesar than a normal vaginal delivery, so from what I can gather, they are more than eager to promote caesars. It is especially interesting that those who are privately insured are much more likely to ‘need’ a caesarean than those who are patients in the public system.
So why am I not surprised that a group of doctors have deemed elective caesars ‘ethical’?
:rolleyes:
Well, I’m glad the bandwagon for VBAC (vaginal birth after CSection) has finally lost its steam. After attending a few disastrous uterine ruptures during attempts at VBAC, I lost my enthusiasm for that principle in the late 1980’s.
Frankly, I’m not really too keen on Csection on demand, but I suppose in some areas where Obstetricians are scarce from dropping out due to malpractice, it makes a certain amount of sense to schedule the section. And not have to fret over spending up to or over 24 hours staying available during a prolonged labor.
Any docs who do OB posting here?
So, who the hell cares what doctors or any group of them thinks is ethical or not? They have less training in ethics than a Jesuit, and who would rely on a Jesuit? Furthermore doctors and their ethics groups still find involuntary mutilation of male infants and involuntary prolonging of a patient’s life to be ethical.
Ha. If I want some drug or some procedure performed by a physician, he’ll damn well do what I want or I’ll find one who will. The gummint has no rights over my body, and my ethics demand that I take out any doctor who puts his “ethics” between me and my body, the gummint laws be damned!
But I have the prime advantage of not being insured. I can buy my health care in Brazil or Mexico where doctors rightly don’t imagine themselves to have any more ethical sense than a porpoise. The rate of caesarians in Brazil is the highest in the world, by the way, and they have the good sense not to mutilate their male infants.
I’d have to say it’s at least as ethical as elective plastic surgery. It doesn’t hurt the baby, and the mother goes into it knowing what she’s getting into, so where’s the harm? I don’t really see the advantage in most cases, but I don’t see that anybody’s being damaged here.
And I’ve known several women who went on and scheduled c-sections after their first OB appointment. Most of them were like my cousin, who’d had hypertension late in her first pregnancy, had spiked such a huge bp during labor they’d done an emergency c-section, and who was already having a bit of hypertension at 14 weeks into the second pregnancy. Others were women with really narrow pelvises and fetuses that were already pretty big, who were at high risk for dystocia. In these cases, doctor and patient agreed that it would be better for everyone involved to go on and do the section before there was risk of fetal stress. Is doing what’s lowest-risk for your patients ethical? Well, yes. Yes, it is.
I agree with the OP. Aside from cases of medical necessity (which I believe have also been given good coverage here) I have no freakin’ clue why anyone would choose a c-section.
Sure, it may be ethical. Unnecessary surgery asked for by the patient and usually having no major sequelae seems ethical enough to me. Ethical as well as dumb.
I don’t think it’s ethical at all. We’re talking about elective c-sections here, not medically necessary ones.
http://www.ican-online.org/resources/wp_electivecs2.htm
" Babies delivered by elective cesarean have an increased risk of neonatal respiratory distress syndrome (RDS), a life-threatening condition…
Babies delivered by elective cesarean have a five-fold increase in persistent pulmonary hypertension (PPH) over those born vaginally.
Babies delivered by elective cesarean are at increased risk of iatrogenic prematurity…"
And this excerpt doesn’t even begin to talk about the risks to the mother by this proceedure!
Congratualtions on your “advantage”
A-Ha We’re surrounded! Now we can fire in all directions!
So when you accidently lop your arm off, you’ll put it an ice chest and fly to Brazil?
How sad that I as an insured person do not have the benefit of the superior quality of medical care that one can only get in… Mexico.
Heh.
But wait, I can get medical care in Mexico too. Or, I can get it here.
So why do you have the advantage?
Oh, and you wouldn’t happen to know Jack Dean Tyler, would you?
Is there a large difference, ethically, between choosing c-section and choosing to bottle feed?. (From the baby’s POV?)
BTW; the last two sentences of the OP deny each other. 
Peace,
mangeorge
I don’t think a true elective c/sec is ethical. A c/sec done for no other reason than for the mother’s and/or the doctor’s convenience is not ethical.
Scylla,
I recognize you as the kind of guy who doesn’t respond to subtleties, so here is an explanation, like a club:
The person who pays $750/month for health insurance (the national average, according to the NYT) may not have even the airfare to fly off to Rio ($611 RT from my US city) to get reasonable medical care at a reasonable price. Obviously, I have more options than the average insured guy.
Then I also have the advantage enjoyed by the Mafia don, who will always find some doctor to take out a bullet, furnish a drug, stiff the gummint snoops, maintain privacy. You can’t get those benefits very easily if you have to fill out insurance forms and submit CPT codes!
Congratulations, jimbino on being so manly and putting one over on the gummint.
Now, then, this thread is about elective c-sections and how ethical they are.
If you would like to start another thread on the advantages of not having insurance, or the evilness of the gummint, or what majorly huge balls you have, please do so.
Actually, I was getting some Wildest Bill Mexican Fat Burner vibes here…
Scylla, if your wife actually wound up with no scar at all post-Caesarean, it’s worth a writeup in a medical journal.
I am not an obstetrician (thankfully) but at least some of the popularity of Caesareans from the standpoint of OBs is the risk of unforeseen complications to the infant in vaginal deliveries which don’t follow Nature’s Plan. This is an area crawling with potential risk, malpractice attorneys and megamillion-dollar judgments.
I think that the WOMAN having the baby is responsible for making the choice as to whether she should have a natural or c-section. I think that she should discuss her options/opinions with her doctor, and make her decision without the whining masses saying, “you shouldn’t do that because I say you shouldn’t.” (note: if woman has s.o., and s.o. is involved, then they should/could help in the decision, but it’s still HER decision)
As someone who’s had a c-section (breech) and is currently pregnant again, I am the ONLY one who has the ultimate responsibility for making that choice. I was told that after 2 surgeries (one cyst removal that was the “equivalent” to a c-section) the chances of having problems with a vaginal birth were VERY high. My response: Give me another c-section!
My first experience: Be at hospital - 7:00. Surgery 7:30. Beautiful baby daughter born 7:46. Back in my room with daughter in my arms 8:30! I’d do it again in a heartbeat. I was walking the next day (as are most women who have this done) and although I was in a bit of pain, so are the women who go through vaginal birth.
Anyone who is not the birth mother or her supporting cast should butt out.
As a person who has survived (with my child) a c-section, I have to disagree. Let me qualify what I’m going to say by commenting that your circumstance seems to warrant c-section more so than a woman who just wants one. You did have a c-section, which raises the stakes considerably when trying a vaginal birth later. I would not call into question your particular circumstance.
However, there are women out there–and I know, because I used to be one of them–who are TERRIFIED of vaginal birth and, as real as that terror is, it is not justification for c-section, in my opinion. As soon as I found out I was pregnant I planned on getting a c-section. My doctor didn’t think it was a good idea to plan the birth via c-section, though he noted I had a condition that might require it. As it turned out, I did end up needing one (because of the condition), but I dilligently went through the steps to prepare for natural, vaginal birth. By the end of that process I really, really wanted a vaginal birth. I am convinced to this day (ten years later, almost exactly) that there is nothing like it, and wish I could have experienced it. I wish we (my daughter and I) could have experienced it.
That’s the emotional explanation. The rational explanation is that doctors often do prefer c-sections, for many of the reasons outlined earlier–low incident of unexpected problems and high cost (way higher than vag births, btw), etc. Do we really want these concerns driving our medical choices? I don’t. And I don’t want women scared into having c-sections, whether by themselves or someone else.
Just my 2 cents, USD.
I’ll certainly not butt out. 
Both of my daughters were born c section, thirty or so years ago, because their mother was much too small to safely deliver vaginally. But she did have the choice, and the doctor was up front about the risks of both methods of delivery.
Why would it make any difference in the relationship between mother and child, or in the beauty of bringing a new life into the world?
What business is it of anyone’s if a woman chooses to have a c-section? Does it affect you in any way? No. So butt out!
After being in labor for 22 hours after having not slept the night before, I was begging for a c-section. I was tired and the baby was getting tired, too. Doctor knows best, though, and she wasn’t about to get out of bed to do surgery. It was more convenient for her to just let me lay there and suffer needlessly (at one point I didn’t dilate any further for 3 whole hours), wander in during the last 20 minutes and then end up using the vaccum on the baby at the end. I’m not a doctor, but it really pisses me off that my wishes weren’t even considered. The recovery from a c-section for me couldn’t possibly have been worse than the recovery I had from a natural delivery.
I do understand your position. But I find myself having a bit of trouble with:
>The rational explanation is that doctors often do prefer c-sections, for many of the reasons outlined earlier–low incident of unexpected problems and high cost (way higher than vag births, btw), etc. Do we really want these concerns driving our medical choices? I don’t. And I don’t want women scared into having c-sections, whether by themselves or someone else. >
I’m lucky. I have excellent doctors. Ones I trust.
A lot of the things I read about make it sound like all these doctors sit in their offices twirling their mustaches thinking up ways to make more money off their patients. I do not kid myself that there aren’t doctors out there who do this, but I would bet that the Majority of them honestly care about doing what’s best for the women they are assisting with birth.
I wouldn’t want women scared into ANY choices. It could be interesting to see a world populated with people who know all the facts, can make intelligent decisions, and have things turn out the way they want, without ever having someone look back in hindsight and say “I should have done it the other way!”
All I’m saying is that these things are individual choices made by the people involved. We are constantly being bombarded (at least in the U.S.) by people who want to make these decisions FOR us because “they know what’s best”. It makes me sigh every time I think about how someone is again trying to make decisions for me or limit my choices in such matters.
I don’t regret my c-section (and we could have waited to see if she turned, even though we tried the external cephalic version [sp?] and she didn’t cooperate! In fact, I could have sworn I saw a little middle finger on the sonogram!) and doubt that I ever will. My healthy daughter shows me daily that the way she arrived is unimportant!
The “supporting cast” should work with a terrified mother to alleviate that terror as best as possible.