To follow along I’ll start with my C section story.
When I first got pregnant I was terrified that I would have to have a C section. The thought of surgery terrified me completely. After the first emergency C section I felt like a complete failure for most of the reasons stated about there being a right way to have babies and all that crap. Our second emergency C section ( 4 weeks before my scheduled C section) was actually scarier to me since I knew what was going to happen. Thankfully everything turned out fine. Recovery for the first one was a bit long since I contracted pneumonia in the hospital. Recovery for the second one went much better even with a toddler to run after and a baby in the NICU.
Oh and hubby was in the OR with me both times. He was great for telling me stuff I did not need to know like ‘your uterus is resting on your chest’ and the doctors (different ones each time) gave him a little tour of my innards!
Anyway in response to the OP: Pregnancy and Childbirth (vaginal or surgical) are both risky. I think that any woman who has sat with her doctor and her partner and heard each side should be allowed to chose the type of birth she wants. What is ethical is to allow a woman to make an informed choice about what is best for her baby and herself. She has been making those choices from the moment she decided to become pregnant, or decided to remain pregnant if this is a surprise pregnancy, by taking vitamins and getting prenatal care and chosing what to eat and drink… why not allow her to chose how she feels the baby should be born?
I think I have to agree with tanookie’s take on the subject. We’re talking about adults who are going to be taking responsibility for the child’s entire life; informed choice seems best to me. Although I suppose there would have to be some rules; asking for a c-section 4 weeks early, for example, in order not to have too many stretch marks would IMO be pretty unethical–but then the number of women who try to do that kind of thing is so tiny that it isn’t a huge concern.
(Tanookie, it never once occurred to me that surgery was even a possibility. I sat through the birth classes, going “yeah, yeah, c-sections happen, but it won’t be me.” After all, what are these peasant hips for anyway? My mom had 5 without turning a hair, and I figured I could too. After all that labor and no baby, I was begging for surgery–and as it turns out, she would never have been born otherwise. We would have just died of exhaustion or something. So, yay for medical advancement!)
What amazes me are the negative projections about women that I’ve read here. They are just lazy. They just want to schedule the baby to be born on a special occasion. They are afraid of pain.
There was a similar generalization about the motives of doctors. It always puzzles me why people assume the worst. Have I just been really lucky with the doctors I’ve had and the women I’ve known?
Yes, the mother should be able to make an educated choice.
While your cite has an obvious bias, that alone isn’t enough to say they are promoting falsehoods. On the other hand, I simply looked up their first claim, the one which you quoted. This is from the abstract of the study which they claim to get their info from (bolding mine):
From all appearances, I think the study suggests that performing a c-section at the proper time, based on the proper data, results in zero risk of RDS.
After reading that, I decided to not even bother looking up the rest of their cites.
There is a belief among some women that c-sections make for better babies. There is no coning of the head, or other visible trauma that there often is from a vaginal birth. My doctor praised my baby as looking as good as a c-section baby. Also there is the convenience factor of it being scheduled from the start. There are women that schedule their induction or c-section as soon as they find out they are pregnant. I do believe those women’s doctors are behaving unethically. They are making decisions without all pertinent data. Also, the mother and the doctor may cling the scheduled date, rather than re-evaluating the situation as the time arrives even if doing so would help the baby or mothers health.
And I think that the pain of uncomplicated childbirth (not breech, not back labor) is over emphasized. People act as if the pain of childbirth is more that anyone could reasonably bear and that epidurals don’t have any significant risks. They do have risks, perhaps the worst one is often making childbirth slower and thus more dangerous for the baby.
I know that I was quite scared of the pain of the baby passing through the vagina. Until I educated myself, I thought that was what the epidural was for. It isn’t really. The pain of contractions is what most anesthesia is treating. The pain of the baby actually coming out is both harder to treat and less of a problem at the time. I don’t understand why this in not better explained to women, but then, many women refuse to even consider not having the epidural. I made the decision to do without the epidural unless I was really overwhelmed. It was not a decision made because I was infatuated with natural birth, but rather one made on weighing the risks involved. There were several risks in extended labor that were greater for me and my baby than is usual, as well as some increased risks with epidurals for me. I was treated as if I were naive by the nurses. I know my doctor was skeptical that I would do without the epidural, but he did not treat me as if I was being silly.
This open skepticism on the part of medical professionals even with well informed mothers to be and lack of education on the risks make epidurals the norm and then means the norm has become artificially extended labor that does too often lead to horrible problems for the baby and emergency c-sections…
For some, a scheduled c-section is seen as the easy way to have a perfect baby without pain or risk. It also gives the mother a greater sense of control. It gives her a way to know what it expect and less to fail at. Too much would depend on how she does in a vaginal birth and so, make it someone else’s problem. It is seen as an easy out. Any doctor that lets it appear as an easy out is not adequately informing his patients, and that is not ethical.
There is a belief among some women that c-sections make for better babies. There is no coning of the head, or other visible trauma that there often is from a vaginal birth. My doctor praised my baby as looking as good as a c-section baby. Also there is the convenience factor of it being scheduled from the start. There are women that schedule their induction or c-section as soon as they find out they are pregnant. I do believe those women’s doctors are behaving unethically. They are making decisions without all pertinent data. Also, the mother and the doctor may cling the scheduled date, rather than re-evaluating the situation as the time arrives even if doing so would help the baby or mothers health.
And I think that the pain of uncomplicated childbirth (not breech, not back labor) is over emphasized. People act as if the pain of childbirth is more that anyone could reasonably bear and that epidurals don’t have any significant risks. They do have risks, perhaps the worst one is often making childbirth slower and thus more dangerous for the baby.
I know that I was quite scared of the pain of the baby passing through the vagina. Until I educated myself, I thought that was what the epidural was for. It isn’t really. The pain of contractions is what most anesthesia is treating. The pain of the baby actually coming out is both harder to treat and less of a problem at the time. I don’t understand why this in not better explained to women, but then, many women refuse to even consider not having the epidural. I made the decision to do without the epidural unless I was really overwhelmed. It was not a decision made because I was infatuated with natural birth, but rather one made on weighing the risks involved. There were several risks in extended labor that were greater for me and my baby than is usual, as well as some increased risks with epidurals for me. I was treated as if I were naive by the nurses. I know my doctor was skeptical that I would do without the epidural, but he did not treat me as if I was being silly.
This open skepticism on the part of medical professionals even with well informed mothers to be and lack of education on the risks make epidurals the norm and then means the norm has become artificially extended labor that does too often lead to horrible problems for the baby and emergency c-sections…
For some, a scheduled c-section is seen as the easy way to have a perfect baby without pain or risk. It also gives the mother a greater sense of control. It gives her a way to know what it expect and less to fail at. Too much would depend on how she does in a vaginal birth and so, make it someone else’s problem. It is seen as an easy out. Any doctor that lets it appear as an easy out is not adequately informing his patients, and that is not ethical.
<I made the decision to do without the epidural unless I was really overwhelmed.>
Exactly. YOU made the decision. Each woman should be allowed to make the decisions regarding her birth situation for herself. Whether it be to go completely natural, be “elective” c-section (no medical reasons) or somewhere in between.
<For some, a scheduled c-section is seen as the easy way to have a perfect baby without pain or risk.>
Anyone who goes into a c-section thinking there’s no “pain or risk” or that it’s easy needs to get hit with a clue hammer. I’d believe, instead, that they KNOW the consequences and choose the option after making the educated decision. My doctors, and the classes taken before birth, were very careful about clarifying the risks/rewards of all the different methods available.
There are always going to be people who make decisions that we wouldn’t. Does that mean we have a right to stop them from making those decisions or that they have the right to stop us from making ours? Who decides which ones are right? Heck, I’ll volunteer for the committee to decide, if only to make sure I get to chose!
Yes, but the whole idea of an elective c-section is that they are usually planned ahead of time. The woman isn’t allowed to go into spontaneous labor. That is part of the danger of an elective c-section. We aren’t talking about the other kind!
For exaple, my neighbor was expecting her 2nd. She lives in Tucson without any family to help after the baby was born. Her mother was planning to come for 2 weeks, but they had no idea how the birth of the baby would overlap with her mother’s arrival. So she scheduled an elective c-section for the day before her mother’s arrival. There were some problems (none too serious, but the baby had to stay in the hospital a few extra days) because the timing was misjudged and he wasn’t quite ready to come out yet.
This is exactly what the statistic quoted is referrring to.
Not exactly disagreeing with you but doesn’t the doctor also have a right to decide what he or she will do? I mean, maybe a pregnant woman does have a right to schedule a caesarian (or an induction, for that matter) for a week before the due date because she wants to be sure she can go to her sister’s wedding two weeks after the due date. There are two decisions beng made here- the one the mother makes regarding her birth situation and the one the doctor makes about performing the procedure.That doesn’t mean she has the right to force a doctor to perform it, any more than my legal right to an abortion means that a doctor must perform it.That doesn’t mean she has the right to force a doctor to perform it, any more than my legal right to have an abortion means that I can force a doctor to perform it.
And I think that the pain of uncomplicated childbirth (not breech, not back labor) is over emphasized. People act as if the pain of childbirth is more that anyone could reasonably bear and that epidurals don’t have any significant risks.
You’re saying the pain of childbirth ISN’T unbearable?
Then you had either an easy labor (as far as the pain goes), or you have an enormous pain threshold.
But yeah, I agree. Epidurals do have risks. Glad I had one, though.
Now that this debate has been reduced to a Jerry Springer session, I’d like to relate my own experience as a student chaplain at a 1000-bed hospital.
All males in our 20s, I was the only unmarried guy among the 4 or 5 of us. After attending a post-mortem and a surgery on a woman with terminal abdominal cancer, we attended a vaginal childbirth as part of our chaplaincy training. The other guys all fainted during the delivery, actually, and the doc got pissed off that he had to temporarily lose an attending nurse to their care.
That was before the days of “respecting a patient’s privacy.” But I still thought it strange that I would be checking out her hemorrhoids and episiotomy without her permission. At least she should have been asked for permission, or at least advised of and probably paid for the privacy invasion.
It will be a cold day in some physician’s hell when he subjects me to a similar invasion of privacy! I’d like to know whether or not you women know about these common invasions of your privacy.
Doreen said <“Not exactly disagreeing with you but doesn’t the doctor also have a right to decide what he or she will do?..”
Yes. I agree. In previous posts I put “and supporting cast” and should have included it here as well. I also think, though, that if a woman wants something done, and her current doctor won’t do it, she can (note: not necesarily should!) look for another doctor. Happens all the time in other treatments when a doctor and patient don’t agree.
Well I concede that it is indeed a woman’s choice how she wants to have her baby, just as it is her right to chose to have an abortion. However, I truly cannot understand why a woman would choose this if it were not medically necessary. It just strikes me that women choose these elective caesareans for convenience, so they can check in at 9 a.m. and be resting with the baby an hour later. This just strikes me as perverse, to have major surgery, your abdomen sliced open, for convenience. I mean, come on, reproduction is not convenient! And keep in mind, recovery from a c-section is longer.
Women have been giving birth to babies for thousands and thousands of years. It is a natural process. If there were no medical reason to do it, why chose the caesarean? Fear of pain? Fear of having incontinence or an episiotomy? Well if you fear pain that much, then maybe you shouldn’t be reproducing in the first place. The whole idea of elective caesareans strikes me as perverse and sick. Just my honest opinion.
Another thought, slightly off topic. If and when I have children, I am determined to do it the natural way, without pain killers. I just think it would be such an incredible life experience.
I have heard several times that it helps a lot to go through labor standing up and walking around, and to give birth in a squatting position. The gravity does a lot to ease the process. I heard somewhere that Native Americans traditionally gave birth this way. Has anyone heard of this?
wife of Drachillix steps in…
I got QtM beat, hands down: as a Labor and Delivery RN I have attended well over 1000 vaginal deliveries, have circulated on more than 100 c-sections and have been in labor twice, delivering vaginally twice.
An ethical medical decision is only as ethical as the people who make that decision. Cutting out parts of healthy stomachs as in gastric bypasses is considered ethical. Cutting into healthy breast tissue for augmentation or reduction is considered ethical. Personally, if a surgeon I trust is willing to accept the risks to his licenses and hospital privledges to give me the procedure that I request, that is between that surgeon and myself. Scylla----I have seen Dr.s go from first cut to sewing before the 5 minute APGAR, so I know there are some fast hands in the OR, and Dr. V 's c/s scars are works of art, near invisible for those who are looking.
Cyn, OB/GYN RN
For easing the process, it also helps to not have pitocin. Pitocin makes the contractions more painful. Unfortunately, circumstances dictated that I lie still, on my side, and have what seemed an all too aggressive pitocin drip. I decided not to say absolutely beforehand that I would not get an epidural, because I thought that the decision should be made with all available data, including how I dealt with early labor. I have talked to a woman so devastated that she did not “go the distance” and have a natural childbirth that she had trouble enjoying her new baby.
BTW:I never said that women should not be allowed the choice of elective c-sections, just that in some circumstances chosing to have a c-section was indeed unethical. Women who never have been pregnant before, who decide to get c-sections based only on what is convenient and easiest without finding out the real risks involved are, in my opinion, behaving unethically.
Also, more women than you would think do try to have early inductions or c-sections to save their figure and looks, or just to have the whole thing over. Some even try do it yourself methods, such as cod liver oil. There is sometimes too much faith in the wonders of modern medicine. I have heard women who seem to think that a few weeks or even a couple of months premature is nothing that can’t be fixed by the NICU. I have also heard a woman brag, proud that she tricked her doctor into thinking the pregnancy was more advanced than it was, just so she could have the c-section early. We can hope she was wrong, that the child was 38-40 weeks as the doctor thought and not 35-36 as she believed. She said that she thought preemies are cuter anyway!
Despite the two surgeries I still consider my children’s births to have been incredible life experiences. I honestly hope your pregnancies go as well for you as you plan them to - mine didn’t. I was determined to do a vaginal birth the first time but things did not work out that way. My doctor was amazing at handling my tired and distressed response to his assertion that this was not working and surgery would be the best thing for my baby’s health.
I also am amused by the hubris of anyone who thinks they can plan their birth at their first prenatal checkup! So much happens in the following months to change your path.
I would like to think that any doctor who would perform an elective C Section before 38 weeks would require an amniocentesis to check for lung development. I also wonder what kind of prenatal care someone has gotten if her doctor does not know how pregnant she truly is?
NICUs are amazing places but I did not like having to leave my baby there and he was only there 2 weeks. I am trying to grasp the thought process that thinks having a preemie is cute.
Pitocin makes contractions much more intense. It also made mine come in couplets. The nurses were very nice about checking to see if I wanted an epidural.
I absolutely agree with this and think that, although you can certainly do a lot to maximize the chances of having a drug-free, vaginal birth, it’s really something you need to play by ear once you get closer to delivery and when you’re in the delivery room.
This whole thread brings up a little pet peeve of mine - although I had a pitocin-induced, epidurally enhanced, emergency c-section, I carried the child for 9 months, have the stretch marks, and the kid came out of my body. I didn’t have a vaginal birth, but it was definitely natural.
I think any woman who chooses her method of childbirth based on what’s best for her and her child is making an ethical decision, whether or not that decision includes drugs or surgery. I would even say that that could include a c-section for “convenience” - for instance, a woman who had to be back at work during a certain timeframe and wanted to maximize the time she had with the baby before then.
I don’t know how this would work - you should see my scar! And it’s a lot harder to start getting those abdominal muscles back into shape after they’ve been sliced through.
That woman someone mentioned that lied to her doctor about how pregnant she was and the said “peemies are cuter, anyway” was a MORON of the highest degree. And, I daresay, NOT the norm, at all.
I held a preemie at church not long ago that is about 6 months old now. He probably doesn’t weigh much more than my daughter weighed at birth: he was like, 10-12 weeks early. I’m sure his mother would probably slap the mother above if she heard her make such a flippant remark.
It’d be terrible to have a 35 week baby just for the sake of convenience: they’re not “done” yet! Babies put on quite a bit of their weight during the last 4 weeks!
