Portland hospitals banning elective c-sections and early inductions

Article here.

I know we’ve had a few pregnancy and childbirth threads which have gotten heated, but I think this will do fine here.

I applaud this decision. While I think women should have choices in just about every area of reproduction, the decision to induce for non-medical reasons or to elect c-sections is not one I support. I suspect, though, that this will possibly have a flurry of 38-week-pregnant women hounding their doctors to drum up medical reasons to justify going early. In fact, I know plenty of women who already do that and get very upset when their doctors or midwives tell them they just have to wait until baby is cooked.

I guess what I find most encouraging is that all 17 hospitals agreed to this, despite the fact that they stand to lose revenue. Maybe the tide of the business side of babies is turning?

Are there large numbers of women demanding induced labor or wanting C-sections because it’s easier? I hadn’t heard anything about it. I suppose it’s possible, but it’s news to me. AFAIK, everyone I know had non-induced normal births. Except Pepper Mill, whose labor was induced – but in her case it’s because the swelling of pregnancy had reached outrageous proportions , and was threatening to dislocate joints. No joke.

My boss’ daughter-in-law is a CFO of some huge financial corporation, and she’s had two kids so far. The first was when she was angling for the CFO slot, and the second one just a few months back.

She scheduled both births for a Friday evening so she could be “recovered” and back at work on Monday morning. Apparently the corporate culture mavens informed her that if she missed any work for any form of motherhood-related activities, she’d be straight onto the shit-list, and apparently she wasn’t interested in finding out if it was true.

I am usually all for free will and lots of choices, but I really don’t think that should be necessary or encouraged.

:eek:

That’s tremendous!

There are* some physicians here that schedule deliveries and c-sections so they don’t have to find someone to cover while they take vacation.

No, really.

And yes, those same docs will* perform early inductions/sections for the mother’s scheduling convenience also.

I’m glad to see the tide turning on this, even if it will be a slow process.

*TBH, it has been a while since I had these discussions, so I can’t swear that those docs are still doing this. But’d I’d bet they’ll keep it up until the wave breaks over them.

I understand not encouraging induction, but is a non-emergent C-Section considerably more dangerous to the baby than a natural birth? If not, I don’t see why women shouldn’t be able to choose a scheduled C-Section.

I’ve never known anyone who has done an elective c-section or early induction, and I didn’t.

But I think it should be my right. Its my body and my child - and the risks associated with either are not more significant than me letting Junior ride his bike.

I agree. It seems a little silly to say “I support choice, except in matters of how to deliver a full-term fetus.”

I’m having an elective c-section 4 or 5 days before my due date in November. Partly because I’m due on Thanksgiving and I do NOT want to take a chance on finding a cab on a holiday or potentially navigating icy roads while in the middle of labor and partly because I’m having my tubes tied while they are in there so that I don’t have to ever be pregnant again. I am also horrifyingly bad at handling medical situations and it will be much easier for me to be calm enough to handle an epidural or a spinal when I’m not freaking out about contractions and stuff.

I don’t understand why this bothers some people. Once the baby is born they are going to let me take it home without so much as giving me a multiple choice quiz on appropriate baby care. For all they know I’m going to bottle feed it Fresca or something but they trust me to do what I think is right for my child…unless, of course, that decision also impacts me, my body, and my personal medical decisions I guess.

I support a woman’s right to choose how to deliver her baby, and I am against this regulation. Paternalism at it’s finest…

That’s how I feel.

Best of luck. (And don’t feed the baby Fresca - the dental bills even with diet soda will eat into their college funds. Not that I’m telling you how to raise your baby ;))

My mother was induced 3 days before my due date. Officially it was because there was a forecast for an ice storm. Really, the doctor wanted Christmas off to be with his family.

Great post, I totally agree. This banning is shameful and ridiculous. What if a woman elects c-section or induction because it is beneficial to her career, education, or the needs of her other children? Guess she’s just fucked then. Thanks a heap, Portland!

Yeah, that’s not why they do it–they have to arrange coverage regardless, for the people who don’t want induction/c-section and for emergencies like pre-term labor, and that coverage costs the same whether there are 50 deliveries that week or there are none.

But you’re right that a lot of doctors don’t really like for big stuff to happen with their patients while they’re out of town. You never get as full a picture of what’s going on from reading a chart after the fact as you do having been there yourself, for one thing. And you’re never 100% certain that when there’s a judgment call needed the substitute will make the same call you would, which makes it a real bitch when your patients come to you after the fact wanting to know why Dr. Soandso did thus and such instead of that and the other.

Then too, a lot of patients really don’t like the idea of delivering with someone other than their doctor who has done all their prenatal care and knows exactly what’s been going on with their pregnancy. And they’re often not thrilled at the notion of some random stranger saying “Hi, good to meet you, I’ll be sticking my hand in your crotch now while you scream, cry, and soil yourself.” Nor are they thrilled at the idea of someone whose philosophy, personality, and credentials they know nothing about being the one calling the shots about their and their baby’s care, especially if there has been anything remotely out of the ordinary about their pregnancy.

If scheduling an induction a week or so early alleviates these stresses for both doctor and patient and does no harm to the baby…what’s the big freaking problem?

I was trying to figure out how I wanted to reply to this, but you said it better.

I’m curious… what’s the status of elective appendectomies, gall bladder removals, and hysteretomies? It seems to me like a c-section is an equally big deal as all these, and its status as an elective or non-elective surgery should be the same.

(I had an emergency c-section five months ago)

I guess that my problem with it here was that at least several women were told “we’ll be scheduling you for an early induction, because that fits my schedule better”. The women I talked to weren’t really given much of an option.

Well, except for a couple who were thrilled that they could schedule a c-section and skip that whole birth thing.

And yes, c-section is more hazardous for both patients. If you actually read the article, that’s one of the reasons for the ban. There’s also mounting evidence that unnecessary induction is more hazardous for both patients. It’s one thing if the mother knows those risks and chooses them anyway; it’s something else entirely when scheduling early inductions / c-sections has become routine.

I was thinking also of the articles posted in that other thread where OBGYNs are starting to say “hey, we’re getting outta hand with this stuff, gang”.

I’ll admit I hadn’t really thought about it from the other side as far as it being actually banned. I just know several women who have felt very pressured into the induction/c-section route and am happy to see the strong push for induction/c-section getting some push-back.

Actually, most of those are done via scope these days, so they’re not as big a deal as you might think. A c-section is an entirely different level of surgery.

My wife had a scheduled C-section with our twins. Both those kids had been big all through the pregnancy and were more than seven pounds (which is pretty damn big for twins) at birth. Her OB was concerned that labor might do some serious damage to either her or the babies.

She was at 37 weeks, so it counts as an early delivery. And since no one can actually say going through labor would have caused problems, it was elective, as well.

Who wants to tell her that she and her OB shouldn’t have been able to do it that way?

Yea, um, choice means “it’s the woman’s choice.” Elective c-sections might not be your cup of tea, but choice means you don’t get to dictate that choice to a woman and her doctor.