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April 2015 Moms
elective c-section
This discussion has been closed.
Re: elective c-section
You've probably already realized that this is a pretty electric topic on this forum!
By all means read last weeks FFFC thread. I had an extremely hard time trying to convince the posters that there is no medical conspiracy to force unnecessary c/s on women in order to reduce doctors risk (and that as an MD I found it offensive that they were implying there is). An MDs exposure to risk is only reduced if they provide appropriate care and unnecessary surgeries do not reduce a doctor's risk of being sued.
Research shows that part of the reason c/s rates are increasing is that women are asking for elective sections. The reason they are being provided is that analyses of risks show that overall the risks of an elective section versus an uncomplicated vaginal birth are similar.
The exact nature of how those risks break down is interesting - they are not exactly the same. For instance a section brings with it higher risks of infection whereas a vaginal delivery entails higher risks of incontinence.
The risks of a section after a failed trial of labour are much higher than those of a scheduled section so ultimately trying to quantify how likely a person is to not be able to successfully deliver vaginally would be really helpful in helping women decide whether to have a section initially or not.
But there's the rub. Unfortunately it is really difficult to predict how labour will progress. Even estimating birthweight prenatally (by ultrasound) is very (very!!) inexact since they essentially guess based in the width of baby's thigh and can't account for overall length.
Here is an article you might want to read: https://onlinelibrary.wiley.com/doi/10.1034/j.1600-0412.2003.00194.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false
My own experience as a patient was that I had a section with my first. It was considered elective and not medically necessary but I was having severe issues with symphysis pubis dysfunction (literally could not walk) and I did not want to risk the vaginal birth making it worse or permanent (low risks but very significant to me for personal reasons - I am a serious competitive athlete). The section was fine except I reacted to the spinal with low bp and required medical intervention several times for that. That reaction to the spinal is actually very common. DD was born healthy and no worse off. I was back in training 4 weeks after my section (felt pretty normal 2 weeks after).
This time around I am on the fence. I am only 18 weeks but so far so good with my pelvis so I am delaying deciding about VBAC or another elective section.
I guess my point is that not all elective sections are for selfish doctor reasons and they don't always result in bad outcomes. If they did they wouldn't be allowed. But this board is very anti-choosing a c/s (see the initial "I judge FTMs who consider an elective section" comment that spawned the wonderful thread from last week) so you wouldn't know that from reading these threads.
In terms of my MD experience (I was a family doc prior to becoming a psychiatrist and actually did obstetrics as part of my practice) I definitely agree with posters who say that second and subsequent labours are often MUCH less difficult than primaries. I've known women who had horrendous first deliveries who pushed for 20 minutes the second time!! It's just really hard trying to predict how it will go, but most of the time it will go well and better than the first time.
Good luck deciding and maybe try asking your doc to help you try to predict a little more precisely what she thinks your risk of having a similarly difficult labour this time would be. It's not going to be precise but it may help away you one way or another. Best wishes!!
(Tempted to sign off as Dr Evil thanks to a gif from last week's thread, lol!!)
I have a lot of feelings on this subject. While I first and foremost believe that every woman should be able to make her own decision about her body, I also think that due diligence should be done including research, talking with your doctor and possibly getting a second opinion.
OP - None of us know the exact details about your labor, so I think it would be a really good idea to ask your doctor more questions about why he is recommending a c-section this time around. I also truly think you need to listen to your gut instinct and figure out what you are most comfortable with.
As a sidenote, it's hard not to take it personally when there are so many people who really villify c-sections in general. I had one with my DS and I FIRMLY believe it was the right call and was necessary for me. I will be having a RCS and I wish I didn't feel like I had to go over my reasons why on here. It's my body, I am the one who knows the details of my first labor and why I have decided to do a RCS instead of trying for a VBAC this time around.
I guess I'm also one of the unicorns or something because I didn't have a horrible recovery at all - I barely took any pain meds when I was both recovering in the hospital and when I went home. I never filled the prescription for the pain meds they gave me, I used OTC a little bit and that was it. I'm not trying to downplay a c-section because it IS a major surgery, just sharing my experience.
As another sidenote, I have a friend who had an absolutely horrible labor. They tried to vacuum her son three times (which is a huge no no) and then ultimately ended up using the forceps. She was torn very VERY badly and had surgery to correct it a month or so after giving birth. Her lady bits are *still* not right and she has seen several doctors for second, third, fourth opinions. She almost sued the doctor who delivered her son because her labor was not handled properly and she likely should have instead gotten a c section due to how he was positioned and the complications she had during labor. All that being said, if she has another child she likely will opt for a c section and I don't think anyone should fault her for that.
Sorry, this was a total deal diary post but I have seen so many discussions on c-sections around here lately and I clearly have a lot of pent up feelings about it.
M/C 7/8/12
Perfect baby boy born 7/8/13
BFP 8/20/14 EDD 4/27/15 It's a GIRL!!
I kind of wondered that too. I'm relatively fit but damn.
@moreamanda6213 My sister had a very traumatic first delivery (I was in the room with her) she ended up with a 36 hour labor induction. The Dr forced her cervix to 2cm which for her was extremely painful. Her DD had microcephaly and her head was in the 5th percentile, so was extremely small. Still she tore so bad the doctor ended up having to give her an epesiotomy which ended in a 4th degree tear. Also, her stitches healed over and she had to have them burned out. It was a 6 month recovery for her. So when she got pregnant she was also considering an elective c/s. Her doctor talked her out of it.
Her second baby was delivered (I was in the room this time also) with a normal head. She only had a 2nd degree tear and only pushed about 3 times before the baby came out.
I know that this story is just anticdotal but still, many women experience a much easier birth the second time. I think that is also worth considering before deciding to go for an elective c/s. But you are the only person here who can decide that and you are the only one who needs to live with that decision. Do what's right for you.
Factor V Leiden Homozygous, Advanced Maternal Age
TTC #1, 5 yrs, PCOS, Femera + Ovidrel.
IUI#3 BFP, DD 5/31/2012
TTC #2, 2 yrs, PCOS, Femera+Ovidrel
IUI#2 BFP!
Not unrealistic! Just depends on your recovery and how soon after delivery you are able to start doing walks. I would just start slow and listen to your body. I went to target 1 week post c section feeling really good and then I was winded and not feeling well after walking around the store once and had to go home. But I tried to walk a little more every day and eventually I was doing really long daily walks with DS and they were a LIFESAVER when I couldn't get him to nap. Put him in the stroller and almost immediately to motion would lull him to sleep.
M/C 7/8/12
Perfect baby boy born 7/8/13
BFP 8/20/14 EDD 4/27/15 It's a GIRL!!
The first page discussed capitalizing and other trivial issues. But ok! She's bringing up a serious conversation that her doctor started.
This is true. All were very informative and I actually decided to ask a lot more questions....because of what these ladies told me.
Again, I'm really glad you have gotten information here that will allow you to make the best decision for you and your baby. Power to the mama. :-bd
A little backstory: My DS was complete breech and there's not a hospital or midwife in my city that will deliver a complete breech vaginally.
Recovery was uneventful, painful at times, but I doubt any birth experience is not painful at times.
I agree with pps that the notion that our bodies are "made" to give birth is seriously awful. In the exact same light as @KateRN08 mention about shaming women who can't breastfeed.
It's really hurtful to those of us who had to, medically, have a cs. As a result of this inadvertent shaming, I feel as though I actually mourned my lack of a vaginal birth, like I'm less of a woman. I'm getting over it, but it still remains at the back of my mind.
My doc is well aware that I want to vbac. She fully supports my decision and is really excited that I'm very pro vbac. I have several friends/family members who are docs and I don't believe that there's a hidden agenda to increase csections (though my experience is, admittedly, anecdotal).
Op, I hope the conversation with your doc goes well! Keep us posted on what you decide.
It's great to see how your attitude about this thread turned around!
Sorry, I can't help - I suck at math. I could ask my dad and my brother for you if you're really stuck; They're both math professors.
So sorry (not really) that my posting on this thread strikes so many of you as beyond my scope of practice. I didn't realize my own experience of an elective section was irrelevant. I guess I shouldn't be surprised that having done some OB as an md would offend as well.
To the OP: I'm glad this thread was thought provoking and has helped you clarify which follow up questions to discuss with your doctor.
I think my most condescending sounding replies are actually those in which I'm directly referencing the language and sentence structure of the people I was responding to (eg. What's wrong with the medical consumer community" was directly referencing the "what's wrong with the medical community" that preceded it. In any event that was all lost in the feeding frenzy already underway and this post is also in danger of becoming TL;DR.
So yes, lots of people hate me now but I don't think I was the only one not reading for comprehension last Friday.
I had been in labor from 10 pm -10 am I was 2 cm at 10 pm and 4 at 10 am, I had walked the halls, bounced on birthing ball and refused the epidural, at 10 my ob came into break my water, they lost our sons hb and found that he was cord prolapse, I was wheeled to OR and at 1045 my son was born a healthy 6 lbs 1 oz.
I was put to sleep for crash section and my hubby was not in the OR.
I have no memory of the first 24 hours of LO life, and even the first 3 days are hazy. This was very traumatic to me and I suffered and still do have PTSD in relation to this. I have PPD and PPA I'm on lexapro I understand now that I have a healthy 20 month old baby boy but there are so many questions and regrets and so much anger and sadness in relation to his birth that I still have a hard time with.
I can't see the ob in my practice that delivered him even though it's not her fault and if anything she saved him, I can't watch any shows about birth on tv without full on sobbing. I often ask hubby questions about what happened, we go over it over and over again and he has been great supporting me.
My section recovery was not too bad, I sometimes pushed myself too much especially when forgetting to take the meds, but overall I feel like I had it easier than a friend that had a 4th degree tear.
I'm choosing the section this time bc I can control it. A bonus to a section baby, he had a PERFECT round head.
Due in April 2015 with Number 2!
"I am judging the FTMs who are saying whatever birth I have is fine, even a c/s. MOST people can deliver vaginally, and to put so much trust that your doctor will only recommend surgery if necessary is laughable. You're doomed unless you educate yourself."
She was not incorrect and if i am not mistaken, it was in direct relation to a poster who said her doctor was recommending a CS bc her baby was too big... AT 20 WEEKS. If a woman agrees to do a CS bc the baby MIGHT be too big, that means she has agreed to an elective CS and it is NOT medically necessary. It is to make it easier on the doctor, quick in and out, NOT bc it would necessarily be easier on the mom. I hear a lot of women who regret their CS. There are stories of Mom's who were coerced into having an invasive surgery bc they thought it was medically necessary only to find out it wasn't. Those women tend to regret their decision, even though their baby is fine, but that doctor stripped her from the chance of delivering vaginally (and potentially risking her to infection or other problems) bc he didn't want to wait around/whatever.
Here in the US CS rate are ridiculously high. Not all doctors will have your best interest or wants at heart bc they have insurance companies and pharmaceutical companies with their hands in their back pockets. And the major point you keep leaving out of her post is the simple fact that she said, EDUCATE YOURSELF. Which is exactly what everyone has pretty much said. You're getting offended over a quote you aren't even quoting exactly and only sticking up for your (Canadian) medical system.
You say you felt her comments were rude bc it was referencing what is wrong with the medical system, but she was not off base. What's wrong with the medical consumer is not enough educate themselves and blindly put faith in a system that has been known to screw people over. She said something that is not off base and she did it without calling doctors biggoted, dirty hippies. THAT would be why no one likes you and THAT would be why no one takes you seriously. Just bc i educate myself doesn't mean i do not want or need doctors, nor does it mean i am biggoted or a hippie. It means i am not going to believe everything a person tells me just bc they have a degree. Guess what, i don't have a degree and I'd like to think i am still an intelligent and successful person who will raise my child to be the same way.
That's another thing I cried everyday!!! Everyday for 6 months before getting on the meds. I couldn't tell about his birthday without crying. I would be just sitting holding him and I'd loose it. I'd watch him nurse and think about how I didn't remember the first time. I don't want to go through that again.
@trollsniper
Due in April 2015 with Number 2!
---quote box fail---
Also, in rural settings in the US it's extremely common for family practitioners to also do OB for normal, low risk women. She isn't crazily off-base here.
It sounded to me like @Cliffhaven did her main residency as a GP with a specialty in OB then went on to psychiatry after. Is that correct? A good friend of mind is starting her fellowship as a GP with an OB speciality. I don't think it's that uncommon to the specialize afterwards.
I was lucky that there is a shortage of psychiatrists here so the government and residency program facilitated the switch. If I'd suddenly decided to be a dermatologist it likely would not have happened.