Tough decision - Elective C or not ?

Consultant has given us the choice :-

1. Elective C-section at 39 weeks.
2. Induce at 40 weeks.

How about option 3: get a second opinion?

The baby is measuring large? Has this been determined by u/s? If so, those
are notoriously wrong.

I was told my son was going to be huge. He was born after natural rupture of
membranes at 38 weeks, and weighed just under 6.5 pounds. I was told the same
thing with my daughter, measured on u/s. I was induced for high bp at 39
weeks, and she weighed a little under 8 pounds.

The fewer interventions you have, the better. Why not let things go naturally,
and if there's a problem take care of it if it comes up. Don't make problems
by having unnecessary interventions.

Just my $.02


Amanda

I guess I'm a little puzzled as to why you are ok with an elective
c-section
but 'don't want' a forceps birth. Surely the c-section is FAR more
invasive
than a pair of forceps...


Naomi


I know plenty of people who were born with various problems due to forceps
being used (it killed my Uncle at birth). I can't say the same about anyone
I know who was born by c-section.

I don't like the idea of using forceps or the vacuum *at all*.

--
Sophie -
TTC #4

Elfanie wrote:


Babies delivered by elective cesarean are cut by the surgeon's scalpel
from two to six percent of the time.
Researchers believe these risks to be underreported.

I can tell you that I have seen babies cut (on the forehead) during
cesareans. BUT....just because I've seen it doesn't mean it is common
or likely to occur. (although 2-6%...that's a LOT of babies!!!)


I've heard the risk is around 1 percent for vertex
babies and the 2-6 percent figure is for breech babies. Of
course, since breech baby is a common reason for a c-section,
that still adds up to a lot of babies.

Best wishes,
Ericka

I know plenty of people who were born with various problems due to forceps
being used (it killed my Uncle at birth). I can't say the same about anyone
I know who was born by c-section.


Forceps as used a generation ago are a very different animal than forceps are
used today. Forceps today are used almost exclusively in the very final stages
of labor, when babies head is already on the perineum. In earlier generations,
mid-forceps (and even high forceps) were commen) with baby still much further
up the birth canal, and injury to mother and/or baby was very common. Today,
if the situation was such that forceps would have been used that early in prior
generations, a c-section would be done today.


Naomi
CAPPA Certified Lactation Educator

(either remove spamblock or change address to to e-mail
reply.)

(Vijay) wrote in message . com...
Mary Ann Tuli wrote in message ...
paul williams wrote:
Wifes now 36 weeks but baby is measuring up to 40 weeks already so it
looks very large.

snip

How do they know for sure that the baby is dagerously large? Numerous
women in this group have been told to induce b/c of a 10-11lb baby
that turned out to be 8-9lbs. That said, it is possible to give birth
to an 11lb baby naturally, so I'm still not seeing a clear reason to
induce or schedule a c-section.

-V.

Hmmm. Possible or ideal ???

"Sue" wrote in message ...
I would do neither one and let nature take its course. You have to remember
that ultrasound weights are typically off and just an estimate. I have heard
of women being told that their babies are measuring 10 lbs and they are born
at 7 lbs. Measurements based on ultrasounds are just an estimate too. Are
you sure about the dates? Dates can go two weeks either way so I wouldn't
put too much emphasis on what the ultrasound is saying. Based on that
knowledge alone, I would not induce nor have a C-section. Women's bodies are
made to have children, trust your wife's body to deliver the baby (unless
there is medical problems or baby is in huge distress). Your wife should
probably educate herself more on delivery and perhaps find different
techniques that will get her through labor.

--
Sue
mom to three girls


Appreciate your point but expert opinion says that ultrasound
estimates are accurate within 10-15%.

Well, my understanding is that a baby is considered large for gestational
age (LGA) or macrosomic if his/her weight is at or above the 90th percentile
for full-term newborns. So, in theory at least, only about 10% of babies
should wind up being macrosomic (which is typically defined as a birthweight
over 8 lbs., 13 oz.). That may not be really rare, but it does mean that the
vast majority of babies should NOT be macrosomic.

That said, a woman who has already had a macrosomic baby has a much greater
chance of having another. Which could explain why more than half of your
mother's babies were macrosomic.

The question is whether having a baby who is at or above the 90th percentile
at birth should be considered a problem at all. Both my boys went to weights
and heights at or above the 90th percentile by the time they were a month
old in spite of having been around the 50th percentile at birth. No one
thought it was a problem that they'd gotten big after getting *out*, so I'm
not sure why it should be thought to be a problem if they do it before
getting out!
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [18mo] mom)


Last two ultrasounds where head and abdomen were measured have put the
babies size slightly above the 97th percentile...

"paul williams" wrote in message
m...
(Vijay) wrote in message
. com...
Mary Ann Tuli wrote in message
...
paul williams wrote:
Wifes now 36 weeks but baby is measuring up to 40 weeks already so
it
looks very large.

snip

How do they know for sure that the baby is dagerously large? Numerous
women in this group have been told to induce b/c of a 10-11lb baby
that turned out to be 8-9lbs. That said, it is possible to give birth
to an 11lb baby naturally, so I'm still not seeing a clear reason to
induce or schedule a c-section.

-V.

Hmmm. Possible or ideal ???

That depends. Exactly what outcome are you hoping for?

I've had 2 cesareans - one for no good reason, one for very good reasons. I
just had a vaginal birth (with venteuse) - a 7 lb 14 oz baby who was quite
large for my 4'10" body, yet fit through my pelvis just fine. I would
rather have another vaginal birth, of a baby of any size, any day, rather
than have another cesarean for anything other than a real medical reason - I
mean, 'this is a problem right now, we have to solve it right now' rather
than 'this might be a problem, so let's just cut'.

A small baby, with a small head that's presenting badly may be much more
difficult to birth than a big baby that's presenting ideally. Presentation
is *very* important. Size is a whole lot less important than you think.
Medically-minded birth attendants tend to treat all head-down positions as
equal (because after all, if it doesn't work, we can just do a cesarean) but
this isn't true. And there is a lot a pregnant woman can do to help her baby
line up in an ergonomically-positive position for birth.

Sir, surgery should be a *last* resort, not a "something might go wrong, so
let's cut 'er open" attitude. I wouldn't wish a cesarean on anybody for
anything but the most important reasons: immediate threat to mother and/or
baby. Recovering from major abdominal surgery *sucks*. Being told you will
have *no choice* but to have major surgery because you're a woman and you
got pregnant again.....sucks. And that's what's happening to a great many
women now, who have had previous cesareans. Not because a c/s is safer for
the woman or the baby, but because it's less of a liability for the
hospital. It's not demonstrably safer for your wife at this point. It's
not safer for your baby. So what is the appeal here?

Thank god for cesareans when they're needed.

This situation doesn't sound like a "needed" cesarean.

--angela

paul williams wrote:

(Vijay) wrote in message . com...

Mary Ann Tuli wrote in message ...

paul williams wrote:

Wifes now 36 weeks but baby is measuring up to 40 weeks already so it
looks very large.

How do they know for sure that the baby is dagerously large? Numerous
women in this group have been told to induce b/c of a 10-11lb baby
that turned out to be 8-9lbs. That said, it is possible to give birth
to an 11lb baby naturally, so I'm still not seeing a clear reason to
induce or schedule a c-section.

Hmmm. Possible or ideal ???


If it's successful without causing any problems, definitely
ideal. The only downside to trying to birth the baby vaginally
is that you might end up with an intrapartum c-section rather
than a scheduled c-section. While intrapartum c-sections are
slightly more risky than scheduled c-sections, they are not
as risky as true emergency c-sections. It is *not* an emergency
to do a c-section for failure to progress because the baby is
too large. It may not be the most fun choice to labor a while
and then end up with a c-section, but with good planning and
a supportive birth team you've got a really good chance of
making it and not having to deal with the consequences of
a c-section.

Best wishes,
Ericka

paul williams wrote:


Appreciate your point but expert opinion says that ultrasound
estimates are accurate within 10-15%.


That's not a particularly accurate statement.
Here are a few studies you might be interested in:

http://tinyurl.com/owwv
--Compared the accuracy of sonographers versus maternal-
fetal medicine specialists and found that sonographers
were better, but even they only hit within 10% of actual
70% of the time (the doctors only hit within 10% of
actual 54% of the time).

http://tinyurl.com/owx3
--Studied 758 patients, half of which had birth weight
estimated by ultrasound and the other half by clinical
examination (e.g., palpation). Clinical examination got
within 10% of actual 58% of the time, and ultrasound
fared worse, only getting within 10% of actual 32% of
the time.

http://tinyurl.com/owxa
--This one compared different sonographic models for
estimating birth weight for macrosomic infants. It
found the various models got within 10% of actual
53-66% of the time, depending on the model.

So, sure, they define accuracy as getting within 10%
or so of actual (which, by the way, leaves quite a
bit of latitude--that gives them a 1.5 pound spread
on an average sized baby!). But the fact is that
ultrasound estimates of weight only get within that
range somewhere between 50 and 70 percent of the time!
I wouldn't be keen on making a decision about attempting
major abdominal surgery with those odds, especially
considering that the risks of a wait and see approach
are minimal.

Best wishes,
Ericka