Tough decision - Elective C or not ?

On Sat, 27 Sep 2003 21:29:25 -0400, Ericka Kammerer
wrote:

If the baby is a girl, the 97th percentile at birth
would only be about 9.5 pounds, which many, many women
deliver quite successfully vaginally

At birth, I weighted 9lb. 4oz. My mother gave birth to me vaginally.
She weighted maybe 160 pounds at the time, and she is 5'6". She had
no problems giving birth to me.

--
Daye
Momma to Jayan
"Boy" EDD 11 Jan 2004
See Jayan: http://jayan.topcities.com/

That depends. Exactly what outcome are you hoping for?

Obviously, a birth with as little problem as possible resulting in a
healthy baby and healthy mother.


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?

I can see your point but I think you're missing my point a little.

Yes. Ideally for everyone involved a natural birth is MUCH, MUCH
better than
anything.

Since the baby is big (based on head and abdomen size NOT 'guessed'
weight) the consultant has said that an induction at term would be
done rather than waiting too long. Also, my wife plans to have an
epidural in the instance of natural birth anyway.

But, neither of us are keen on ventouse or forceps. Risks of this are
increased with epidural, large baby, and inducing....

However, an emergency C-section after 25 hours labour is the worst
option by far. You're operating on a mother whos already exhausted,
possbily having to rush the op, cutting through contracting muscle
etc...

However, we both understand the issues with a C, in terms of recovery.
Yes, it is major abdominal surgery. (BTW. My wifes a qualified nurse -
recovery specialist at that !)


Thank god for cesareans when they're needed.

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

--angela

"nicky" wrote in message ...
"paul williams" wrote in message
om...
Wifes now 36 weeks but baby is measuring up to 40 weeks already so it
looks very large.

I measured 4-5 weeks bigger through the last trimester and was also
predicted a large baby especially as my second baby had been 8lbs 11 oz
...Thomas was 7lbs 11oz !! Perfectly average weight. I hope the hospital
aren't basing their judgement on this being a big baby solely on the fundal
measurement. In any case unless the baby is an absolute whopper is there any
reason to think hat your wife wouldn't be able to deliver vaginally, ie does
she have a very narrow pelvis?

Nicky

Research and expert opinion says that ultrasound measurements and
estimates are accurate to within 10-15%. We've had two and both have
been consistent.

Head and abdomen measurements in both instances place the baby size
slightly above the 97th percentile on the fetal growth chart. So, I
guess this means its in the top 3% with regards to size...

Ericka Kammerer wrote in message ...
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

Agree that not every unplanned C should be classed as emergency.
However, every unplanned C where labour has taken place for any length
of time (be it natural or induced), results in an op being performed
on a possibly fatigued and stresses mother, and also having to cut
through contracting muscle (i.e. the uterus).

(KR) wrote in message . com...
The size of the baby as measured externally is just an estimate. To
me, I would rather be induced then opt for a c-section any day. A
c-section is major surgery. There is also the possibility that the
baby could come naturally in the next 4 weeks.


Yes. Agreed that would be better!

(Elizabeth Reid) wrote in message . com...
(KR) wrote in message . com...
The size of the baby as measured externally is just an estimate. To
me, I would rather be induced then opt for a c-section any day. A
c-section is major surgery. There is also the possibility that the
baby could come naturally in the next 4 weeks.

I will say, though, that it's not like you're necessarily choosing
induction vs. c-section; you're choosing (induction + chance of
post-labor-c-section) vs. elective c-section. I really, really
wanted a vaginal birth with my son, and hung in through lots of
hours of unproductive labor to try to have one. I have to admit,
though, that if I do it again I would waver on whether to just go
straight to the c-section, because a c-section after 36 hours of labor
REALLY sucks. You get the worst of both worlds that way, or
that's how it seemed to me. I guess you at least get the knowledge
that you did try, but I'm not sure that would be enough for me
when weighed against going into the surgery with no resources
after a useless labor.

Which is not to say that the OP's wife should opt for the section,
because the big baby thing is notoriously unreliable apparently.
However, if the provider is already talking c-section the
chances aren't bad that it's going to end up that way anyway after
the induction 'fails' (this does not sound like a let-nature-take-
its-course kind of doctor) and the risk of that happening should
be taken into account.

Beth
Sam 8/16/2002

Ah ha. Someone whos thinking along my lines !!!!

No. Doctors first choice was for induction. Since baby is large enough
to be in the 97th percentile he says that its best not to go over
term.

Ericka Kammerer wrote in message ...
paul williams wrote:


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


If the baby is a girl, the 97th percentile at birth
would only be about 9.5 pounds, which many, many women
deliver quite successfully vaginally (even with lousy
support--with the support of a birth team skilled at
supporting vaginal births of large babies, the odds are
even better).

Best wishes,
Ericka

Why the difference between boy and girl? Are boys born larger then?

BTW. Its a boy.... (we know :-) )

"Sue" wrote in message ...
Paul Williams wrote:
Last two ultrasounds where head and abdomen were measured have put the
babies size slightly above the 97th percentile...

Ericka Kammerer wrote in message
If the baby is a girl, the 97th percentile at birth
would only be about 9.5 pounds, which many, many women
deliver quite successfully vaginally (even with lousy
support--with the support of a birth team skilled at
supporting vaginal births of large babies, the odds are
even better).

And my 97th percentile baby was 9 pounds and was by far the easiest delivery
I had. She was born under two hours with only three pushes and no
medications or interventions. I went home the next morning and felt
wonderful.

Unfortunately Paul, you sound like you put your 100% trust in the medical
professionals that you are dealing with. To a certain extent, you should
trust them. But at the same time, you must keep in mind that doctors do a
lot of interventions to save them from getting sued. They do these things,
not in the best interest of the patient, they do it for their best interest.
Not a good thing, imo. The patient needs to be educated on what
interventions are truly needed and what interventions are just done for the
convenience of the doctor and staff.
It doesn't sound like you have done much research on birthing babies. Ericka
gave you some good books to read, perhaps you can look them over quickly to
give you a better idea of what having a baby is really like and not one that
hospitals make you believe that you should do. Good luck.

Not sure I agree with you there. Doctor has offered his opinion that
induding at 30 weeks is the best option. My wife is keen on the C
section.

BTW. My wifes a registered nurse (and a theatre recovery nurse at
that!) so knows a bit about things.

Linz wrote in message . ..
On 27 Sep 2003 17:18:33 -0700, (paul williams)
wrote:

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

How tall/large are you and your wife?

Both of us are pretty short. Shes 5' "2 and I'm 5' 8".

Maybe I should have a word with the postman !!! :-)

In message , Elfanie
writes
And you're operating after many hours of labor...
which is BENEFICIAL to the baby! That's why many moms who PLAN to
have a cesarean...still want to wait and go into labor and labor for a
while before the planned cesarean. There are many health benefits to
mom and to baby if they labor prior to surgery.

A cesarean after 25 hours of labor isn't usually considered the worst
option....since you've given your body the option of having a vaginal
delivery as well as prepared the baby for birth.

i have to strongly disagree here. an emergency caesarean section after
labourin for 35 hours is a terrible option - both pychologically and
physically for the mohter. the risks of haemorrahge, infection and deep
vein thrombosis are significantly raised.
i disagree entirely that there are health benefits to be gained from
labouring before the caesarean. show me your data, and i'll show you
mine.
--
Helen Johnson