Tough decision - Elective C or not ?

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

Consultant has given us the choice :-

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

Option 1 seems OK but consultant highlighted the risks involved with
any C-section.

Option 2 seems better if natural birth is possible. However, theres a
higher risk of emergency C-section which is obviously worse.

Are there any stats on how many Elective C-sections have problems ?

What about stats on how many large babies get forced down the
emergency C anyway? What about the extra risks of an emergency C
compared to an elective?

Also, my wifes decided on an epidural anyway in the event of normal
birth. Does'nt this provide problems with larger babies anyway? I'e'
forceps or ventouse delivery? Not what we want either....

Confused Father....

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

Consultant has given us the choice :-

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

What exactly is the problem with the baby being large...I mean is there
some medical risk to Mum or baby? Is the baby actually really large, or
the bump (fluid etc).

Option 1 seems OK but consultant highlighted the risks involved with
any C-section.

Option 2 seems better if natural birth is possible. However, theres a
higher risk of emergency C-section which is obviously worse.

I really have not looked into either of these myself, but my personal
feeling if it were me would be to aim for the most natural birth.
With an induction you will still probably have a natural birth.

Are there any stats on how many Elective C-sections have problems ?

I don't know those. You should be able to get stats. for your hospital
from the Web (I can't remember the site I'm afraid) which will be much
more relevant to you. Or you can ask the hosptial directly.

What about stats on how many large babies get forced down the
emergency C anyway? What about the extra risks of an emergency C
compared to an elective?

Again, I am not sure about this.

Also, my wifes decided on an epidural anyway in the event of normal
birth. Does'nt this provide problems with larger babies anyway? I'e'
forceps or ventouse delivery? Not what we want either....

An epidural does increase the risk of other interventions. The size of
the baby does not indicate how painful labour will be. Just because she
might be having a big baby does not mean that her body will be unable to
cope. In only rare cases does a woman carry a baby she is unable to
birth. I would advise going into labour with a more open mind. I've
known people who vowed to take every drug they could and were terrified
beforehand, only to have a totally drug free birth and other who vowed
NOT to take a thing, but ended up with everything.

Mary Ann

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.

(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 ???

"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

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

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

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).

On 26 Sep 2003 02:57:54 -0700, (paul williams)
wrote:

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

Consultant has given us the choice :-

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

Option 1 seems OK but consultant highlighted the risks involved with
any C-section.

Option 2 seems better if natural birth is possible. However, theres a
higher risk of emergency C-section which is obviously worse.

Are there any stats on how many Elective C-sections have problems ?

What about stats on how many large babies get forced down the
emergency C anyway? What about the extra risks of an emergency C
compared to an elective?

Also, my wifes decided on an epidural anyway in the event of normal
birth. Does'nt this provide problems with larger babies anyway? I'e'
forceps or ventouse delivery? Not what we want either....

If you aren't sure about what's going on, do some research. Your
consultant seems to believe that measuring large automatically means
large baby but this isn't always the case. It could just be that your
baby is lying at a funny angle, or is stretched out, or is long, or
any of a number of other possibilities. A large baby isn't
necessarily harder to birth, it's the size of the head and the width
of the shoulders that can make the difference and both of those are
hard to determine before a trial of labour.

As far as the choices you've been given, I don't know much about
elective caesareans but an interesting study done in Australia might
be worth looking at:
http://www.acegraphics.com.au/articles/sally01.html

This shows what can happen with any interventions in labour and is
based on a study of low-risk patients who selected either private
obstetrician care or public hospital midwife care.

--
Cheryl
Mum to DS#1 (11 Mar 99), DS#2 (4 Oct 00)
and DD (30 Jul 02)

"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