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Tough decision - Elective C or not ?



 
 
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  #1  
Old September 26th 03, 10:57 AM
paul williams
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Default 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....
  #2  
Old September 26th 03, 11:30 AM
Mary Ann Tuli
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Default Tough decision - Elective C or not ?



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

  #3  
Old September 26th 03, 12:25 PM
Cheryl
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Default Tough decision - Elective C or not ?

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)
  #4  
Old September 26th 03, 01:11 PM
nicky
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Default Tough decision - Elective C or not ?


"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


  #5  
Old September 26th 03, 01:25 PM
Linz
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Default Tough decision - Elective C or not ?


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


What do they mean by "measuring up to 40 weeks"? Some 40 week babies are
7lbs, others are 10lbs!

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.


And runs the risk that baby isn't actually 'cooked' at that stage.

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?


Are they actually saying baby is big? How big are they thinking? How
have they been measuring? Are they sure it's not that there's a lot of
fluid?

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....


I think that one of the important things to look at isn't necessarily
size of the baby, but size of the head. A big baby is going to have lots
of squishy fat which shouldn't cause too many problems. A big head, on
the other hand, my be harder to birth.

Your consultant has obviously been willing so far to discuss pros and
cons, ask for more information if you can, in order to make your
decision an informed one.

And good luck with the birth, whatever your wife and you choose!


  #7  
Old September 26th 03, 04:38 PM
Mary Gordon
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Default Tough decision - Elective C or not ?

As someone who's had a section and two VBACs and three quite large
babies (9lb 11.5 ounces, 9 lb 8 ounces and 10 lb 4 ounces), I'm a bit
perplexed. For starters, it is very hard to accurately estimate the
size of a baby at term - they can be off as much as 20%. Unless your
wife has had babies before and thus has a history of large babies and
big problems with delivery, or a known pelvic or uterine deformity,
you can't know how big this baby might be or how big a baby she is
capable of birthing. I'm not a big woman, and I pushed out a 10 lber
no problem.

I think its NUTS to schedule a section at 39 weeks because she MIGHT
have a problem. It seems a very extreme solution to something that is
only a potential issue - to leap to surgery with all that entails
(including increased risks and problems for future pregnancies and
births). I can't see any advantage to this at all.

Nor can I see any advantage to induction at 40 weeks. In the last
weeks, babies tend to put on body fat, not head and shoulder size, so
a few extra days, even into the overtime innings is not going to make
much difference in the scheme of things. Fat squishes. So, even if she
goes to 41 or 42 weeks, as long as she is healthy and baby is doing
well, you would not be losing anything at all to wait for spontaneous
labour. If she has any difficulty, she may end up with a section, but
at least then you've given a vaginal the best possible shot
(inductions often fail - a full 30% of first time moms who agree to
induction end up in the OR, even with smaller babies).

I'd be saying no to either option and letting labour kick in and see
what happens.

Mary G.
  #8  
Old September 26th 03, 04:38 PM
Mary Gordon
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Default Tough decision - Elective C or not ?

As someone who's had a section and two VBACs and three quite large
babies (9lb 11.5 ounces, 9 lb 8 ounces and 10 lb 4 ounces), I'm a bit
perplexed. For starters, it is very hard to accurately estimate the
size of a baby at term - they can be off as much as 20%. Unless your
wife has had babies before and thus has a history of large babies and
big problems with delivery, or a known pelvic or uterine deformity,
you can't know how big this baby might be or how big a baby she is
capable of birthing. I'm not a big woman, and I pushed out a 10 lber
no problem.

I think its NUTS to schedule a section at 39 weeks because she MIGHT
have a problem. It seems a very extreme solution to something that is
only a potential issue - to leap to surgery with all that entails
(including increased risks and problems for future pregnancies and
births). I can't see any advantage to this at all.

Nor can I see any advantage to induction at 40 weeks. In the last
weeks, babies tend to put on body fat, not head and shoulder size, so
a few extra days, even into the overtime innings is not going to make
much difference in the scheme of things. Fat squishes. So, even if she
goes to 41 or 42 weeks, as long as she is healthy and baby is doing
well, you would not be losing anything at all to wait for spontaneous
labour. If she has any difficulty, she may end up with a section, but
at least then you've given a vaginal the best possible shot
(inductions often fail - a full 30% of first time moms who agree to
induction end up in the OR, even with smaller babies).

I'd be saying no to either option and letting labour kick in and see
what happens.

Mary G.
  #9  
Old September 26th 03, 05:00 PM
Vijay
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Default Tough decision - Elective C or not ?

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.
  #10  
Old September 26th 03, 05:05 PM
Sophie
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Default Tough decision - Elective C or not ?



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


What's "very large"?

Consultant has given us the choice :-

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


What about letting things happen on their own?

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


As someone who has had 3 c-sections (2 elective) do not, not, not, not, not
have a c-section unless it's medically necessary.

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


Not necessarily - depending on the reason for it to be an emregency. A big
baby is hardly an emergency. My first c-section was not planned and went
perfectly fine.


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


I've had 3 c-sections - one not planned, 2 planned. With the 3rd one
(planned before I was even pregnant!) was the worst - no anesthetic. Just
cos it's planned doesn't mean it'll go smoothly.


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?


Problems can occur whether it's planned or not.

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....


Pretty late in the game to still be confused IMO but anyway, I say let
things go and see what happens.

--
Sophie-
TTC #4


 




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