early placenta previa, no vaginal bleeding

Pologirl wrote:
Anne Rogers wrote:
I don't think the blame lies exclusively with doctors, I think women
have a responsibility too, but the reality is the attitude of "trust the
doctor" and "the doctor is always right" is spread across healthcare.

More than that, many women are afraid of pain, any pain, and want to
avoid it at all costs. My unmedicated labors were painful, but with
the exception of crowning with the first, the pain was entirely of the
extreme effort variety. That sort of pain is familiar to competitive
athletes, and people who do work of a physical kind, but is foreign to
many women.

Also, many women want to shorten their pregnancy by 2-3 weeks.

Also, many women want the convenience of a scheduled delivery.

Dont know about it being for the convenience of the woman. My second
child was also born by c section. The OB insisted that once a C always a
C. Found out later that it was to fit in with his golf games and that he
scheduled a lot of C sections for that reason. My third child was born
by C as by then (under a new OB) it was considered safer after two. He
told me there was no need for the second one to be a C section. The same
OB gave me the option of the natural birth if I went into labour before
the set date for the C section.
Not so sure about the pain thing either. After labour its is fairly
quick recovery. Caesars take usually at least six weeks to recover from.
A nurse did once tell me though that she preferred to work with C
section mothers as they were more motivated to get up and moving than
the natural labour mums. We decided that may be due to the length of
labour and the physical strain on them whereas the Caesar mums were not
subjected to that.

Pologirl

Dont know about it being for the convenience of the woman. My second
child was also born by c section. The OB insisted that once a C always a
C. Found out later that it was to fit in with his golf games and that he
scheduled a lot of C sections for that reason. My third child was born
by C as by then (under a new OB) it was considered safer after two. He
told me there was no need for the second one to be a C section. The same
OB gave me the option of the natural birth if I went into labour before
the set date for the C section.
Not so sure about the pain thing either. After labour its is fairly
quick recovery. Caesars take usually at least six weeks to recover from.
A nurse did once tell me though that she preferred to work with C
section mothers as they were more motivated to get up and moving than
the natural labour mums. We decided that may be due to the length of
labour and the physical strain on them whereas the Caesar mums were not
subjected to that.


Problem is, if you've not had a c-section you don't know these things,
lots of women haven't even had surgery of any sort and really have no
idea what to expect and can see it to a solution for a lot of problems.
Or they can be like be and be absolutely scared out of my mind by the
idea of a c-section.

There really is no one answer to why the c-section rate is so high.
Various bits of investigation and research keep showing that the direct
choice factor is a very low one, I suspect it's a little higher as I
think there will be a number that latch on to any possible reason which
other women might reject, so it gets recorded as something different.

I read Pologirl's suggestions not as direct causes, but as indirect
ones, with inductions and epidurals probably not helping the c-section
rate.

I moved from the UK to the US a bit over a year ago, amongst the women I
knew in the UK, the vast majority wanted to avoid an epidural and even
if they expressed "not for me" kind of emotions like a home birth or
water birth, the attitude was mostly "good on you", that kind of thing.
I've been shocked and saddened as I get to know people here that almost
all the women I know want or had epidurals as soon as they get to the
hospital and that the response to a vague acquaintence's homebirth was
verging on it being discusting. The c-section rate in the UK is still
far too high, but it's a long way behind the rate in the US.

The insurance system in the US doesn't exactly favour normal birth, a
doctor can bill much more for carrying out a major operation than for
catching a baby, but national health care systems in other parts of the
world aren't doing a great job either. My understanding is that Holland
is about the only place in the western world that has a tolerable
c-section rate, I'd really love to know more about how things are
handled there.

Cheers
Anne

Anne wrote:

Problem is, if you've not had a c-section you don't know these things,
lots of women haven't even had surgery of any sort and really have no
idea what to expect and can see it to a solution for a lot of
problems. Or they can be like be and be absolutely scared out of my
mind by the idea of a c-section.

I had abdominal surgery (appendectomy) when I was 17, and recovery was rough!
When we started TTC that appendectomy kept popping up in my head when I
thought of birth and possibly having a c-section, and it terrified me to
think of trying to recover from surgery and care for a newborn. Avoiding
a surgery was the primary motivator in most of my birth choices (i.e. no
epidural, hiring a doula, etc.). When people ask me why I went natural instead
of opting for the epidural and I tell them it was to avoid a possible c-section,
most of them look at me like I grew a second head (especially women who have
not ever had surgery).

--Jodi

Diana BB wrote:
Dont know about it being for the convenience of the woman.
[...]
Not so sure about the pain thing either.

Avoiding a painful labor, and the convenience of scheduling, are the
two most common reasons for having a C-section that I hear from the
primiparas in a face-to-face support group I visit now and then.

I wanted nothing to do with a C-section. I use my abs and don't need
scar tissue there from an elective(!) surgery, thank you very much.

Pologirl

"Jodi B" wrote in message
t.net...
Anne wrote:

Problem is, if you've not had a c-section you don't know these things,
lots of women haven't even had surgery of any sort and really have no
idea what to expect and can see it to a solution for a lot of
problems. Or they can be like be and be absolutely scared out of my
mind by the idea of a c-section.

I had abdominal surgery (appendectomy) when I was 17, and recovery was
rough! When we started TTC that appendectomy kept popping up in my head
when I thought of birth and possibly having a c-section, and it terrified
me to think of trying to recover from surgery and care for a newborn.
Avoiding a surgery was the primary motivator in most of my birth choices
(i.e. no epidural, hiring a doula, etc.). When people ask me why I went
natural instead of opting for the epidural and I tell them it was to avoid
a possible c-section, most of them look at me like I grew a second head
(especially women who have not ever had surgery).

--Jodi

Ugh, I know that feeling! When I awoke from my appendectomy I was in agony,
and let's face it, they made a relatively small incision and removed a
relatively small bit!! The thought of going through a biger operation and
then having a baby to care for was terrifying for me. I said that if I had
to have a c-section, I'd want it under GA as I'm phobic about epidural's
since a botched lumbar puncture. I was so relieved and blessed to have a
natural birth with only gas & air. Yeah, if there have been previous
complicated/traumatic births for the mother, then I can understand her fear
of NOT having a c-section, but In a woman that simply chooses not to give
birth, i can't understand the thinking. Your body is designed to push a baby
out, it's not designed to be cut open, or we'd all have a zip across our
tummies!

lucy x

Anne:

For an anecdotal point of view, I had an IVF pregnancy and was
diagnosed with complete placenta previa by 18 weeks. Even so, my
doctor (admittedly a fairly liberal doctor) told me I didn't need to
go on pelvic rest until after week 27. (I still took it VERY easy).
By my 32 week scan to see if it had resolved, it had! (It was still
"complete" as of 28 weeks, but by 32, it was GONE!).

Anyhow, there is at least one doctor out there who tells patients
pelvic rest starting at 28 weeks. So, like most things in life, there
are several schools of thought.

Now, my doc also said that if I had any bleeding, that I'd be on
strict, strict pelvic rest from then on out, but as long as I didn't
have any bleeding, no worries.

Yellowgirl

Ugh, I know that feeling! When I awoke from my appendectomy I was in agony,
and let's face it, they made a relatively small incision and removed a
relatively small bit!! The thought of going through a biger operation and
then having a baby to care for was terrifying for me. I said that if I had
to have a c-section, I'd want it under GA as I'm phobic about epidural's
since a botched lumbar puncture. I was so relieved and blessed to have a
natural birth with only gas & air. Yeah, if there have been previous
complicated/traumatic births for the mother, then I can understand her fear
of NOT having a c-section, but In a woman that simply chooses not to give
birth, i can't understand the thinking. Your body is designed to push a baby
out, it's not designed to be cut open, or we'd all have a zip across our
tummies!

One of the advantages of local anesthesia for a c-section is that with
the right drugs and technique it can give pain relief for a good few
hours afterwards, compared to GA, when you wake up with no local
anesthesia in place, not long after everything has been finished and
post op pain does subside quite a lot in the first few hours. After my
recent op, it took 20mg of morphine, plus some fentanyl and pethidine to
get the pain level down to a grudging 6, but within a few hours was on a
normal dose of oxycodone and fairly comfortable.

I think c-section can represent control, you know what you are dealing
with, though in reality, the complication rates are quite high, higher
than the uncontrollable complications of vaginal birth, such as severe
tearing.

Once you've had a birth with complications, the issue becomes a lot more
cloudy, on an assessment of my pelvic floor alone, I was recommended to
have a c-section if I have any more babies, yet considering that alone,
there is no way I'd have a c-section, true, my function and sensation
are not great, but I'd take the risk of worsening them over a c-section
any day. As it happens, they are not the only complications, but there's
still a huge part of me that runs a mile at the thought of a c-section
and if I were to plan another baby, knowing I could get care that could
cover both possibilities would be important to me. Though I rather
suspect I won't plan another pregnancy, it still could happen!

Cheers
Anne

On Tue, 27 Nov 2007 14:36:08 GMT,
(Elfanie) wrote:

On Mon, 26 Nov 2007 16:49:21 -0800, Anne Rogers
wrote:



Ugh, I know that feeling! When I awoke from my appendectomy I was in agony,
and let's face it, they made a relatively small incision and removed a
relatively small bit!! The thought of going through a biger operation and
then having a baby to care for was terrifying for me. I said that if I had
to have a c-section, I'd want it under GA as I'm phobic about epidural's
since a botched lumbar puncture. I was so relieved and blessed to have a
natural birth with only gas & air. Yeah, if there have been previous
complicated/traumatic births for the mother, then I can understand her fear
of NOT having a c-section, but In a woman that simply chooses not to give
birth, i can't understand the thinking. Your body is designed to push a baby
out, it's not designed to be cut open, or we'd all have a zip across our
tummies!

One of the advantages of local anesthesia for a c-section is that with
the right drugs and technique it can give pain relief for a good few
hours afterwards,

Other reasons are...

* general anesthesia is quite a bit more dangerous to the baby than a
spinal or an epidural.
* with regional anesthesia there is no need to intubate like for
general
* you can hear your baby's first cries
* you can be alert for breastfeeding afterwards (especially if you
request no Versed be used after the birth, which is a pretty routine
thing to give you)
* dad doesn't have to see mom being intubated and unaware for the
birth
* there is less "disconnect" with the birth (which is common even for
regional anesthesia and cesarean...this feeling of "is this my baby?
did I actually give birth?" etc)

Well, I've had it done both ways.... with a general and with an
epidural. While I didn't really care for the feeling of loss of
control while I was awake under the epidural, I'd choose it again,
hands down.

With the general I missed the entire birth and only have "memories"
because dh filmed the whole surgery for me.
* When I woke up I was in so much pain that I was crying and couldn't
hold my new baby until a nurse got the surgeon to okay some pain
relief meds in my IV.

With the epidural my dh didn't film the birth but I have *real*
memories of the baby crying, dh saying she had my earlobes G and the
doctor showing her to me. Even though I probably drifted in and out
for a while after her birth, I got to hold her right away. I had NO
post op pain whatsoever, for the next 24 hours, as the
anesthesiologist said he put a "cocktail" in my epidural that would
give long term relief. I was up and moving around very well the next
morning.

Nan

* general anesthesia is quite a bit more dangerous to the baby than a
spinal or an epidural.
* with regional anesthesia there is no need to intubate like for
general
* you can hear your baby's first cries
* you can be alert for breastfeeding afterwards (especially if you
request no Versed be used after the birth, which is a pretty routine
thing to give you)
* dad doesn't have to see mom being intubated and unaware for the
birth
* there is less "disconnect" with the birth (which is common even for
regional anesthesia and cesarean...this feeling of "is this my baby?
did I actually give birth?" etc)

Well exactly! I wrote on my birth plan for my first baby that if
c-section I'd want a GA, no one even discussed it with me, I doubt
they'd have followed it without discussion unless it had to be very
fast, but labour isn't exactly a great time for such a discussion, I
think someone should have discussed with me my reasons for that and ways
that we might have been able to deal with it, because the advantages are
too great to ignore based on fear. I now know I don't have a normal
response to local anesthesia, so I don't think there would be a great
chance it would work, but as long as everyone else was happy, I'd want
to give it a try.

The other thing I've discovered is that I have a greater tolerance to
opiates, which means I need more to get the same pain relief,
anesthetists tend to understand that, but then the nurses who have to
carry out their prescriptions are often unwilling, which is rather
frustrating if you're in pain and the nurse has to go talk to the
anesthetist and you can hear the anesthestist saying "but I told you...".

In the UK, the tendency is for dads to not be allowed in theatre if mum
is under a general, some have suggested it's due to an underlying belief
that dad is there for mum, not to witness the birth, so if mum is
unconcious, no need for dad to be there. What mothers seem to say is
this actually increases the need for dad to be there so one parent
witnesses it. A lot of doctors don't like it though and worry that one
of their team will have to deal with dad.

Cheers
Anne

Elfanie wrote:
On Tue, 27 Nov 2007 12:00:48 -0800, Anne Rogers
wrote:

I now know I don't have a normal
response to local anesthesia, so I don't think there would be a great
chance it would work, but as long as everyone else was happy, I'd want
to give it a try.

Just making sure that you know....
but an epidural or spinal is not a local anesthesia. Local is
something like Lidocaine...
They are regional anesthesias...that act very differently. Big big
big difference between a local anesthesia and a regional anesthesia.
(so there is a very high likelihood that you have problems with local
anesthesia yet wouldn't with regional..?)

I wasn't aware of where the boundary was drawn in the classification and
understanding it fully isn't helped by the term "local anesthetic"
being applied to the -caine drugs used in both local and regional
anesthesia.

My problem is a non typical response to the -caine drugs, regardless of
where you put them and even the experts haven't figured out why people
with my condition don't have a normal response, particularly as the
response seems to vary, but not in a consistent way.

I've had surgery under generals where a local anesthetic has been
administered for post op pain management work absolutely perfectly and
not work at all.

When going through my notes after my 2nd baby, I discovered I had been
given the exact same anesthesia as they would give in theatre prior to a
c-section (in that hospital, injection into the relevant space and
nothing left in to top up) as well as the usual epidural, with catheter
left in and the basic dose given, as they thought baby was in trouble
but didn't need urgent intervention, so they got me ready to go if
things hadn't turned around in half an hour. There is no way I was numb
enough for a c-section, but there was some effect, the component of
contraction pains coming from the uterus did get blocked, but not that
from an OP baby pressing on the back, I felt as if I had completely
normal sensation, could feel monitors and belts and discomfort from them
being too tight, I could fully support my own weight and walk etc. I
don't think there is anyway of knowing without actually trying it
whether a greater dose could numb things up enough, some women with my
condition have reported this working. So if do have another baby and
decide a c-section is a better choice, I would definitely have to be
prepared for a GA, but I'd hope that the doctors would consider the
benefits of regional anesthesia sufficient to be prepared to take the
time to see if it can be made to work.

Cheers
Anne