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#41
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C-section rate (was placenta previa)
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 |
#42
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C-section rate (was placenta previa)
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 |
#43
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C-section rate (was placenta previa)
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 |
#44
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C-section rate (was placenta previa)
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 |
#45
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C-section rate (was placenta previa)
"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 |
#46
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early placenta previa, no vaginal bleeding
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 |
#47
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C-section rate (was placenta previa)
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 |
#48
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C-section rate (was placenta previa)
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#49
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C-section rate (was placenta previa)
* 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 |
#50
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C-section rate (was placenta previa)
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 |
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