Tough decision - Elective C or not ?

I'd say there's a world of difference between working with people who've
had
surgery, and being the one who's had surgery. And speaking as somebody
who's spent far too much time in hospitals either having things done to
her,
or watching things done to her children, I think medical folks learn to
tune
out the fact that they're hurting people with their procedures. They can't
afford to be empathetic or even sympathetic, when painful things have to
be
done. But, if she really wants to have surgery rather than try an induced
labor, well, she may just find out the difference between theory and
reality.

Anyway, as far as I can tell, I have to agree with the other ladies: you
folks seem to have made up your mind already and aren't really interested
in
anyone's opinions or even cited articles from peer-reviewed medical
journals. So what are you hoping for from us?

--angela



Bit of a negative comment here. As I think I've said earlier, our decision
is merely 'pencilled in' at the moment. Surely, my willingness to discuss
these issues in this NG (after all I did start the thread!) shows that I'm
interested in others opinions !

Just because my opinion is slightly different to yours, doesnt mean that I'm
not interested in anyone opinion.

This doesn't make any sense at all -- and I saw you repeated this
several times about 'contracting muscle'. A c-section on a
contracting uterus is NOT a problem at all!! It is not medically
worse to have a c-section once labor had started (an exhausted Mom who
has to also recover from major abdominal surgery has it a little worse
than the women who slept right before, sure


This came from my wife about 'contracting muscle' (from her experiences as a
recovery nurse). Maybe shes got it wrong?

Yes...let me dig up some cites. Basically, having
the c-section after labor starts is significantly better for
the *baby* (for several reasons--you know for sure the baby is
ready, and the labor prepares the baby for birth better), but
it is slightly more risky for the mother. In balancing the
two out, I'd take the intrapartum c-section personally because
I think the value to the baby is higher than the risk to the
mother in that case, but there is a slight increase in risk
to the mother.

Here's one cite to get started:

http://tinyurl.com/p45n
CONCLUSION--The attributable relative mortalities of caesarean section
compared with vaginal delivery and intrapartum compared with elective
caesarean section are lower than the overall relative mortalities of
these modes of delivery and are approximately 5:1 and 1.5:1
respectively. These data are crucially important in the decision to
recommend elective caesarean section compared with trial of labour.

Best wishes,
Ericka


Ericka,

You seem to come up with some great stuff. If you don't mind me asking - are
you a healthcare professional ?

"nicky" wrote in message
...

"paul williams" wrote in message
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...

but still within normal range!

So far it seems that you and your wife are scared about giving birth to a
large baby and are seriously thinking of opting for c-section. There is
nothing to suggest that she can't give birth vaginally to this baby and as
everyone else has pointed out the vaginal route offers far more benefits
to
both mother and baby than a c-section that is not medically necessary.

I totally understand your fear, I was terrified of labour(having never
experienced it with my first child) with my second child after having had
a
section with my first ( I begged for a repeat section but my hospital had
a
policy of VBAC unless good reasons were present) but I can honestly tell
you
that it was a far more positive experience. He was on the big side at 8lbs
11 oz and he had a big head too. He was my first labour and it was less
than
3 hrs start to finish 9 I didn;t go into labour with my first- DD due to
elective CS for placenta previa)
Would you really opt for major abdominal surgery for no good reason?


Hmmm. Take your point. We are now seriously considering the options
availanle....

Nicky

Still, it's pretty obvious to me that:

1) You put complete faith in the ultrasound estimates of your baby's size
despite a lot of evidence that it could be inaccurate.
2) You are convinced that a large baby is a problem and intervention is
necessary.
3) You don't WANT to consider alternatives to intervention.

That being the case and given your wife's apparent fear of a vaginal
birth,
I'd actually go with a C-section over induction because I think the
chances
are VERY high that induction at 40 weeks with a suspected large baby will
fail (statistically, the odds are not good for successful induction prior
to
41 weeks in women who have not had a prior vaginal birth and they are also
not good for *any* woman being induced because the baby is suspected to be
large) and your wife will end up with a section anyway. In your situation,
I'd give induced labor no better than 50/50 odds of succeeding, and
probably
less. If you're not willing to let nature take its course to give you the
best chance for a vaginal birth (and if you look at the research that has
been done by medical professionals, waiting for spontaneous labor does
give
you the best chance regardless of the baby's size or gestational age), I
can't see any logical reason to put your wife through an induced labor
(the
worst sort, IME) she doesn't want when there's such a high likelihood of a
c-section being the end result anyway.

I wouldn't normally recommend an elective c-section, but I'm a realist:
you're one the road to one anyway, so why not cut out the middle man?
--


Barbara,

I'm a little insulted that you seem to have brushed my opinions off in this
way. As I said in another post,. if I was'nt interested to learn I would'nt
have started this post, would I ?

However, your last paragraph seems to have hit it on the head...

I would note, however, that when I started this post (which was shortly
after our last visit to the hospital), I was'nt even aware that the option
of no C, no intervention was even viable.

The docs words ere something like - Its a large baby so we won't let u go
over term. No mention of doing nothing...

"Vicki S" wrote in message
...
"Circe" wrote:
I wouldn't normally recommend an elective c-section, but I'm a realist:
you're on the road to one anyway, so why not cut out the middle man?

I agree with Circe. You really sound like you've made up your mind
already and like nothing you read that disagrees with your preference
makes any impact. Happy c-section, and I hope you don't want a lot of
children.


Vicki,

Hmm. Pretty pointless post really.

May I suggest if u don't like my views or my attitude or whatever you ignore
this thread rather than post this sort of rubbish.

"Taniwha grrrl" wrote in message
...
Circe wrote:

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

She knows what recovery from surgery is like; what she
doesn't
realize, I suspect, is how much *harder* recovery from
surgery
generally is than recovery from a normal vaginal birth.

Not to mention taking care of a newborn baby while
recovering from surgery, I don't think she'll have
experience in that. You can't pick up your baby to comfort
him when he cries, you can't put him to the breast, you
can't even pull the bassinette close by to gaze at him
without using that buzzer to get the staff to come in and do
it for you. Your totally dependant on other people to help
you care for *your* baby in those first day's after surgery,
it can be very depressing. It was torture to me, as I'm very
independent, to have to ask someone to pass me my baby when
she cried so I could put her to the breast.


Yep. Agreed. This is something, obviously, neither us have any experience
in...

Be really cautious here--as so many have posted, estimates
can be really off, there is no good evidence that induction or
elective c-section for suspected large baby improves outcomes,
and larger babies are not necessarily more difficult to birth.


So do you mean that induction is worse then c-section in general or do
you
just mean that in the case of this woman who's scared of a vaginal
birth?


I interpreted her to mean that if you don't want a vaginal
birth anyway, an induction is a waste of time and energy for all
involved ;-) Also, since induction (particularly if done in a
less favorable situation) can increase the odds of a more painful
labor and instrumental or surgical delivery, it's not necessarily
a nice option for someone already afraid of vaginal birth.


I REALLY want another vaginal birth, I'm pretty much terrified of having
surgery.


If you really want it and plan for it and have a good team
to support it, odds are you *will* have another vaginal birth,
even with a large baby. Also, all inductions are not created
equal. If somehow you find yourself in a situation where an
induction really is the best thing, you may be able to get by
with a much more gentle approach than cervical ripening followed
by loads of pitocin.

Best wishes,
Ericka


Seems childbirth is a pretty non-exact science. I've certainly learned that
!

My wife is keen on the C
section.

Then why are you asking for opinions and arguing? If she wants a
c-section, let her have one. You said that she is a nurse. She is
medically with it enough to figure out the risks etc.

Just let it go...

And is there any harm in finding out as much as you can before the final
decision needs to be made?

If you really want it and plan for it and have a good team
to support it, odds are you *will* have another vaginal birth,
even with a large baby. ...
Best wishes, Ericka

"Paul W" wrote:
Seems childbirth is a pretty non-exact science. I've certainly learned that!

Nope, childbirth is not an exact science. It's not science, either.
Neither is parenting, or marriage, or many other things. We get the
best information we can (often using science) and do the best we can
with it. We have to figure in our own idiosyncrasies and needs and
hopes and abilities, too. Life is not an exact science.

--
-- Vicki
Married DH May 21, 1995
Ima shel DS, born 11/16/99; and DD, born 5/19/02.
"Stay-at-home" Ima since October 2002.
An ounce of mother is worth a pound of clergy. -Spanish proverb
I may not currently be pregnant, but I look pregnant, does that count?