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Tough decision - Elective C or not ?



 
 
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  #21  
Old September 26th 03, 08:52 PM
Elizabeth Reid
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Default Tough decision - Elective C or not ?

(KR) wrote in message . com...
The size of the baby as measured externally is just an estimate. To
me, I would rather be induced then opt for a c-section any day. A
c-section is major surgery. There is also the possibility that the
baby could come naturally in the next 4 weeks.


I will say, though, that it's not like you're necessarily choosing
induction vs. c-section; you're choosing (induction + chance of
post-labor-c-section) vs. elective c-section. I really, really
wanted a vaginal birth with my son, and hung in through lots of
hours of unproductive labor to try to have one. I have to admit,
though, that if I do it again I would waver on whether to just go
straight to the c-section, because a c-section after 36 hours of labor
REALLY sucks. You get the worst of both worlds that way, or
that's how it seemed to me. I guess you at least get the knowledge
that you did try, but I'm not sure that would be enough for me
when weighed against going into the surgery with no resources
after a useless labor.

Which is not to say that the OP's wife should opt for the section,
because the big baby thing is notoriously unreliable apparently.
However, if the provider is already talking c-section the
chances aren't bad that it's going to end up that way anyway after
the induction 'fails' (this does not sound like a let-nature-take-
its-course kind of doctor) and the risk of that happening should
be taken into account.

Beth
Sam 8/16/2002
  #22  
Old September 26th 03, 09:11 PM
Sophie
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Default Tough decision - Elective C or not ?



"Elizabeth Reid" wrote in message
om...
(KR) wrote in message

. com...
The size of the baby as measured externally is just an estimate. To
me, I would rather be induced then opt for a c-section any day. A
c-section is major surgery. There is also the possibility that the
baby could come naturally in the next 4 weeks.


I will say, though, that it's not like you're necessarily choosing
induction vs. c-section; you're choosing (induction + chance of
post-labor-c-section) vs. elective c-section. I really, really
wanted a vaginal birth with my son, and hung in through lots of
hours of unproductive labor to try to have one. I have to admit,
though, that if I do it again I would waver on whether to just go
straight to the c-section, because a c-section after 36 hours of labor
REALLY sucks. You get the worst of both worlds that way, or
that's how it seemed to me. I guess you at least get the knowledge
that you did try, but I'm not sure that would be enough for me
when weighed against going into the surgery with no resources
after a useless labor.

Which is not to say that the OP's wife should opt for the section,
because the big baby thing is notoriously unreliable apparently.
However, if the provider is already talking c-section the
chances aren't bad that it's going to end up that way anyway after
the induction 'fails' (this does not sound like a let-nature-take-
its-course kind of doctor) and the risk of that happening should
be taken into account.

Beth
Sam 8/16/2002


There is a *HUGE* difference between choosing a repeat c-section, and
choosing one right off the bat without even trying labor with a first baby.


  #23  
Old September 26th 03, 09:20 PM
Mary W.
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Default Tough decision - Elective C or not ?



Sophie wrote:

"Elizabeth Reid" wrote in message
om...
(KR) wrote in message

. com...
The size of the baby as measured externally is just an estimate. To
me, I would rather be induced then opt for a c-section any day. A
c-section is major surgery. There is also the possibility that the
baby could come naturally in the next 4 weeks.


I will say, though, that it's not like you're necessarily choosing
induction vs. c-section; you're choosing (induction + chance of
post-labor-c-section) vs. elective c-section. I really, really
wanted a vaginal birth with my son, and hung in through lots of
hours of unproductive labor to try to have one. I have to admit,
though, that if I do it again I would waver on whether to just go
straight to the c-section, because a c-section after 36 hours of labor
REALLY sucks. You get the worst of both worlds that way, or
that's how it seemed to me. I guess you at least get the knowledge
that you did try, but I'm not sure that would be enough for me
when weighed against going into the surgery with no resources
after a useless labor.


Remember that good things happen during labor too. Things
that prepare the baby for birth.

Which is not to say that the OP's wife should opt for the section,
because the big baby thing is notoriously unreliable apparently.
However, if the provider is already talking c-section the
chances aren't bad that it's going to end up that way anyway after
the induction 'fails' (this does not sound like a let-nature-take-
its-course kind of doctor) and the risk of that happening should
be taken into account.


I had a similar situation with my doctor, and I believe his fear of
a big baby contributed to my c-section. What I regret most was
not switching providers. It is *never* too late to find a new doctor
or midwife.

There is a *HUGE* difference between choosing a repeat c-section, and
choosing one right off the bat without even trying labor with a first baby.


Yup, a whole new set of risks to consider.

Mary


  #24  
Old September 26th 03, 10:04 PM
hierophant
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Default Tough decision - Elective C or not ?



Puester wrote:

KR wrote:


There are lots of big babies (10+ pounds) who are born naturally
without incident. Some people even claim that bigger babies are
easier to push out.





And some people lie....


Now that is an interesting comment. I'm going to remember that the next
time I hear one of those horror stories I hear that women call "birth
stories". They must be lying!

Kris, mother to three babies who were all over 10lbs and easy to push out.

  #25  
Old September 27th 03, 12:03 AM
Warwick
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Default Tough decision - Elective C or not ?

In article ,
says...
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....


Not surprised you're confused. The consultant appears to have not read
any of the current literature and is stuck in the 80's.

How have they come up with the baby size? Very recently, my sister's
baby was estimated as 'huge' where Johanna (my wife) was estimated as
having a 'large' baby (going to be 8lbs+). Comparisons of the bumps with
my sister being a couple of weeks behind Jo showed her being very much
the 'beached whale' courtesy of the size of her bump and with
positioning and baby activity, it felt like a large baby was going to be
coming out.

Her son (Alexander) came out at 5lb 11oz and what seemed like gallons of
fluid apparently. My daughter weighed in at 9lb 7oz.

The attitude of both sets of parents was different too. We wanted
minimal drugs and were OK'd for a home birth (we started there). My
sister wanted drugs and to have the re-assurance of a hospital and an
epidural.

My sister didn't get her epidural since she wasn't in labour long enough
for it to take effect and had a drug free birth. We, with our assessed
perfect pregnancy and planned natural birth ended up with an epidural
and forceps being tried as a last minute attempt to avoid a C-section.
In both cases the estimates were *wrong* and the plans ended up being
binned.

In Johanna's case, the epidural was the right thing to do by that stage
of labour and with a very good team in the hospital they managed to get
the dose exactly right to leave her feeling enough to be able to push.
It wasn't assessed to be the right thing any earlier and the
intervention wasn't the right thing earlier either.

We nearly had a C-section, will probably have baby size checked by
ultrasound on the next one towards the end of pregnancy and may end up
with one due to Jo's build. Otherwise, we'd try to stay as close to the
real thing as possible.

Warwick
  #26  
Old September 27th 03, 03:50 AM
Ericka Kammerer
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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.

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....



Sorry, but I might be here to confuse you even further.
Late pregnancy ultrasounds are notoriously bad at estimating
weight accurately. The margin of error is at least 1.5 *POUNDS*
either way, which is huge when you're talking about newborn
babies! Furthermore, there is no medical evidence that it
makes any sense to induce for suspected large baby, much less
incur the risks of a c-section for suspected large baby.
Frankly, if there's nothing going on besides a suspected large
baby here, I would summarily *FIRE* any caregiver who
actually suggested a c-section just because the baby seemed
big.
Yes, there are stats on the risks associated with
elective c-sections. While elective c-sections are slightly
less risky than emergency c-sections, both are significantly
more risky for the mother than vaginal birth. According to
one relatively recent study, the maternal mortality rate
for c-sections is 5 times that of vaginal births (after
eliminating the really high risk situations). They found
the risk for intrapartum c-sections to be 1.5 times that
of elective c-sections. A study came out earlier this
year in the Journal of Perinatology showing that vaginal
delivery is achievable in almost 90 percent of pregnancies
with macrosomic infants. Personally, given that you don't
even really know this baby is big to begin with, I would
be extremely uninterested in signing up for a c-section
when there's a really good chance that a vaginal delivery
is possible! Furthermore, studies don't suggest that
inductions improve outcomes in this case either, so I
wouldn't be all that excited about signing up for an
induction, which can put her on the fast track to a
c-section if her body isn't really ready.
Henci Goer's books (_Obstetric Myths verus
Research Realities_ and _The Thinking Woman's Guide
to a Better Birth_) give a bunch of stats on c-sections.
Here are the risks mentioned:

- Pain (25 percent report pain at 2 weeks, 15 percent at
8 weeks; 15 percent report difficulty with normal
activities at 2 weeks; 10 percent at 8 weeks)
- Transfusion (1-6 percent of women need a transfusion
after a c-section)
- Injury (2 percent rate of surgical injury to bowel,
bladder, uterus, or uterine blood vessels; some studies
show a uterine injury rate as high as 10 percent)
- Infection (8-27 percent)
- Pulmonary embolism (1-2 per 1000)
- Blood clots in legs (6-18 per 1000)
- Baby cut (1 percent of head down babies; 6 percent breech)
- Baby more likely to be in poor condition at birth (babies
with low APGARs after healthy pregnancies were half again
as likely to have been c-sections; c-section babies three
times as likely to need intermediate or intensive care
and five times more likely to need help with breathing)

One of the big things to weigh when considering a
c-section that might not be necessary is the risk of
placenta previa and/or placenta accreta/increta/percreta
in future pregnancies. If you're planning on future
pregnancies, a prior c-section significantly increases
the risks of these conditions, which can sometimes be
quite dangerous. In addition, with a prior c-section,
you'll have to weigh VBAC versus an elective repeat
c-section for future births.

As far as the epidural goes, that could potentially
be an issue. *IF* the baby is large (which is by no means
established), her ability to move around and adopt different
positions during labor can make a huge difference in her
ability to deliver vaginally. An epidural can make it
difficult for her to do that. Staying off her tailbone
can open the birth canal an additional 30 percent. While
some women with epidurals can manage a side-lying position,
other positions will be impossible.

Best wishes,
Ericka


  #27  
Old September 27th 03, 04:12 AM
Nina
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Default Tough decision - Elective C or not ?


"Ericka Kammerer" wrote As far as the epidural goes,
that could potentially
be an issue. *IF* the baby is large (which is by no means
established), her ability to move around and adopt different
positions during labor can make a huge difference in her
ability to deliver vaginally. An epidural can make it
difficult for her to do that. Staying off her tailbone
can open the birth canal an additional 30 percent. While
some women with epidurals can manage a side-lying position,
other positions will be impossible.



My 2nd born was 9 lbs and facing the wrong way, I am SO glad I didnt have an
epidural because i ws able to get on hands and knees long enough to get her
to turn.
I think its crucial to know what to expect and how to deal with it. I'd read
a lot and when the time came, it was me who told the nurses "Put me on all
4s". No one suggested it, or gave me any ideas. They were perfectly content
to let me labor miserably on my back for another few hours. You have to be
aware o the possibilities and what actions YOU can take to deal with them.
If not, you will be subject to more and more interventions.
I think I did ok, a 9lb baby w/no epidural or episiotomy and a 6 hour labor.
AND it was an induction, so there was a LOT of pain. But preparation
andknowlege are crucial.
Nina


  #28  
Old September 27th 03, 05:27 AM
She's A Goddess
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Default Tough decision - Elective C or not ?


"Puester" wrote in message
...


And some people lie....

LOL. Well I don't know that my larger baby was easier, it certainly hurt
one heckuvalot more, but it was faster. My 7lb9oz DD took over 2 1/2 hours,
my 9lb11oz DS took just 1 1/4 hours.


--
Rhiannon
Madison Sophia - 9/6/01
Owen Grady - 6/23/03


  #29  
Old September 27th 03, 08:07 AM
Natalie
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Default Tough decision - Elective C or not ?

Hi Paul

It is your decision at the end of the day but if you feel strongly about it
I would opt for the Induction at 40 weeks.

You may end up having a c section if things are not good but I would have
this as the last option so to speak.

My feeling anyway!
Natalie


"paul williams" wrote in message
om...
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....



  #30  
Old September 27th 03, 01:49 PM
Naomi Pardue
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Posts: n/a
Default Tough decision - Elective C or not ?

Consultant has given us the choice :-

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


Having read all the comments, (and seconding strongly the suggestion to just
wait to let your wife go into labor and then have a c-section IF NECESSARY if
it turns out that the baby turns out to be too big to birth vaginally)... just
one more question...



if the consultant is pushing (no pun intended) for a c-section... why do it at
39 weeks? Why not wait until 40 weeks?
At least that way you can be relatvelysure that baby is 'fully cooked.' And if
she goes into labor before then... so what? So you either go ahead and try a
labor and see what happens, or you go ahead with the planned section a little
ahead of schedule. Does'nt this provide problems with larger babies anyway?
I'e'
forceps or ventouse delivery? Not what we want either....


I guess I'm a little puzzled as to why you are ok with an elective c-section
but 'don't want' a forceps birth. Surely the c-section is FAR more invasive
than a pair of forceps...


Naomi
CAPPA Certified Lactation Educator

(either remove spamblock or change address to to e-mail
reply.)
 




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