infants breathing problems following c-section

  1. There has been a thread running on the OBGYN page about the incease in patients requesting c-sections for reasons of vanity, eg..vaginal stetching. This article raises some interesting points. Not so sure about the sentance that states women who have C-sections are 4 times more likely to die during childbirth. I would have to see that study for myself. It is a very sweeping statement and makes no note of why the c-section was performed in the first place. If the study is looking at only emergency c-sections, you would expect a higher rate of fatalities due to the very nature of the section being an 'emergency!'
    Anyway, link below:

    http://www.timesonline.co.uk/tol/lif...cle3037202.ece
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  2. 8 Comments

  3. by   kukukajoo
    Vanity? I would rather have a natural birth anyday than a big ole honkin scar across my abdomen!
  4. by   ElvishDNP
    I believe it. When I hear a c/s baby is coming to the nursery, I automatically assume they are going to be a little junky, a little grunty, and a little pale. I put their crib as close to the pulse ox machine and hook up the O2 just in case. I'm pleasantly surprised when they end up NOT needing any of the above.

    I believe the increased mortality of c/s moms too. In the years that I've been working OB/GYN/mother-baby, I've seen hemorrhages from retained frags/membranes post NSVD but nothing like the crap I've seen happen after c/s. Of course, stuff CAN happen in a vag delivery but not nearly as much. In my years there, ALL the readmits I've seen for endometritis/other postpartum infections have been c/s moms. ALL the patients I've seen go into DIC have been post c/s. All the r/o DVTs I've seen have been post c/s. Pulmonary edema? You guessed it. Nothing but c/s. (The last is probably r/t the massive amounts of fluid pumped into these moms, but that's because they had c/s. They don't get that much fluid with a NSVD.)

    Of course there are good reasons to have a c/s. Nobody's going to tell a mom with a complete previa to birth vaginally. At least not anyone who deserves their license, anyway! But the risks to VBACs for healthy women are lower than the risks of repeat c/s. Just most people don't know that. People with 3-4 c/sections, I'm just waiting for one to either bleed out or rupture silently.
    Last edit by ElvishDNP on Dec 13, '07
  5. by   danissa
    [QUOTE=kukukajoo;2546210].........".. a big ole honkin scar "


    LMAO!!! What a FAB description!
  6. by   cvryder
    When I worked nursery (many years ago, to be sure!) I felt the same way about C-section kids. The ones whose moms had at least gone through some labor weren't usually too bad, but I always hated to see the repeat section babies come in...they were often delivered a week or so early and were almost invariably junky. Most of the time if we stimulated them enough for the first hour or so they cleared right up. My daughter will be having a repeat C-section for complicated reasons (little bitty girl, big dad, and big baby this time...last time was CPD and nuchal cord). I told her under no circumstances to let her doc talk her into going in early.

    I've seen some real complications in the C-section moms too, partly because some postpartum nurses don't think to listen to breath sounds. Had one at one hospital go really bad with ARDS and end up in my ICU because of that. She's now in a permanent vegetative state in a nursing home.

    I think the real reason for so many sections isn't just vanity, or the docs playing CYA; it's the medicalization of childbirth. I fought against that when I was having mine (not always successfully on all fronts). Now all the "risks" are emphasized and the moms are being told they should have epidurals, etc. The best of my births was the one where the baby decided she wasn't waiting any more and the nurse ended up catching her <grin> The doc didn't come near me until afterwards, but he still collected his fee!
  7. by   ElvishDNP
    Quote from cvryder
    I've seen some real complications in the C-section moms too, partly because some postpartum nurses don't think to listen to breath sounds. Had one at one hospital go really bad with ARDS and end up in my ICU because of that. She's now in a permanent vegetative state in a nursing home.
    What a horrible story.

    I don't get it, though. Why is a c/s mom any different than a surgical patient in that regard. Meaning, why WOULDN'T you listen to breath sounds?! To be sure there are other differences, but in that regard, you have to treat them like surgical patients, because they are!
  8. by   Spidey's mom
    My scar is little - you can barely see it.

    (3 vaginal/1 cesarean).

    steph
  9. by   EmmaG
    Quote from stevielynn
    My scar is little - you can barely see it.
    steph
    Same here. I didn't realize it at the time, but me and my daughter were in some serious trouble. Ignorance is bliss, I suppose. After I was in school, I wondered why he'd done a 'bikini' incision for an emergent c/s. On a side note, I will always be in debt to the L&D nurse who attended to me that night--- she saved our lives, I have no doubt of that.
  10. by   jgrossberg
    Perhaps the additional problems are related to the hypervascularity and hypercoagulability of the post-partum patient. Lots of extra blood around, and it clots faster and in greater quantity than the typical surgical patient who has not been pregnant. Must assess well, and communicate concerns rapidly. Then, even with the best assessment and emergency measures, such as when ARDS or DIC occur, post-partum patients (esp. with c/s) can have really negative outcomes.

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