More Hospitals Banning Elective C-Sections More Hospitals Banning Elective C-Sections - pg.4 | allnurses

More Hospitals Banning Elective C-Sections - page 4

Saw this article today and I think it is a great idea, wanted to see what everybody else thought.... Read More

  1. Visit  Nascar nurse profile page
    1
    Quote from Scrubby
    That's a little judgmental don't you think? There's a lot of women out there who are scared of childbirth (I'm one of them) and education is the key, not making silly blanket statements.

    I don't really have a strong opinion on the subject because my knowledge of childbirth etc is very limited. I guess as long as it's not done before the baby has developed why does it matter whether it's vaginal or through an incision? I can see why some women would chose it as an option, I personally would consider it if I choose to have children. I mean who wants to push something the size of a melon through your vagina (ouch!) , be in labor for hours, crap yourself in front of strangers and end up with an incision anyway? (epistotomy) Sounds pretty medieval, I think I'd rather go with a c-section.

    First let me say I am not an OB nurse and would never consider myself to be a "natural birth" fanatic but I am a mother of 2 kids. Trust me, it is no where near as bad as it sounds pain wise (and I had one without any pain meds because of a cord wrapped around his neck with a low fetal heart rate with each contraction). As soon as that baby is out the pain is gone. Later that same day (each time) I'm up and around feeling great...my roommate post C-section is in the next bed moaning and groaning in pain, can't even sit up and hurts to bad to even hold her baby. You will have pain either way. Guess I would as soon get it over with.
    caregiver1977 likes this.
  2. Visit  Jolie profile page
    21
    Quote from Kewpie Doll
    I had 2 elective c sections. They are great and I would do it again. One of the problems with the bad sentiments and statistics against elective c sections is that there is not good and conclusive data on elective c sections vs. c sections performed under conditions of duress and/or trauma. An elective c section is performed under ideal conditions - in a state absent of or before the advent of duress/trauma. The patient is in peak condition and the procedure is fast. That data of such c- sections is shunted into the same catagory with duress c-sections so the results are skewed showing mortality and morbidity that are likely due to the poor conditions of the other procedures.

    In my case conditions and outcomes were ideal. I don't feel I missed out on any part of motherhood. After birth I felt in good shape to enjoy my new baby and as an added bonus, I did not suffer any vaginal trauma, cutting, or perforations that 3 of my close friends had to go for follow up surgeries (and in one case more than a year of embarrasing issues.) I've read one expert who is pro elective C section because of all the, urine and fecal incontinence, prolapse and pelvic floor disorders he sees in his practice in later years due to vaginal births. Many of the complications of vaginal births are not readily revealed by sufferers due to embarrassment, and are not typically seen by the gynecologists who deliver the babies so the connection is not readily observed, reported and known to the public.
    Women arriving at the hospital for routine childbirth are also typically in "ideal" condition and their bodies are typically well-prepared to perform the function of labor and childbirth. Complications you mention such as cervical or vaginal trauma are rare. If you know of a physician with an unusually high number of patients complaining of these complications, perhaps it is his/her practices that should be examined. Pelvic floor disorders are more related to pregnancy itself than vaginal delivery, as well as aging, so patients are not likely to be spared this complication later in life by subjecting themselves to unnecessary surgery.

    I'm glad that you did not experience any complications as a result of your C-sections. When they occur, they are miserable to deal with, and I wouldn't wish them on my worst enemy. In 12 years of OB nursing, I can't recall a single mom who suffered extensive pelvic, cervical or vaginal trauma, but I can recall dozens, if not more, women with the following complications: Anesthesia problems ranging from ineffective anesthesia, severe hypotension, oral and dental trauma due to intubation (in a patient with an elective C-section who insisted on general anesthesia. She knew she had abnormalities of her palate and mouth, but didn't reveal that to the anesthesiologist because she was afraid it would disqualify her from general anesthesia. Darn right it would have. She woke up with oral trauma wishing she'd spoken up.), and a mom who broke her leg getting OOB by herself against orders because she felt so darn good after her elective C-section with spinal anesthesia. Not to mention those pesky spinal headaches and the severe itching so many women experience with Duramorph.

    On to other complications, including hemorrhage (saw one uterine artery inadvertently severed), infection, paralytic ileus, a bladder inadvertently nicked by a surgical instrument. Mom went home with a Foley for several months. And then there's the poor gal who contracted c-diff as a result of her "routine" antibiotics. This was almost 20 years ago, before it was widespread.

    As horrific as these complications are, they pale in comparison to the suffering of newborns thrust into the world too early and without the benefit of the transition provided by labor and passage thru the birth canal. We can debate all day whether purely elective C-sections should be performed, but there is no denying that there is (in the absence of medical contra-indications) physiologic benefits to the infant of passage thru the vagina on the way into this world, including preparation of the cardiovascular and respiratory systems to transition to extra-uterine functioning and colonization of the gut with normal flora.

    I suspect that the "expert" pushing purelely elective C-sections is more interested in his 9-5 M-F work schedule than his patients' and their infants' well being.
    Alikatz, Chixie, crissrn27, and 18 others like this.
  3. Visit  CrazierThanYou profile page
    10
    Quote from Jolie
    Women arriving at the hospital for routine childbirth are also typically in "ideal" condition and their bodies are typically well-prepared to perform the function of labor and childbirth. Complications you mention such as cervical or vaginal trauma are rare. If you know of a physician with an unusually high number of patients complaining of these complications, perhaps it is his/her practices that should be examined. Pelvic floor disorders are more related to pregnancy itself than vaginal delivery, as well as aging, so patients are not likely to be spared this complication later in life by subjecting themselves to unnecessary surgery.

    I'm glad that you did not experience any complications as a result of your C-sections. When they occur, they are miserable to deal with, and I wouldn't wish them on my worst enemy. In 12 years of OB nursing, I can't recall a single mom who suffered extensive pelvic, cervical or vaginal trauma, but I can recall dozens, if not more, women with the following complications: Anesthesia problems ranging from ineffective anesthesia, severe hypotension, oral and dental trauma due to intubation (in a patient with an elective C-section who insisted on general anesthesia. She knew she had abnormalities of her palate and mouth, but didn't reveal that to the anesthesiologist because she was afraid it would disqualify her from general anesthesia. Darn right it would have. She woke up with oral trauma wishing she'd spoken up.), and a mom who broke her leg getting OOB by herself against orders because she felt so darn good after her elective C-section with spinal anesthesia. Not to mention those pesky spinal headaches and the severe itching so many women experience with Duramorph.

    On to other complications, including hemorrhage (saw one uterine artery inadvertently severed), infection, paralytic ileus, a bladder inadvertently nicked by a surgical instrument. Mom went home with a Foley for several months. And then there's the poor gal who contracted c-diff as a result of her "routine" antibiotics. This was almost 20 years ago, before it was widespread.

    As horrific as these complications are, they pale in comparison to the suffering of newborns thrust into the world too early and without the benefit of the transition provided by labor and passage thru the birth canal. We can debate all day whether purely elective C-sections should be performed, but there is no denying that there is (in the absence of medical contra-indications) physiologic benefits to the infant of passage thru the vagina on the way into this world, including preparation of the cardiovascular and respiratory systems to transition to extra-uterine functioning and colonization of the gut with normal flora.

    I suspect that the "expert" pushing purelely elective C-sections is more interested in his 9-5 M-F work schedule than his patients' and their infants' well being.
    Nothing else needs to be said but THIS. The end.
    Alikatz, Dazglue, ShifraPuah, and 7 others like this.
  4. Visit  losbozos profile page
    2
    "Elective c-section" means that one just decides to have a surgical delivery just because ________; fill in the blank. Not a medical necessity but "just because". I've even heard people doing it just because they think their vaginas will be stretched out (now, who would have thought of that?). I don't get it. Who was it that said, "do no harm"?
    ShifraPuah and Jolie like this.
  5. Visit  lifelearningrn profile page
    3
    Quote from Nascar nurse
    First let me say I am not an OB nurse and would never consider myself to be a "natural birth" fanatic but I am a mother of 2 kids. Trust me, it is no where near as bad as it sounds pain wise (and I had one without any pain meds because of a cord wrapped around his neck with a low fetal heart rate with each contraction). As soon as that baby is out the pain is gone. Later that same day (each time) I'm up and around feeling great...my roommate post C-section is in the next bed moaning and groaning in pain, can't even sit up and hurts to bad to even hold her baby. You will have pain either way. Guess I would as soon get it over with.
    I think for everyone it's different. For my sections, as soon as they removed the cath and epi and I had feeling back in my legs, I was getting out of bed. Was there a little pain? Sure, but it wasn't moaning/groaning I can't sit up to hold my baby, pain. By the time I was released from the hospital I didn't even need the pain meds. It depends on who you are.
    Not_A_Hat_Person, Quark09, and Scrubby like this.
  6. Visit  SJerseygrle profile page
    6
    I think it's fine and healthy that they are eliminating early C-sections but i think moms should be allowed a choice even if it's "only" for their convience. People have the right to try and have the life/birth/pregnancy they want to have. Life is hard enough without us judging other people for their choices.
    I am sure both sides have a ton of anecdotal stories about the negatives to each method but until the do actual studies which show signifigant harm to the baby due to non-premature elective c-sections vs. vaginal births no one has a leg to stand on.
    This is just another way to get women to fight amongst themselves so they can try and mandate other women's lives based on their own experiences and opinions.
    Can't the moms who are so wonderful just content themselves with their own (and their child's) superiority instead of trying to mandate everyone else's life?
    Quark09, ValDonovan, cogath, and 3 others like this.
  7. Visit  rn/writer profile page
    6
    Quote from SJerseygrle
    I think it's fine and healthy that they are eliminating early C-sections but i think moms should be allowed a choice even if it's "only" for their convience. People have the right to try and have the life/birth/pregnancy they want to have. Life is hard enough without us judging other people for their choices.
    I am sure both sides have a ton of anecdotal stories about the negatives to each method but until the do actual studies which show signifigant harm to the baby due to non-premature elective c-sections vs. vaginal births no one has a leg to stand on.
    This is just another way to get women to fight amongst themselves so they can try and mandate other women's lives based on their own experiences and opinions.
    Can't the moms who are so wonderful just content themselves with their own (and their child's) superiority instead of trying to mandate everyone else's life?
    This isn't just about choice or convincing anecdotes or engaging in mommy wars. There are sound medical reasons for avoiding convenience-based elective c-sections. Hospitals and docs are pulling back to 39 weeks because there are studies that show the potential for significant harm to the baby. If we could predict which babies would be endangered and which ones would be fine, it would be safe to take a chance, but we don't yet know how to do that.

    To use your logic, we should allow post-op moms to stay in bed for three days and let everyone have as much pain medication as they want because that's their choice.

    I wouldn't fault anyone for wanting an early section based on comfort or convenience. I know I sure had rough times those last couple of weeks. But sometimes we have to choose between what we want and what we (and our babies) need. That doesn't mean that anyone who already had an elective C-section for comfort or convenience is bad. It just means that if everything went okay they were lucky.

    Really, this is so not about trying to act or sound superior to another mother.
    Last edit by rn/writer on Nov 21, '11
    Alikatz, CCRNDiva, Elvish, and 3 others like this.
  8. Visit  Elvish profile page
    9
    Quote from SJerseygrle
    I think it's fine and healthy that they are eliminating early C-sections but i think moms should be allowed a choice even if it's "only" for their convience. People have the right to try and have the life/birth/pregnancy they want to have. Life is hard enough without us judging other people for their choices.
    I am sure both sides have a ton of anecdotal stories about the negatives to each method but until the do actual studies which show signifigant harm to the baby due to non-premature elective c-sections vs. vaginal births no one has a leg to stand on.
    This is just another way to get women to fight amongst themselves so they can try and mandate other women's lives based on their own experiences and opinions.
    Can't the moms who are so wonderful just content themselves with their own (and their child's) superiority instead of trying to mandate everyone else's life?
    I don't want it to feel like everyone's jumping on you, but as Miranda said, there is plenty of evidence to show that c/sections aren't, generally speaking, the best thing for babies or moms. There is a reason that a NICU/peds team goes to every c/section at my hospital and not every vaginal delivery. (Read the NICU and Ob/Gyn forums around here and it sounds like a pretty set standard across the country.) Infants born via c/section are more likely to be admitted to a NICU, have respiratory distress, and have feeding issues. Even without the risks to the mom attendant with major abdominal surgery, the risks to the infant alone should be reason enough to keep away. As a nursery nurse, if L&D calls and says they're bringing a baby from a c/section, I get ready to hear some junky lungs, I automatically turn on the warmer closest to the pulse ox and get my O2 set up because I often end up needing one or both. It happens that much. This has nothing to do with being superior to anyone and everything to do with the health of newborns, which should always trump convenience. I'm not out to tear anyone down for what's already been done, because being a mom is hard.....but when the evidence is clear that c/section babies are at that much risk vs. a NSVD, I don't really get the heated argument.

    NO ONE here is saying that c/sections that are actually done to save someone's life are bad. Goodness knows I have been taken care of some patients who would clearly have lost their own or their babies' lives without one. But that's not quite the same as waking up one day and deciding you're finished being pregnant.
    Last edit by Elvish on Nov 21, '11
    crissrn27, Dazglue, ShifraPuah, and 6 others like this.
  9. Visit  Elvish profile page
    0
    In case anyone is interested in the evidence about elective c/sections:
    http://www.marchofdimes.com/pregnanc...n_indepth.html (of particular interest to the topic at hand are the sections 'The risk of preterm birth' and 'Other risks for the baby'.)

    A very long but interesting read:
    http://journals.lww.com/greenjournal...elivery.7.aspx
  10. Visit  dscrn profile page
    0
    Quote from rn/writer
    The inherent pitfall here is that too many women get sectioned for a "failed induction." Never mind that the induction failed because it was too early.
    And sometimes the induction fails because the doctor has dinner plans..or whatever. When my niece delivered 2 years ago, he doctor told her that "Mondays were the days that he delivered, and that she had a 50/50 chance of being sectioned"-luckily, she went into labor on Sunday-sorry about that, doc!
  11. Visit  tntrn profile page
    4
    Quote from Elvish
    I don't want it to feel like everyone's jumping on you, but as Miranda said, there is plenty of evidence to show that c/sections aren't, generally speaking, the best thing for babies or moms. There is a reason that a NICU/peds team goes to every c/section at my hospital and not every vaginal delivery. (Read the NICU and Ob/Gyn forums around here and it sounds like a pretty set standard across the country.) Infants born via c/section are more likely to be admitted to a NICU, have respiratory distress, and have feeding issues. Even without the risks to the mom attendant with major abdominal surgery, the risks to the infant alone should be reason enough to keep away. As a nursery nurse, if L&D calls and says they're bringing a baby from a c/section, I get ready to hear some junky lungs, I automatically turn on the warmer closest to the pulse ox and get my O2 set up because I often end up needing one or both. It happens that much. This has nothing to do with being superior to anyone and everything to do with the health of newborns, which should always trump convenience. I'm not out to tear anyone down for what's already been done, because being a mom is hard.....but when the evidence is clear that c/section babies are at that much risk vs. a NSVD, I don't really get the heated argument.

    NO ONE here is saying that c/sections that are actually done to save someone's life are bad. Goodness knows I have been taken care of some patients who would clearly have lost their own or their babies' lives without one. But that's not quite the same as waking up one day and deciding you're finished being pregnant.
    You said it and said it well. In addition, c/section babies often don't want to eat and if they do, it all come back up, until they manage to clear their tummies out themselves or we gavage them. Let's see now: 35 years and I can tell you that the vag babies are rarely the ones gavaged.
    iteachob, LibraSunCNM, Elvish, and 1 other like this.
  12. Visit  Jack245 profile page
    0
    Quote from ThePrincessBride
    The longer baby bakes, the better. Until it grows to be 20 lbs!

    Indeed! haha. As a guy, I realize my opinion on the matter probably has less weight, owing that I've never delivered a child either way, but I was a late baby. Almost 2 weeks late, and my mother finally consented to be induced.
  13. Visit  caregiver1977 profile page
    1
    Quote from rn/writer
    The inherent pitfall here is that too many women get sectioned for a "failed induction." Never mind that the induction failed because it was too early.
    And that failed induction was usually the result of the wants of the medical staff, not the mother. Many of these unnecessary c-sections are just as much for the convienence of the medical staff as is the mother's.
    mystory likes this.

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