C-section vs. letting Mom go naturally

Specialties Ob/Gyn

Published

Why am I hearing more and more of Dr.'s that ASK their patient's if they want to have a c-section instead of waiting and letting nature take it's course and baby comes naturally? I just don't get it!

I have a friend that is pregnant for the first time, isn't due for a few more weeks, has a very healthy pregnancy, no problems with her or the baby except that at last U/S, they guesstimated the baby is almost 9 lbs and has still not descended any and her cervix is still closed and thick. He offered her a c-section in a few days and she took the offer! Ugh! Ok, I may be old-school here in my thinking but I just don't see why any Dr. would offer that (besides they see it as easy money in their pocket) or why any woman would want that!! C-sections are major surgery to the body, as we all know. They are relatively easy in uncomplicated pregnancies but there is still more room for post-op infections, bleeding problems, etc...why can't Dr.'s just leave well-enough alone and let nature take it's course and let the woman's body do what it was made to do and has been doing for centuries...the baby will come out when it's good and ready, her body will tell her it's time to deliver that baby. She's not even at her due date yet, and it's her first baby, of course the baby hasn't descended yet and there's no dilation! Duh! Give it a few weeks, tell her to go walking, have sex, etc...geez!

I can totally understand if there were underlying circumstances here that would make a c-section the better option, but for my friend, there isn't any. It's not even a case where the Dr. doesn't think the baby will pass through the birth canal, he just gave her a choice, and being first-time pregnant and tired of being pregnant, she took the c-section. Baffles me!:uhoh3: I'm an advocate for natural birth, as natural as medically possible of course and I'm all for women making decisions and all but to me, this is just ridiculous that a Dr. would suggest this to a first-time mom who will never even know if her body can deliver a baby naturally, and more than likely, she never will be able to experience that (even though I realize there are VBACs though it seems more and more Dr.'s are going away from those as well).

What do you all see in your L&D's? Is this practice normal when there are NO medical reasons for a c-section? :confused:

How about just the simple fact of being induced? It drives me nuts when women are induced just because they are going on a vacation or their husband can only take off work such and such week. Or they are told their baby is going to be 9+ lbs, they deliver 3 weeks early, and it comes out 7lbs.

This same thing drives me nuts too! All of theses factors are what makes me want to stay away but stinks too because I'm pulled in that same direction and would LOVE to be a part of it all. I want to be a part of helping to bring babies into the world (my second love behind NICU). But I think I would rather be the educator and the one to reinforce her choice to go lady partslly (and naturally) and cheering her on during labor, helping her to have the birth experience she wants (doula anyone? Lol). The elective c-sections, inductions for no reason and the pushing of epidurals and drugs that seems to go on more and more these days, "just because", are what I think would frustrate me to no end. In our facility, from the little I saw in my OB rotation, I would prob be frustrated (and we are a teaching hospital with tons of residents). Ugh.

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scary. as a nurse and pregnant with number two...i go as natural as possible. our bodies r made to handle birth...why not let them unless medically necessary? hell, i think taking pain meds during labor is dumb. ;) bit too each their own.

I remember lonnnng ago when I had my first, I was in labor for over 34 hours...I had an older Dr that knew I wanted to go natural. I'm a very petite woman, short and only going over 100 lbs when pregnant (well, not anymore! Haha). I labored and labored to the point I was so exhausted I fell asleep in between contractions (my mother watched the monitor and as a contraction started I'd wake up and start my breathing and as soon as it was over, out I would go again! Pretty cool how our bodies compensate!). While I was pushing to get my baby to crown (for hours! Ugh), the nurse got concerned because my baby's HR dipped too low a few times too many. She went and told the Dr and he had me push with every other contraction. All was fine. That did the trick. Not once did I hear the word "epidural" or "c-section". Granted, had my baby's heart rate continued to drop or not be fixed by turning me and only pushing with e/o contraction, I'm sure it would have been a c-section for me. I did have a shot of Demerol at some point, which probably contributed to the sleeping btw contractions but my doc was of the philosophy that my body was made to do this and as long as there weren't any adverse things happening, he was going to let me go that way...so glad he did. I'm glad I listened to my mother too. All throughout my pregnancy (and labor), she would tell me how women have been doing this since Adam and Eve times and that we were NOT going to die (although I felt like it during all that labor!). I carried that with me for my next two pregnancies and births and nope, I didn't die and yes, all my babies were born lady partslly and the correct weight that my body could handle. All my kids were just over 6 lbs and my body held them in until the middle of my 38th week. I fully believe that my friend's body can handle this baby if he/she is 9 lbs or more and that her body would spit it out when it was done and ready. Errrrr!

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You are preaching to the choir! We watched a documentary in nursing school regarding the outrageous numbers of scheduled c-sections in the U.S. as opposed to other industrialized nations. Over in Europe, they embrace natural childbirth, home births, and midwives. One thing we tend to forget is that birth is a normal process and a majority of mothers are healthy, not sick so why do major surgery?

I agree that OB nursing is not for everyone. When it's good, it's great. When it's bad, it's the worst day of your life. It is frustrating to deal with physicians who practice based on convenience whether it be their own or the parents. However, there are some wonderful OBs out there and CNMs are becoming more and more popular. I love OB, I love taking care of mom and baby, witnessing miracles every day. Having a baby is a momentous occasion in people's lives and getting to be part of that is an amazing feeling. I love watching new parents together with their newborn, witnessing private moments between new families. That makes up for the bad. Despite it all, these are not the reasons I wanted to be an L&D nurse. When I took my OB rotation, I saw that many of these women were not very well informed as to their options. I think that if women were better informed, many would stand up for themselves and opt for a more natural way. This is the reason I wanted to be an L&D nurse. I want to educate my patients, to help them achieve what they want, to support and advocate. Afterall, isn't that what nursing is really about?

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Specializes in ICU.

I agree with everyone here, I am the kind of person that also advocates for conscious birthing. Many women don't receive informed choices. We need more, out of hospital, birth-class'. Next week, I will be cross-training in L&D, and I know there will be times that I will hate having chosen L&D. But I want to be their voice for many reasons mentioned here.

Childbirth is a rite of passage! Bonding with the mother is so important, but insteat in todays high-tech driven world our babies bond with machines.

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And it also seems as if the medical staff goes for the more modern approach regardless.. I had a very lengthy birth plan (I was probably laughed at) and I specifically mentioned that I do not want the goop in the eyes - vitamin K?? (not a nurse yet..) and they did it anyway....

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Specializes in Anesthesia.
And it also seems as if the medical staff goes for the more modern approach regardless.. I had a very lengthy birth plan (I was probably laughed at) and I specifically mentioned that I do not want the goop in the eyes - vitamin K?? (not a nurse yet..) and they did it anyway....

That was erythromycin and it is a state law in many states for newborns to receive it, so that probably wasn't even an option. The erythromycin ointment decreases the chance of blindness in newborns from bacterial infections transmitted from the mother.

Vit K is one of the 1st shots that newborns get to prevent bleeding. http://newborns.stanford.edu/VitaminK.html

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Specializes in Community, OB, Nursery.
That was erythromycin and it is a state law in many states for newborns to receive it, so that probably wasn't even an option. The erythromycin ointment decreases the chance of blindness in newborns from bacterial infections transmitted from the mother.

You are right, it is state law in many states, but parents can still decline it. Ditto the Vitamin K. We have people decline one or both pretty routinely where I work (and it is state law here) and it's not a big deal at all. Just to clarify.

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Specializes in Anesthesia.

C-sections aside, all these "medical interventions" IVs, pitocin, epidurals, spinals (epidurals and spinals aren't just for pain relief), fetal monitoring, maternal monitoring are what make labor/delivery extremely safe.

Epidurals are also used to decrease the sympathetic demand on the mother during labor, helps control BP for pre-eclamptic/HTN patients, helps decrease the incidence of eclampsia, and epidurals/spinals have shown to decrease the mortality rate in C-section patients by up to 16x over a general anesthetic. So for all those laboring mothers that don't want the epidural and have a true emergency c-section, where there isn't time for spinal, their odds of dying are increased by 16 times over the same kind of patient with an epidural.....

Queen Victoria is actually credited with popularizing anesthesia in labor.

[i"]The Invention of Anesthesia

Perhaps one of the other greatest "inventions" for childbirth was the invention of anesthesia. It was in 1853 that Queen Victoria of England gave birth to her 7th baby. Her doctor gave her chloroform to ease the pain. This was a great success and the Queen quickly spread the 'word' about how wonderful it was to have relief from the pain!

So it is really only in the last 150 years that pain relief has been available to women. Before that time there was no anesthesia available and childbirth pains were greatly feared by women. Young girls were encouraged to witness and hear women birth their babies so that they could "mentally prepare" for their turn to give birth to their own baby!"

[/i] http://www.thehistoryof.net/history-of-childbirth.html

Before OB patient turns down any medical intervention you should know exactly what you are getting into (just getting information off the internet doesn't count) and talk with your Obstetrician, CNM, and/or your anesthesia provider before making that final decision.

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Specializes in Anesthesia.
You are right, it is state law in many states, but parents can still decline it. Ditto the Vitamin K. We have people decline one or both pretty routinely where I work (and it is state law here) and it's not a big deal at all. Just to clarify.

I am kinda conservative when comes to vaccines/mandated medications. These are all there for a reason, and I think that if you don't want them you shouldn't even come to the hospital, but that is just my :twocents:.

I guess everything is alright until a newborn loses their eyesight or dies from massive cerebral bleed, and these will be the parents that will be the first to sue also.....

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
That was erythromycin and it is a state law in many states for newborns to receive it, so that probably wasn't even an option. The erythromycin ointment decreases the chance of blindness in newborns from bacterial infections transmitted from the mother.

Vit K is one of the 1st shots that newborns get to prevent bleeding. http://newborns.stanford.edu/VitaminK.html

It's a state law that it has to be offered or provided, not that it has to be given. Like any other procedures given to a child, parents DO have the right to decline it.

Like Elvish, I see it declined quite routinely where I work. Not a big deal. However, peds can refuse to circumcise an infant if the parents refuse the Vitamin K shot (which I think is a sad and strange contradiction - they don't want their child to have a shot, but they're willing to let them undergo a medically unnecessary cosmetic procedure).

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Specializes in Community, OB, Nursery.
I am kinda conservative when comes to vaccines/mandated medications. These are all there for a reason, and I think that if you don't want them you shouldn't even come to the hospital, but that is just my :twocents:.

I guess everything is alright until a newborn loses their eyesight or dies from massive cerebral bleed, and these will be the parents that will be the first to sue also.....

I can respect where you're coming from, but the problem with telling people to either get stuff or stay home is that home birth in my state is even less safe because CPMs aren't legally allowed to practice, there are no OBs that do it, and there are exactly two nurse-midwives that do it. So if you want a home birth and you're unlucky enough to not live by one of the CNMs you are essentially forced to either go it alone, or deliver with a CPM whose practice in this state is unregulated and who may or may not have the skills to safely catch your baby. It's a pretty unfair conundrum.

About the risk of losing eyesight and cerebral bleed, the bigger concern is the eyesight. I'm really okay with people who decline the Vitamin K. It won't prevent early-onset HDN, and the incidence of late-onset HDN is extremely uncommon in untreated infants. Cerebral bleeds in term healthy newborns are very rare. Unfortunately, people can and do sue for much less than a brain bleed and currently there isn't much anyone can do to stop it.

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Before OB patient turns down any medical intervention you should know exactly what you are getting into (just getting information off the internet doesn't count) and talk with your Obstetrician, CNM, and/or your anesthesia provider before making that final decision.

People should do that any way, before they turn down any medical intervention or before they ACCEPT one either. I am still glad that I turned down epidurals and the elective c-section. I wish I had of turned down all the pain meds I took during labor (I think I could have if I had more family/friend support during labor).

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