C-section vs. letting Mom go naturally - page 5

by JRP1120, RN

7,569 Views | 56 Comments

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... Read More


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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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    Quote from KareBear0609
    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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    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.
    melmarie23 likes this.
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    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.
    sweetnepenthe likes this.
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    Quote from Elvish
    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 .

    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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    Quote from wtbcrna
    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).
    melmarie23 likes this.
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    Quote from wtbcrna
    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 .

    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.
    Last edit by Elvish on Jul 1, '11
    melmarie23 and wtbcrna like this.
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    Quote from wtbcrna
    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).
    melmarie23 likes this.
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    Quote from patient1977
    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).
    I never really understood taking IV/po pain medications over getting an epidural, but I respect each of my patients choices as long as it is safe and if it isn't safe then I just won't participate in their care. Pain medications (non-epidural) during labor have much more cognitive effect on the patient and effect the baby a lot more than the normal epidural ever will. Beside the fact that most IV/po medication never truly help with the labor pain anyways unless you give the patient such a big dose they practically stop breathing.
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    Quote from Elvish
    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.
    All these things maybe rare, but that doesn't stop them from popping up or becoming less rare when people are encouraged by various sources to refuse them.

    I just anesthesia for a tracheostomy for epiglottis presumably caused by HIB which should have never happened.


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