Elective Cesareans/On Demand

allnurses Guide · Aug 18, 2005

After a thorough health education on the advantages and disadvantages of C/S vs Normal Labour, the mother to be should be given the chance to choose the method she wishes to use in having her baby.
I have always worked in a system whereby the clients are not allowed to opt for elective C/S and in some cases they either end up with emergency C/S when there is fetal distress or maternal distress or worse still , the end story is a stillbirth who in the first place was meant to be a preciuos baby!!!
Fortunately, suing in such cases do not go very far since the obstetrician in question would always use some convincing reasons that might have caused the loss of the baby in such circumstances!!
I had my first two babies normaly and the last one by C/S and is still convinced that elective C/S would have been my first priority. Men would always vote for normal labour since they would never understand what exactly normal labour involves.....agony, overstretched perineum, vvs, lady partsl tears, loss of ruggaes, possible separation of symphysis joint, just to mention a few of the dangers of which some of them are usually the cause of divorce in some marriages!!-loss of sexual interest.This is my opinion.

Loss of sexual interest from the male? Or the female?

If the female - hey, you lose interest because you are tired, not because a baby traveled out of your body via the lady parts vs. the abdomen.

I do not understand the issue with supposed lady partsl problems after delivery. I had three lady partsl deliveries and one cesarean - no problems there.

steph

SmilingBluEyes · Aug 18, 2005

I too had a rather difficult forceps-assisted lady partsl delivery over a 3rd degree tear after 3 hours pushing.

No permanent problems that I could not work out w/exercise and keeping weight in check. I find, since I have been overweight, I tend to have "bladder issues" when I sneeze, TMI I know. But I think w/losing weight and improving my overall tone, I can over come this one thing. Too many of us want a quick fix or "perfect outcome" w/o any risk. NOT gonna happen...

Not to say others don't have problems. But I dont' think they are numerous enough to think csections should automatically be an elective option.

Ever stop to think of the risks w/csection? Like nicked bowel (nasty when it happens), nicked bladder? Future higher risk of uterine rupture on the scar line? Infection? other things????

Really now, bottom-line: If you don't want to risk life-altering changes, perhaps having a baby is not a good idea at all.

allnurses Guide · Aug 18, 2005

I too had a rather difficult forceps-assisted lady partsl delivery over a 3rd degree tear after 3 hours pushing.
No permanent problems that I could not work out w/exercise and keeping weight in check. I find, since I have been overweight, I tend to have "bladder issues" when I sneeze, TMI I know. But I think w/losing weight and improving my overall tone, I can over come this one thing. Too many of us want a quick fix or "perfect outcome" w/o any risk. NOT gonna happen...
Not to say others don't have problems. But I dont' think they are numerous enough to think csections should automatically be an elective option.
Ever stop to think of the risks w/csection? Like nicked bowel (nasty when it happens), nicked bladder? Future higher risk of uterine rupture on the scar line? Infection? other things????
Really now, bottom-line: If you don't want to risk life-altering changes, perhaps having a baby is not a good idea at all.

This is what I find amazing - new parents being SHOCKED that a baby is going to change their lifestyle. That babies don't sleep through the night and need to be fed every couple of hours.

That article recently about hiring other people to teach your kids to potty train or ride a bike is certainly indicative of the change . . ..

steph

SmilingBluEyes · Aug 18, 2005

Well I think that is the crux of our problem here.

We are a fast-food-easy-to-dispose society that does not wish to be inconvenienced for ANY reason, even our KIDS.

No place is it more evident than in L and D and in our schools today.

wannabemw · Aug 18, 2005

My eyes keep getting bigger & bigger w/each post. WOW! I personally LOVED having each and everyone of my babies lady partslly. And I enjoyed breastfeeding each & everyone of them! I knew that motherhood would be difficult, but hey, motherhood is a sacrifice! I knew that even at the tender age of 19yrs. Having a child did open my eyes, certainly. And no, I wasn't truly prepared as to how my life would change. But no one really does! But having children was a choice that my DH and I made for us. I am glad that I had good roll models about natural childbirth and its benefits. Yes, I was terrified of giving birth. But I educated myself & that helped me to overcome some of my fears. Did my labors go perfect? Nope. Were my babies fine? Yes. (despite the fact that all of them were OP & went into distress when delivering). This conversation only continues to encourage me to become the Holistic CNM and educator of childbirth that I know that this world wants & needs.

~MJ

BTW: I have my 1st BS as a Health Educator, so thanks for furthering my education! I am always up to learning something new!

wannabemw · Aug 18, 2005

I've also heard the 50% rate. We're building a new birthing center & are adding another OR room for this. One of the reasons....suppose a woman asked for a C/S because of intuitively feeling something was wrong, but it was denied & there were complications (abruption, ruputre, etc). The woman could have a very strong case in litigation.

So I guess if you want a "natural birth" one should choose homebirth? So sad... I recall when Birth Center meant a homebirth-like setting w/little to no interventions. And they were free-standing (near a hospital for emer). My how the times have changed....

iceNICUnurse · Aug 22, 2005

Hi!

I am a NICU nurse in Iceland.

Here we have a CS rate of 18% and are trying to bring it down. Here they almost never do CS on the mothers demand. And they do VBAC´s all the time.

Here they dont do elective CS until after 39 weeks and no inductions until about 42 weeks if everything is OK.

We have wery low morbidity and mortality rate both for moms and babies. I dont have the numbers with me but I think they are among the lowest in the world.

We have pretty good prenatal care, all women have at least 10 visits with Midwifes during pregnancy and midwifes do all the normal deliveries with no help from the OBdocs.

SmilingBluEyes · Aug 22, 2005

So I guess if you want a "natural birth" one should choose homebirth? So sad... I recall when Birth Center meant a homebirth-like setting w/little to no interventions. And they were free-standing (near a hospital for emer). My how the times have changed....

It seems to be coming to that. The problem is very complex, however. AND it would require people willing to be responsible for some of what happens in their L/D experience. Right now, we are a society in the USA VERY aware of our "rights" but not so very up on our "responsibilities". That is a BIG part of the problem.

subee, MSN, CRNA · Aug 22, 2005

Hi!
I am a NICU nurse in Iceland.
Here we have a CS rate of 18% and are trying to bring it down. Here they almost never do CS on the mothers demand. And they do VBAC´s all the time.
Here they dont do elective CS until after 39 weeks and no inductions until about 42 weeks if everything is OK.
We have wery low morbidity and mortality rate both for moms and babies. I dont have the numbers with me but I think they are among the lowest in the world.
We have pretty good prenatal care, all women have at least 10 visits with Midwifes during pregnancy and midwifes do all the normal deliveries with no help from the OBdocs.

I have toured an Icelandic hospital and had some of your health care systems explained to me. Icelanders are one healthy group of people.

You only reinforce my point that normal deliveries should be removeed from the obstetricians' hands and given over to midwives, who in the U.S. are viewed as the obstetrician's competition rather than a complement to care.

SmilingBluEyes · Aug 22, 2005

As long as physician special interest groups abound......as long as insurance companies have their strong hold on medicine and nursing today----that just won't happen.