Elective Cesareans/On Demand

SmilingBluEyes · Jul 14, 2005

I don't know of any law prohibiting this. In our litigation and insurance-run medical climate, I can see where a certain segment of the population might "demand" them. And sadly, I see our csection rates only rising in the coming decade or two. The ,medical community can certainly "justify" them with medical terminology that makes them seem "necessary"----particularly if there were ever a law against such a thing, believe me. They do it already for the insurance companies and lawyers.

2 decades ago, routine inductions for "maternal discomfort" and "social " reasons were all but unheard-of. Now they are as common as ants at a picnic. I don't doubt csection on demand (esp to prevent potential later complications such as bladder problems, prolapses, etc) is much further behind. It's a "fast food" society we live in, where the customer is almost always right------and wants things on schedule.

sjt9721, BSN, RN · Jul 14, 2005

I agree that we're in a "fast food" society :rolleyes:

Last I heard, our induction rate is right at 90%. And about a third of our deliveries are C-section. I don't know what the breakdown is for "elective" sections.

sgent · Jul 14, 2005

I agree that we're in a "fast food" society
Last I heard, our induction rate is right at 90%. And about a third of our deliveries are C-section. I don't know what the breakdown is for "elective" sections.

Nationally the c/s rate is about 50%. ACOG (assoc. of OB's) put out a statement last year which essentially said that c/s on demand was acceptable medical practice.

amber1142 · Jul 14, 2005

Do you know if Elective Cesareans/On Demand are legal? I thought they were not but I remember watching "Birth Day" on the discovery channel and a woman had a schedule cesarean because her OB was going out of town. I am taking a political science class so I can transfer for a BSN and have to write a paper on a political issue. I thought this could be a good one but if it is still illegal no sense in arguing that it should be.... Does any one know? I tried to look it up on line but got no where.

It's legal, though there probably has to be a valid reason for insurance to pay for it (and I'm sure it's not hard to invent a reason). It bugs the crap out of me, but really, it's not my business (hmmm, as an OB nurse, I suppose it *is* my business- lol. Let me rephrase, I believe my business is to educate people about surgical risks and the best evidence-based practice, but it isn't my business to impose my birth agenda on my patients.) It still annoys me, though.

New CCU RN · Jul 14, 2005

I am one of those people that will find a doctor that will do an elective primary c/s. I haven't had any babies yet - but b/c of the horrible labors my mother, my grandmother on my dad's side, and my sister have had. My mother had seven babies - all at least 9 lbs. Tore big time with all of them. All were vacuum or forcep assisted. My dad's mom had big babies - this was years ago and they broke her pelvis to get my uncle out - don't even want to think about that one. My sister also had huge tears and big babies. My husband's family also has big babies - but much better labors. If I am having a big baby - I am just not going through it lady partslly. I don't see why not wanting a third or fourth degree is so horrible. I realize the risks of surgery - and do not take it lightly. And I realize that having a baby involves pain - it isn't to escape that (b/c I am sure the pain post op is horrid as well)

I don't think a c/s should ever be taken lightly - but I also believe that if a woman is going to poop out of her lady parts vs getting a section - she should be informed and given the choice. It is not selfish to not want that to happen.

SmilingBluEyes · Jul 14, 2005

National csection rate is 50%? I thought it was more like 26%. Where did you get that figure, out of curiosity? (not trying to start a debate, but I am really behind the times if these rates are that high). Thanks in advance for any info you can provide me.

subee, MSN, CRNA · Jul 15, 2005

It's legal, though there probably has to be a valid reason for insurance to pay for it (and I'm sure it's not hard to invent a reason). It bugs the crap out of me, but really, it's not my business (hmmm, as an OB nurse, I suppose it *is* my business- lol. Let me rephrase, I believe my business is to educate people about surgical risks and the best evidence-based practice, but it isn't my business to impose my birth agenda on my patients.) It still annoys me, though.

Maybe its time we did put change on our agendas. I find OBGYN's to be pretty much under the thumbs of the patients. 45 year primips are allowed to labor "for the experience" and the c-section goes at 10 p.m. so we can get the patient out of the OR before we have to use the night call team. No one can have a baby anymore without a garden hose in her back. Giving birth used to be such a growth experience for women - it definitely helped your self-esteem that you were able to experience some short-term pain (nothing like the pain, however, that a snotty teenager will give you later).

Kowtowing to so many ridiculous, expensive patient demands is just a form of whoring. Lets give labor and delivery back where it belongs - to the midwives.

fergus51 · Jul 15, 2005

In some ways we only have ourselves as women to blame for this. How many women do you know who love to go on and on in agonizing detail about their labors and births? TONS!!! They seem to take delight in scaring primips to the point where they aren't even willing to consider that their labor isn't necessarily going to be the same as their mother/sister/grandmother/neighbour/whoever.

I had a patient come in at complete, but she didn't want to deliver lady partslly so they got an epidural in place and did the section (and they had to push the baby's head up to do it!!!). The baby was about 7lbs, not the 10lbs her mother's had been. It's so disturbing to see a woman completely convinced that she is unable to give birth without surgery.

SmilingBluEyes · Jul 15, 2005

That is why I take EVERY opportunity to stop women from "scaring" primips to death. Another problem, is all those stupid reality TV shows, like Baby Story and Maternity Ward. The latter, in particular, would scare anyone half to death. All the births there seem to be high-risk "emergencies" dramatized for titillation. We are becoming a society literally hooked on violence and thrill-seeking on TV and in games, so much that shows like this have to "whip up the drama" just to keep our attention. Well, unfortunately, they also do a huge and grave disservice to people in this process of "entertaining" them.

CHATSDALE · Jul 15, 2005

i know that some of the younger girls are opting for c-sections because their mothers and grandmothers are having incontinent problems and because of the lady parts muscular tone

don't know how to advise them..they don't believe that there are any dangers from surgery..they see everyone having 'beauty tx surgs and breast agumentations and this is just something else

Trauma Columnist · Jul 15, 2005

I almost think we women have this one upmanship thing going on. We all have heard it:

Lady A: "My labor was 23 hours, I pushed and pushed for 3 hours and then I tore....."

Lady B: "Well, my labor was 38 hours long and the baby was 10 lbs...."

Personally, I think birth is a natural experience and can't believe the c-section rate is so high (I think 26% is too high, let alone 50%). Glad I had my kids long ago (25 and 20 years). It wasn't all that bad (and believe me, I'm a big woos).