Elective C-sections- moms idea or the providers?

[LovelyMe]

I'm not a nurse yet so I wouldn't know what is going on in the hospitals here where i live.

BUT when I was pregnant, i was almost in SHOCK when my OB (In Denver) asked me if I wanted to have a Csection or Vag delivery!!!

I asked him why I would need a C/S and he said "well some women opt for that becuase they can schedule it, its easier, etc..." I couldn't believe it.

I ended up being induced but had no problem delivering my healthy baby girl vaginally.

I have friends that say "oh i'm going to have a C/S so I dont have to deliver vaginally so I dont stretch out etc... "

I guess its a choice now...

[HeartsOpenWide, RN]

I'm not a nurse yet so I wouldn't know what is going on in the hospitals here where i live.

BUT when I was pregnant, i was almost in SHOCK when my OB (In Denver) asked me if I wanted to have a Csection or Vag delivery!!!

I asked him why I would need a C/S and he said "well some women opt for that becuase they can schedule it, its easier, etc..." I couldn't believe it.

I ended up being induced but had no problem delivering my healthy baby girl vaginally.

I have friends that say "oh i'm going to have a C/S so I dont have to deliver vaginally so I dont stretch out etc... "

I guess its a choice now...

First, I would never go to a doctor that would let a woman choose between low risk and high risk for no other reason than "what she wants" and not for medical reasons. C/S are high risk and should not be done unless their is a valid medical reason. Something to keep in mind is that if a woman is allowed to choose this and there is no medical reason her insurance may not pay for it; last time I checked ins does not pay for cosmetic surgery...and if there is no medical reason for the C/S that is simply what it is; just like how more insurances will not pay for circumcision. There are many women that have been denied health insurance because of past C/S, do you think ins is going to pay for an expensive unnecessary surgery?

[linzz]

When I had my children, I was never offered a C-section, nor would I have demanded one. My first child's delivery went very poorly and my child was born in a lot of distress. I often wonder if I should have had an emergency c-section.

My second delivery went very quickly but required forceps. I was glad that forceps was an option instead of a c-section. I can't imagine demanding a c-section for a normal labour because it seems to me that it is invasive and does require an incision and healing time afterwards. JMO.

[Elvish, BSN, DNP, RN, NP]

I don't want to pin the blame on one source, because I truly think it is multifactorial. Too complex an issue to say is caused by just one thing. One thing is sure, I would not want a c/s for any amount of money. It would truly have to be an emergency (those mentioned by HeartsOpenWide are good examples) for me to ask for one. (At that point the baby's health is more important than my not wanting a c/section.)

I take good care of my C/S mamas, and it does no one any good for me to lecture them once they get to me, nor does it ever cross my mind. But it is dismaying that we shrug it off as 'just a c/section' when the fact is the incidence of perinatal complications for mom and baby is higher with a c/s than with a NSVD.

[RNBelle]

I worked in 2 different hospitals. One hospital a MD would do a c/s so they could get to dinner on time. The other place sometimes the docs needed to be cornered into doing a c/s - constant hounding that it has been HOURS with no progress despite every laboring intervention you can think of and now the baby is tachy with lates, etc. One place did VBACs, the other place no VBACs just repeat c/s.

[JulesNC]

Thank you all for your input, everyone has lots of valid points. I do agree wholeheartedly with those who said we need to be sure not to judge any woman's birth choices, as we never really know the story behind it, and it is honestly usually none of our business!

PART 2

Other than talk among other nurses, has anyone ever tried to express their concern to the OBs or Nurse Managers? I know when I was working the floor it was rare for us to complain to anyone other than other nurses. Has anyone asked the "dinner time cutters" about the practice? I would love to hear their answer!

I also want to make it very clear that I am in no way anti OB/Gyn or anti C-section when needed, even if that need is from an extreme fear of childbirth, especially among those that have already experienced a traumatic birth! I just worry that we aren't taking the best possible care of our moms, as we expose them and their babies to higher risks, many times without them having all the facts. We can say it is not our issue as it is the docs doing it, but shouldn't we fight for our patients? Not trying to create guilt or anything, as the reality of needing to feed our own families is their for us all, but just trying to understand the reasons behind why the system just seems to get worse, and further away from evidenced based practice!

Anyone got any ideas as to how to work on this issue?