I'm a first-year nursing student, and I just read an article in the Nov. issue of Vogue on a small but increasing number of women choosing to have elective c-sections for various reasons, including avoiding labor, and decreasing the likelihood of shoulder dystocia for the baby and eventual lady partsl prolapse for the mom.
Vogue doesn't publish their non-beauty/fashion articles online, so I can't provide a link for the whole text of the article. It does point out that, no matter which "ideology" you buy into, "there's only one standard that truly matters: a successful birth is a birth in which mother and child emerge alive and healthy."
I personally was floored that anyone would choose major abdominal surgery when it wasn't absolutely necessary.
While my hospital doesn't do c-sections for non medical reasons, many patients request them. Probably a higher number than who want to even think about labor.
Why?
Reputation. Two of the OB docs, my wife and another lady, do a marvelous job in surgery. Pts feel wonderful comming out, have almost no complications, and 3rd day discharge... they go home and come back for their pp visit talking about doing major house work while STILL caring for their baby. You rarely see ANYTHING written for pain upon discharge (always offered, never accepted). These moms just end up with an occasional Tylenol.
Any clue how hard it is to convince someone to labor when their sister/friend/niece/aunt just had a c-section and is doing EVERYTHING now?
I think it's funny that 3rd day discharges are considered to be great when a lot of vag deliveries go home within a few hours:) I definitely agree it's the perception that the c-section is the easy way that draws a lot of women in. I had a vbac patient once practically screaming at us because she wanted a c-section (had an epidural and was physically comfortable). I went to see her on PP and she was gushing about how much better she felt after this delivery and how grateful she was that we got her to deliver this way. If there's one thing I know: any kind of birth can be smooth and any kind can be brutal
Specializes in NICU, PICU, PCVICU and peds oncology.
I have had four pregnancies.
My first, as an unwed teenager (and therefore my least enjoyed pregnancy) was totally uncomplicated and ended in lady partsl delivery. I had been warned that I had a small pelvis and could require a c-section if the baby was large enough, which he wasn't. I had no epidural or nitrous, just a little bit of ketamine as the shoulders were delivered. My episiotomy stung like a bugger for about a week, by which time the baby was in foster care awaiting adoption.
My second time through was smooth sailing right up to the caseroom doors. My contractions stopped and started and stopped and started. After a pelvic x-ray revealed a small baby with a large, very stuck head, I had a section. I had a bad reaction to the anaesthesia and ended up fainting the first time I saw and held my then 12 hour old daughter. I was a miserable failure at breast feeding. I couldn't comfortably wear jeans for nearly a year.
Then came my third attempt. This time I had an anterior previa resulting in monthly fetal assessments. Fortunately as things grew, the placenta moved off to one side and my second section was relatively uneventful (if you don't count the failed epidural). The baby was flat at birth and required aggressive resuscitation. I had less pain this time around, but still had discomfort wearing jeans for some time. My scar was a thing of beauty! The breastfeeding went much better.
For my final act, I had mild PIH and developed a "window" in my uterine scar. This put me at high risk... so I was put on a very restrictive diet and modified bedrest... with two toddlers and an absentee husband. We lived on a military base out in the middle of nowhere with only one OB, who had booked his two-week vacation for three weeks before my due date. Of course, my membranes ruptured three days before my elective section was booked and the OB wasn't back from holidays yet, leading to hair-raising helicopter medevac through a thunderstorm. As you can see, I lived to tell the tale, with a hideous scar, a distorted abdomen and belly full of adhesions.
I don't believe that c-sections should be offered in cases lacking an obvious medical need. The risks, current and future, are not acceptable, to my mind. Sure, it's nice to know exactly when your baby will arrive, but HELLO, it's major surgery. And it hurts!!!!
Cesarean Sections are major surgery and patients should make careful, informed decisions. Yes, lady partsl births do have risks and possible long term disadvantages such as uterine prolapse, urine incontenence, etc. But how about C/S? Risks such as bladder nicks, bowel perforations, paralytic ileus, dehiscence, infection, adhesions, and the list goes on. C/S also carry a high risk of uterine rupture during subsequent pregnancies.
As for labor, well, they don't call it LABOR for nothing. The child bearing generation today enter into pregnancy with blinders on. Most women expect to feel little to no pain with labor. Many don't even except to feel any discomforts with pregnancy. This is a very much "it's all about me" generation. I don't believe C/S's should be a choice, but I feel it is definitely the wave of the future.
I cannot for the life of me imagine someone wanting a c-section if they can deliver lady partslly. I know some women do, but, OMG!...
I remember the very first c-section I ever saw when I was the labor coach for my younger half-sister. She wasn't progessing well, little dialation, baby not descending, many hours of labor and then the baby in distress. Emergency C-section ordered by Dr.
I had participated as a labor coach in several other deliveries, including a breech. Never in my life was I prepared for what I saw, and what I saw my half-sister go through during and after the c-section. I nearly fainted, had to ask for a chair to sit down in while holding her hand. She asked me what they did afterwards, because she said it felt like they were ripping her guts out (not pain, just ungodly pressure). I told her that they basically did, I got to see her uterus, fallopian tubes and ovaries as they placed them all on her abdomen, sutured everything back together and then proceeded to STUFF it all back into her and staple her up!
It took her a while to recover, of course...longer than a vag delivery to be sure. Her second and third children were delivered lady partslly, which she is very thankful for.
I would certainly have to agree with the other posters...if not medically necessary, I can't see doing it.
I am in nursing school at the moment with aspirations toward being an L/D nurse. Go figure...
Specializes in Case Mgmt; Mat/Child, Critical Care.
Originally posted by dreamon
Regardless of how we all feel about c-sections over lady partsl deliveries...the main point is that this is the mothers choice. Not anyone elses. I also read the article in Vogue. The doctors interviewed said that today- women are getting more information and they are more prepared for what will happen after the surgery. If they still want to go that route, by all means let them.
I get annoyed by all the "I'm better than you..I had my baby naturally...I had my baby lady partslly....Can't you take pain?...." bullcrap. After that child comes into this world it no longer matters, it's like some women are more focused on pregnancy than actual parenthood.
Sorry, I have to totally disagree with you on this one! Again, more of this "drive-thru" healthcare mentality. Like someone else said "it's all about me"!
A c/section is a major abdominal surgery, and surgery carries it's own risks as well as the anesthesia involved! This truly is not a case of "mother's choice". We are not discussing her "choice" to use cloth diapers vs disposable or to bottle vs breastfeed.
I saw some celebrity on TV about a yr ago chirping on and on about how she shouldn't have to experience any pain with labor and delivery, she didn't want her "shape" ruined (?), so she was "choosing" a c/s! Uh, hello, how can recovery from a SVD, usually 6 wks compare to the recovery time of major surgery 6mos to a yr?!? And talk about pain!
Oh, and BTW, it is NOT better for the baby to be delivered via c/s, babies are SUPPOSED to be delivered lady partslly, they have many more problems post c/s d/t missing out on the "big squeeze", not to mention the delay in lack of bonding w/mom and possible delays in breastfeeding.
I just saw a segment on one of the AM shows; they profiled a doctor, married to a doctor, who had an elective C-section. They said that it was convenient for their lifestyle.
Others complained about the issue of incontinence as their reason for getting a planned C-section.
I have had two kids; my first was 36 plus hours of labor which almost resulted in a C-section but did not. My second, I was induced! Wow, I think that was the way to go. If someone has a choice, go with that!
I have been cut up lots of times, for lots of things, and I would opt to not have that planned C-section. That is what all those drugs are for anyway. :chuckle
I don't believe that c-sections should be offered in cases lacking an obvious medical need. The risks, current and future, are not acceptable, to my mind.
Totally agreed. And very well put. I think that women requesting CS don't really understand all the risks of a CS, because they are so common now. We take for granted that things always go smoothly.
And Dave, I would really like to know what exactly they are doing to make it so "easy" for these CS recoveries. Is it something during the surgery, the repair, the early meds?I have never seen anyone in the recovery room asking for a Tylenol. More like, please more Demerol. :chuckle
Let's get real ladies. Birthing babies is birthing babies regardless of what the outcome is. I personally found labor (no epidural during labor) to be less discomfort than my menstrual cycle. But after 20 hours of labor 100% effaced and 8cm dilated I had a young man that just refused to come down -- we were having our own private tennis match. They said even though the baby was small we just needed to proceed with a c/section. That was ok with me because I knew we were not making ground. But then I never had a nurse tell me to "walk, try squatting" or any of the things we do now. But I had my 8.9 lb. baby boy and 2 of his brothers (8.3 lbs. & 8.15 lbs.) I would not trade my labor for induction or scheduling.
And let's face it 75-80% of 1st time inductions = primary c/section.
Do not fear labor but love the product of your labor.:kiss :kiss :D
Can you elaborate on what the big squeeze does for baby? What are the implications of baby missing this? Thanks.
The "squeeze" helps clear out fluid. Many babies delivered, well, most babies, delivered by csection require suctioning, delee suctioning at times. While most vag births do fine with bulb suctioning mouth and nose only, and some would probably do fine w/o that.
:D
Dave ARNP
629 Posts
While my hospital doesn't do c-sections for non medical reasons, many patients request them. Probably a higher number than who want to even think about labor.
Why?
Reputation. Two of the OB docs, my wife and another lady, do a marvelous job in surgery. Pts feel wonderful comming out, have almost no complications, and 3rd day discharge... they go home and come back for their pp visit talking about doing major house work while STILL caring for their baby. You rarely see ANYTHING written for pain upon discharge (always offered, never accepted). These moms just end up with an occasional Tylenol.
Any clue how hard it is to convince someone to labor when their sister/friend/niece/aunt just had a c-section and is doing EVERYTHING now?
Dave