Why a C-Section?

nurse4theplanet, RN · Nov 4, 2005

I did read your entire post and I don't see how you really accounted for that fact other than stating that because abortion was legal and women were allowed to "choose" to kill their baby, women should be allowed to deliver in any way they choose, since obviously grunting and retractions in a baby is much better than killing it.
I don't think those 2 really equate and in my opinion, still doesn't account for the effects on the baby at all.
Your argument of "well, mothers can choose to kill their babies; I'm simply choosing to have a section which would be not the BEST for the baby, but compared to an abortion it's better..." doesn't seem logical to me at all.

By my analogy, I am simply saying that if women are afforded the right to chose whether their fetus lives or dies, then there is no reason why they are should not be allowed to choose how they wish their method of delivery to progress. My argument is for the right of choice. There is substantial medical evidence that proves there are no long term effects of c/s delivery. It is certainly logical to me.

I also want to make it a point that I DO NOT think all women should choose an elective c/s over lady partsl delivery...I simply feel that women who would rather deliver by c/s should be afforded that right to choose after appropriate education. And I don't think docs should force c/s on pts because it is more conveinient(sp?) for them...It should be up to mom and hubby (if applicable) because they are the ones who will deal with baby and mom after birth.

Q. · Nov 4, 2005

Alta, with all due respect, having an opinion on something does not mean that nurses can't provide good compassionate care to everyone.....
...I can have the opinion that c-sections with no medical indications are not so great, that doesn't mean I don't care for these women like my other patients or that I try to force my opinions on them.

Exactly. I may be a nurse, but I'm not a stone. I am a woman, and a mother with twins of my own and have opinions on things from epidurals to c-sections. I can hold those opinions and still provide good care.

nurse4theplanet, RN · Nov 4, 2005

I am astounded by the judgmental attitudes here. Our job as nurses is to educate people about relative and absolute risks and alternatives and then support them as *they make choices* which are in their best interest. We are not there to decide what their best interest is. (Suppose a woman wants a section so her dying mother can be there for the birth; suppose there are childcare issues; suppose she has a precious six weeks of maternity leave; suppose her spouse is going to be deployed for a year; suppose she is uncomfortable with the controversial practice of VBAC?)
I'm all for lowering the section rates by promoting healthy, sane birth practices, but if a woman says she wants a section it is not my place to second guess her reasons and assume she is vain or weak or lazy or somehow destined to be an inadequate parent. Women have the right to choose to do what they want with their own bodies, including delivering their children in ways that they feel good about.
Did you know that there are places in this country where women have been prosecuted for choosing homebirth and others for *not* choosing c section because judgmental people felt they were better able to decide what was right than the women themselves?
Every one of us has a right to an opinion as a private citizen, but I think as nurses our loyalty should be with patient autonomy, and we should leave the self-righteousness behind.
Altalorraine
P.S. I can't imagine how people with these attitudes manage to take care of the diverse, high-need, high-risk, drug-taking, no-PNC, promiscuous, frequent flyer patient populations that we see so often.

Well said. As American citizens we should all uphold the right of choice because one day, that right may be restricted from something we choose to do that may be unfavorable to the majority.

As nurses we MUST separate our oppinions from our care...which many of the posters have done.

To be judgemental is to degrade one's personal choices in favor of what the poster would do, and to press that policy/legislature should enforce such rigid restrictions.

However, everyone is entitled to an opinion that will affect their own personal choices but will not affect what a new mother will be able to choose when delivering her own child.

I do agree that if someone is EXTREMELY judgemental, then their opinions will interfere with their care. But to be the devil's advocate for a moment, those who get into L&D are passionate advocates for the babies and see many moms come through that probably should never have become parents in the first place. Since this is their forte and they deal with it on a daily basis, they are very solidified in their views and we should try to understand where their emotions are coming from. They certainly may not feel as strongly in certain controversial topics that they do not deal with on a day to day basis.

It is certainly okay to agree to disagree as long as we remain respectful in the process.

great post by the way!

wannabeL&D73 · Nov 4, 2005

I don't think C-sections should be elective even if you are the queen of pop. C-sections do have their place. My daughter is having one on Monday because my grandson is breech. I had two C-sections for breech babies. I would hardly say they are extremely painful for weeks. 24 hours maybe if you have a low tolerance to pain. You get up, get moving and you'll be just fine.

Actually, I have a pretty average pain tolerance, and I was in pain for several weeks...now I was also spending too much time standing up at my baby's bedside in the NICU...maybe if I would have had a healthy baby and could have just been hanging out at home it wouldn't have been so bad. But for several weeks my husband had to help me lay down at night and get out of bed in the morning...the pain was truly excruciating. Of course this was just my expereince...but again, the c-section recovery was significantly more painful than the vag. birth recovery. (Full disclosure: my daughter only weighed 4 lbs. 15 oz.)

Also, I strongly believe that choosing a section over VBAC is not "elective" in the way that scheduling one for convenience is. While I completely support the right to make an informed choice to VBAC, there are real risks to consider.

Shannon

meta4 · Nov 4, 2005

I think that choosing a section for the sake of fear or vanity is silly. I suppose this goes hand-in-hand with a culture that perceives childbirth as a "medical procedure" rather than a natural process. lady partsl tissue is made to stretch and as a mother who gave birth to an eleven pound boy lady partslly I can tell you that things do go back to normal afterwards.

mhall76 · Nov 4, 2005

I can only speak for myself but in my area the c-section rate has shot up due to fear of lawsuits. None of our OBs will take on a VBAC. I also find myself not fighting for vag deliveries like I used too. We dont have as many elective c-section (except for 1 Doc) but we induce everybody. It is joke that if you get to 40 weekd around here you must be hiding out. I think this huge number of inductions is increasing our rates.

mstigerlily · Nov 4, 2005

We must work in the same hospital! And I agree.

I can only speak for myself but in my area the c-section rate has shot up due to fear of lawsuits. None of our OBs will take on a VBAC. I also find myself not fighting for vag deliveries like I used too. We dont have as many elective c-section (except for 1 Doc) but we induce everybody. It is joke that if you get to 40 weekd around here you must be hiding out. I think this huge number of inductions is increasing our rates.

Altalorraine · Nov 4, 2005

Exactly. I may be a nurse, but I'm not a stone. I am a woman, and a mother with twins of my own and have opinions on things from epidurals to c-sections. I can hold those opinions and still provide good care.

I assumed we were here to talk about things *as nurses* rather than to vent our spleens about things that annoy us. There is probably room to do both here, though it can make discussion more difficult.

I do believe that it is possible to provide good care if there is a simple difference of opinion about what you would do as opposed to what your patient is doing, but it does seem to me that many nurses have not internalized the belief that we are advocates for patients' rights as well as for their responsibilities.

Altalorraine

Graciegirlienurse · Nov 5, 2005

I hope that those of you who fear vbac are aware that the rate of uterine rupture is less than one percent. when it does happen, it is usually in grand multips, or women who have had multiple c/s, or women with t or j shaped incisions. It is sad that we are in such a law suit happy society that doctors refuse to attend vbacs that are less risky than many other procedures.

I did quite a lot of research on the subject of vbacs in my senior year of nursing school.

I now work for a large university hospital that has an informed consent form for repeat c/s or vbac that basically says that the c/s is more risky than the vbac.

I had a beautiful lady partsl delivery six years ago and look forward to the day that i can do it again.

Ethel · Nov 5, 2005

hi everyone, i was just wondering why so many women are choosing to undergo ceasarean delivery without even a trial of labor? don't they realize it is a major abdominal surgery and they will be in severe pain for several weeks? i know that it is a very necessary procedure sometimes, but it just seems so overdone and unnecessary sometimes. i'd love to hear from you!

in the hospital where i work c-sections account for about 80% of deliveries due to the large amount of patients who are hiv pos. they unofficial statistics in some antenatal clinics are as high as 40-60% of antenatal mothers tested are hiv pos. a lot of hiv pos. women are having their second and third pregnancy despite their hiv status.

Dayray, RN · Nov 5, 2005

in the hospital where i work c-sections account for about 80% of deliveries due to the large amount of patients who are hiv pos. they unofficial statistics in some antenatal clinics are as high as 40-60% of antenatal mothers tested are hiv pos. a lot of hiv pos. women are having their second and third pregnancy despite their hiv status.

really? i went a confrence recently and the common opion seemed to be that a c/s did'nt decrease the incedence of transmition. do you have info, indicating otherwise? if you do can you post some links? that confrence has really influanced the way we care for our hiv positive patients. if their is newer or differnt reaserch i'd love to see it.

weezer123 · Nov 5, 2005

I have not worked with Mother/Baby in years but when I did it was not up to the patients if they recieved a C-Section it was up to the Doctors.. Can you now choose? We only preformed them mostly in emergency situations..