Why a C-Section?

TweetiePieRN · Nov 4, 2005

Does anyone here know if there is a higher rate of PPD for c/s moms vs vag delivery? Any studies?

DutchgirlRN, ASN, RN · 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.

judyblueeyes · Nov 4, 2005

I, too, have had a delivery of both kinds.

The vag was as easy as they come. The CS was as difficult as they can be (classical, general, infected). I would still choose a CS (provided I had a choice, which I don't due to the classical) over a vag if I were to deliver again. Why? Many reasons...all important to me and none of anyone else's business.

I've been in OB all my nursing career. Many posters have made statements about how "vag deliveries get up right away" or "CS's include weeks of pain and recovery time". None of those kind of blanket statements are true. I've seen vag's try to lay in bed for days, and CS's get up as soon as possible.

Ultimately, it should be the woman's choice about how to deliver (barring emergencies, etc) and she should not be criticized or denigrated for her choice.

I swear, some of these discussions remind me of men comparing member size. A woman is not more womanly for having delivered lady partslly or unmedicated.

SmilingBluEyes · Nov 4, 2005

No one is saying one is better than another for delivery lady partslly. You reading WAY too much into it, Judy. The original premise of the thread was to discuss whether purely NON-medical, elective csections should be done or not. I dont' see a heck of a lot of people denigrating each other for their choices, and I find it interesting to note the definition of what is really "elective" is varied. To me, "elective" means having the choice------yes----but I do not think that "choice" should extend to people getting it "cause they want it". There should be established medical need, at least, that is my argument.

fergus51 · Nov 4, 2005

I'm with you Deb. Whenever someone says they don't believe in strictly elective c-sections (those which have NO medical indication) people start with the defensive replies. No one has ever said that women are less womanly if they don't push a baby out through their lady parts. No one has ever said that there shouldn't be c-sections when medically necessary either.

prettymama · Nov 4, 2005

I had my 2 lady partsl deliveries,and if ever I will plan to have another baby my DR. told me to have a Csec, got a lot of probs., met during my past deliveries.Though I prefer to deliver normally in my next one (hope I am not preg this month) Dr. adviced Cssssssssssssssssssssssssssssssssss. :bluecry1:

Jessica

mrscurtwkids4 · Nov 4, 2005

Personally, I've had a total of 5 c-sections. Although they weren't exactly by choice. My first one was delivered as an emergency due to placental abruption and I was hemorrhaging out. Lost my son, but they managed to save me. Got pregnant with my second child so soon after that section that the Dr. thought it safer to do repeats. In my case, having the section was a lifesaving event. However, I think doing a section as a choice isn't really right. Medically necessary is fine, but I am not sure how vanity would cause the choice for a section. Frankly, it's worse on your appearance having the sections. The scarring that gets left behind isn't the prettiest. And after so many, it caused so much internal scar tissue for me that I ended up with a hysterectomy by age 29 (which was fine by me since I was so done having kids...lol). I just don't think major surgery should be the option of choice when having a baby unless medically necessary. The natural way is generally the best for mother or baby unless complications arise. But that is just my personal opinion. I do feel like maybe I missed out on some great experience because of not going through the delivery process. But even VBAC wasn't an option for me.

kmrmom42 · Nov 4, 2005

the day is comeing when you will come to work and circle the or all day.
like i said i can't say that it's wrong for someone to choose a c/s i just know i will miss laboring paitents when the day comes that we have a 90% c/s rate like other countries

what that day a-comes dayray i will be out of ob forever. i will try to at least help preserve breastfeeding in my role as a lactation consultant but the joy will have gone out of l&d for me.

i didn't have time to read all the posts in this thread but the first 16 probably were a good representative sample. i am saddened by the younger nurses who have bought into this line of thinking. they won't know what they are missing.

i had my first baby by cesarean in 1980 because she was a 9lb 14 oz footling breech. when i became pregnant with my second child in 1981 my doctor agreed after some cajoling to allow me a trial of labor. i had to agree to many things, like no epidural.they would not induce me or do anything that might increase my risk of uterine rupture. i had a nurse sitting by my bedside staring at my monitor the whole time and doctors hovering over my bed when i complained of pain in my scar area. fortunately i had my 10lb 1oz persistent op son lady partslly! i was amazed at how much better i felt than i had after my cesarean. in fact, i felt so good that i told my husband not to bother to call the nurse to help me to the bathroom and i passed out cold! but i felt great and got back to my 19 month old at home within less than 48 hours.

when child number three was coming i lived in a more rural town and had a hard time finding someone who wasn't worried that i would sue him over any problems if he allowed me to vbac. finally i did and had my nicest birth ever. my first actual birthing bed delivery, again a persistent op 10lb 11oz baby. i am fine, i don't wet my pants, i don't need an a/p repair, don't have a rectocele or anything else that people worry about.

i know that one persons experience does not science make but i just had to share my personal feelings on this. i could actually go on forever with research and references but i don't think i will convince anyone who is already sure that c/s is the way to go.

i just know that for me my vbacs were long and challenging but they were also two of the most rewarding things i have ever done in my life. i felt empowered and proud and like i had done what i, as a woman, was meant to do. it was wonderful and i treasure every day that i get to help another woman have such an amazing, transforming experience.

>

Dayray, RN · Nov 4, 2005

I was taught that pain is subjective, that is pain is what the patient said it was. I work through ways of dealing with pain before the drugs come in.
Having said that a friend described labour and delivery to her husband "try jumping out of a third floor window and landing on your bike that's had the seat removed."

Yeah, pain is subjective, that’s kind of, my whole point of view. Patients are making choices in regards to pain meds and now elective C/S based on their subjective concepts of pain. I don't frown on anyone for having pain meds or having difficulty with labor pain. I at the same time realize that their "subjective" point of view is based on what they have experienced in the past. For most in U.S. our life is fairly comfortable and physically easy. As our lives become more and more comfortable you are going too see more of these issues come up like elective c/s. I’m not even saying that’s a bad thing, I’m just saying that’s what’s going on.

People don't realize that c/s recoveries are difficult so it seems much easier and less painful to have a c/s then to labor. This is a decision made upon the patient’s "subjective" view of pain. What I was saying in the place where you quoted me is that the "subjective" perspective on pain that would lead one towards an elective c/s is one born out of our pampered society.

In years past if you offered someone a C/S to avoid the pain of labor, they would have thought you were crazy. People in days past accepted pain as part of life. Having a doctor cut you open and having a needle stuck in your back or being put to sleep would have been scary to them.

Today we see pain as something horrible and see a painless life as our birthright. We also have become more comfortable with medical procedures and surgery. You can see surgery on TV. Never mind the stuff on the discovery channel, just look at the stuff on primetime network television. On ER they show people getting surgery, having bones set, chest tubes placed.

People have become more comfortable with medical procedures then they are with natural, normal pain.

Even if they know about the post op pain many would find it easier to deal with that pain because it is predictable. For most the fear of labor is because they have never experienced real pain. Somehow having pain from a medical procedure is more normal in their minds.

I too, try different things before giving people pain medicine. What surprises me is that just letting them know what they feel is normal seems to work best. That reassurance is for some, enough to provide them a perceptive in place of past experience to conceptualize what they are going threw as okay.

As human beings we draw upon past experience to place the present in perspective. Most people today don't have any really painful experience to draw on so they can't conceive of how to deal with pain and that causes fear. That is why my hospital has a 95% epidural rate and that is why people are looking at elective c/s as an acceptable option.

Yes as nurses and medical people we can point out all kinds of reasons to have a c/s. Bladder incontance, fistulas, pelvic pain etc etc.. But the non-medical person chooses a c/s because of fear of labor pain and really fear of the unknown.

I would never refuse someone pain meds and I don't have a negative opinion of them for requiring them. I at the same time realize the place that need is coming from. Some people will hear judgment in my words but assure you it is not there.

The reason I keep saying, “I can’t say elective c/s are right or wrong” is because right and wrong are not absolutes. They are constantly shifting and “subjective” to the situation and the people in that situation. For a person that doesn’t have the ability to cope with labor, avoiding labor might be worth all the risks and problems that come along with a c/s.

Also in the future as our lives become more comfortable and less painful more of the ability to deal with pain will be lost. So at some point in this evolution elective c/s will be better for patients. Not because of incontance or problems that are attributed to vag delivery. They will be better because if a person doesn’t have the ability to deal with the pain/uncertainty of labor it will cause emotional trauma and as we all know that can manifest in physical ways.

Dayray, RN · Nov 4, 2005

i just know that for me my vbacs were long and challenging but they were also two of the most rewarding things i have ever done in my life. i felt empowered and proud and like i had done what i, as a woman, was meant to do. it was wonderful and i treasure every day that i get to help another woman have such an amazing, transforming experience.
>

:yeah:

thanks for sharing that. to be honest i get a littel tired of birth stories but i really liked that one.

Bama_Jypsy1 · Nov 4, 2005

As a nurse and a mother of five, I had my first child at 17 with an epidural. After 6 yrs passed, I finally got up enough nerve to attempt childbirth again with my first daughter, this time totally natural and only 50 minutes of labor. (I remembered the pain and treatment I'd received at the hands of a Dr. that happened to be on call for my Dr. and nurse Ratchet for years afterward!) I went on to have my 3rd child natural with no complications, in fact, I walked into the ER completely dialated and ready to start pushing. Two years later, I was due to deliver my second son and started hemorrhaging and had to have a emergency section only to wake up to find that my son died during birth. Fast forward 4 yrs and I found out that I was finally pregnant again. I went to my Ob/Gyn of choice and explained what had happened during the last pregnancy and demanded that he promise me that if my b/p should start going up that he take my child via a section immediately. He agreed that he would. My b/p started rising in my 8th month and I was admitted to the hosp. and scheduled later that week for a section and tubaligation. My Dr. asked me several times if I wanted to attempt labor and a lady partsl birth. I stated that I didn't, due to my previous experience. My last two normal deliveries were precipitous and I didn't want to risk having my b/p shoot up and possibly cause any problems for me or my baby. I can say in my case that given a choice, I would much prefer a section to having to go through the pain of natural birth. lol I Know all of the risks of both types of deliveries and still prefer the section over lady partsl.

For me, there was really no difference in the pain. I could either experience all of the pain immediately during natural childbirth, or I could have a little pain every now and then after the surgery. Once I was alert after surgery, I was up and about as usual. I needed no pain meds and was ready to go back home. After the first section, I was back at home within 24 hrs, 48 for the second. I will say that if there had been no medical reasons for the sections, I would never have had them.

As for the one who said that section babies were "prettier", Mother Nature protects a mother from having an "ugly baby". I've never ever heard a mother say that her baby is ugly! The baby could look like "Pumpkin Head" and she'd still not be able to see the baby as ugly, even though it is to everyone else. lol

SmilingBluEyes · Nov 4, 2005

what that day a-comes dayray i will be out of ob forever. i will try to at least help preserve breastfeeding in my role as a lactation consultant but the joy will have gone out of l&d for me.
i didn't have time to read all the posts in this thread but the first 16 probably were a good representative sample. i am saddened by the younger nurses who have bought into this line of thinking. they won't know what they are missing.
i had my first baby by cesarean in 1980 because she was a 9lb 14 oz footling breech. when i became pregnant with my second child in 1981 my doctor agreed after some cajoling to allow me a trial of labor. i had to agree to many things, like no epidural.they would not induce me or do anything that might increase my risk of uterine rupture. i had a nurse sitting by my bedside staring at my monitor the whole time and doctors hovering over my bed when i complained of pain in my scar area. fortunately i had my 10lb 1oz persistent op son lady partslly! i was amazed at how much better i felt than i had after my cesarean. in fact, i felt so good that i told my husband not to bother to call the nurse to help me to the bathroom and i passed out cold! but i felt great and got back to my 19 month old at home within less than 48 hours.
when child number three was coming i lived in a more rural town and had a hard time finding someone who wasn't worried that i would sue him over any problems if he allowed me to vbac. finally i did and had my nicest birth ever. my first actual birthing bed delivery, again a persistent op 10lb 11oz baby. i am fine, i don't wet my pants, i don't need an a/p repair, don't have a rectocele or anything else that people worry about.
i know that one persons experience does not science make but i just had to share my personal feelings on this. i could actually go on forever with research and references but i don't think i will convince anyone who is already sure that c/s is the way to go.
i just know that for me my vbacs were long and challenging but they were also two of the most rewarding things i have ever done in my life. i felt empowered and proud and like i had done what i, as a woman, was meant to do. it was wonderful and i treasure every day that i get to help another woman have such an amazing, transforming experience.
>

well said! i appreciate this post so much. i am with you; the day csection rates reflect the "i want it when i want it--now" school of thought---when that becomes the prevalant way of thinking, i will have to leave ob (at least in the hospital--maybe i can beg a midwife to allow me to be her gopher by then). i will have lost just about all joy in what i do. it's not that csections are not joyful-----they sure can be. of course they can. but not as a routine. and many of the kind of people demanding them due to scheduling or personal desire are the toughest for me to work with anyhow.

yes, csections can be wonderful---they are births afterall, and i cried at my own and those of others-----but it is not the same. and if the prevalant attitude is going to be "get the kid out now, so i can get on with my life", then i can't say i will be the best caregiver for such patients any longer.

i have to start thinking now what else i will do-----ob nursing is all i ever wanted to do. but not like that. it will have lost all its heart for me.