Pressured into c-section?

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Allegra

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I’m not pregnant and in no imminent danger of surgery, but I was in a discussion recently that really made me think. According to some sources, the c-section rate is ballooning. But not the emergency-delivery type of c-section, but the pre-planned kind of c-section. In the discussion I was in, some were claiming that many of these were essentially “elective” c-sections, which is a claim I found suspicious. C-sections are fairly safe as far as procedures go, but they do have notable risks and I find it hard to believe that doctors would agree to perform one for any reasons other than medical necessity.

However, I know from my sister’s case that this does happen at least sometimes. She doctor shopped until she found one that agreed. Officially, it was due to pre-E, but the diagnosis was based solely on my sister saying she had headaches and she worked 60 hours a week until the day she delivered. (Literally, she went in that day.) Basically, my sister was the general manager and the company needed to know when she would be out so they could cover her. She was afraid she’d loose the job if she didn’t get a doctor to agree to deliver the baby on their schedule.

I always assumed that this was an outlaying situation and a particularly lousy doctor, but after participating in the aforementioned online discussion, this is apparently a much more common thing than I thought and some women feel pressured by their employers to deliver by c-section. Thinking back, I remember that with my last two pregnancies, I was asked to provide a date for my delivery. I was also contacted by my direct supervisor in both cases and told that he “needed to know” in order to get coverage for me. At the time, I just laughed and chalked it up to the general stupidity of bureaucracy, but in retrospect, I could see someone less oblivious than myself taking that as pressure to arrange a c-section. My employer also has a policy that gives two extra weeks of paid leave to parents who deliver by c-section. I always assumed that was because the employee would need two extra weeks to heal from surgery, but assuming a world where a woman can ask for a c-section for non-medical reasons, that does sort of put the pressure on.

The group I was having the discussion in is a wide variety of walks of life, including a larger percentage women who work for hourly wages and don’t have access to the most reputable health care, so I was curious about the demographic in this forum, which is probably more middle class to affluent, and health-conscious in general. Have you ever heard of someone being pressured into a c-section for non-medical reasons? Have you ever heard of someone being able to persuade the doctor into doing one? Any idea why a person would prefer this to an induction? I know they do these for non-medical reasons as my second pregnancy was induced (at full term) as my doc was going on a medical mission to Haiti and I didn’t want to be left at the mercy of whatever floor doctor happened to be around that day. But a c-section is a lot different!
 
The medical industry makes more money with c-sections, but It may be the best choice ?
 
I personally don’t know anyone who has been pressured into a c section or who has pressured a doctor into one with no medical reasoning behind it (even if the reasoning is tenuous at best). I’ve heard if it happening online but tend to take that with a grain of salt.
 
Cesareans have saved a great many lives. I personally wouldn’t want major abdominal surgery unless it was a medical necessity, but I support every woman’s right to deliver as she chooses. Patients are all supposed to have autonomy.

I really disapprove, not of cesareans given on maternal request, but of choices that greatly increase the child’s chance of death (especially homebirth for breech or other complications).

I certainly do not think a doctor should pressure a woman into a cesarean unless that doctor truly believes that a vaginal delivery is too risky for mother or child; I have also, however, heard of cases where providers have withheld epidurals or inappropriately continued to press for vaginal birth, at the cost of the baby’s life or health.
 
Allegra said:
some were claiming that many of these were essentially “elective” c-sections, which is a claim I found suspicious.
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I don’t know why you find this suspicious. Elective c sections have been rampant for years.
 
Now, I have dealt with doctor’s pressuring for a c-section and unnecessary intervention before, but I was thinking more of situations where a woman was being pressured by the employer or circumstances outside of the medical aspect. I actually had a hospital doctor that was supposed to be interpreting my ultrasound basically tell me I had to have some very serious interventions with my last pregnancy because I’m overweight. My own doctor and another had very different opinions looking at the same ultrasound and the original doctor failed to catch the true-knots in my daughter’s umbilical cord as well. So, yes, I know that doctors have prejudices for and against different procedures and all that, but I was focusing more on the idea of having a significant medical procedure for a non-medical reason, which I find alarming.
 
Because I don’t know of many doctors who would do one that was truly “elective” in the sense of a non-medical reason. (not just a not-very-compelling-medical reason) My sister had to search far and wide to find the nutter that agreed to hers and the doc had to lie in order to get the insurance to pay for it.
 
There are all sorts of people who go into doctor’s office demanding procedures that don’t exist, won’t help them, or are for conditions they don’t have. Doctor’s have to have the right to refuse to do procedures that violate their Hippocratic oath. A person’s individual autonomy gives them the right to refuse a procedure, but not to demand one. Then they are taking over someone else’s autonomy.
 
Dump the MDs once you are determined to be low risk, and turn your care over to Certified Nurse Midwifes (CNMs), not to be confused with midwifes or doulas. The CNMs are carefully trained to determine if intervention by MDs is required.
 
Purely anecdotal, but it seems the US in general seems to push a huge amount of intervention when it comes to birth and it seems very ‘scheduled’.

Im not based in the US, but am part of an online community for pregnancy and childbirth, which is mostly US posters. Much of the conversation for those coming up to the last few weeks of pregnancy is all about the dates they have inductions or c-sections booked, which is in stark contrast to other posters who come from countries where they just wait for birth to happen more naturally.

Most the reasoning from the posters is due to them wanting to give birth at specific times so they can manage work/no maternity leave. Some of it also seemed to be convenience from the doctor’s end as many women wanted specific doctors to deliver their babies and i suppose that is far less easy with a ‘just watch and wait’ approach.
 
Allegra said:
I always assumed that this was an outlaying situation and a particularly lousy doctor, but after participating in the aforementioned online discussion, this is apparently a much more common thing than I thought and some women feel pressured by their employers to deliver by c-section. Thinking back, I remember that with my last two pregnancies, I was asked to provide a date for my delivery. I was also contacted by my direct supervisor in both cases and told that he “needed to know” in order to get coverage for me. At the time, I just laughed and chalked it up to the general stupidity of bureaucracy, but in retrospect, I could see someone less oblivious than myself taking that as pressure to arrange a c-section. My employer also has a policy that gives two extra weeks of paid leave to parents who deliver by c-section. I always assumed that was because the employee would need two extra weeks to heal from surgery, but assuming a world where a woman can ask for a c-section for non-medical reasons, that does sort of put the pressure on.

The group I was having the discussion in is a wide variety of walks of life, including a larger percentage women who work for hourly wages and don’t have access to the most reputable health care, so I was curious about the demographic in this forum, which is probably more middle class to affluent, and health-conscious in general. Have you ever heard of someone being pressured into a c-section for non-medical reasons? Have you ever heard of someone being able to persuade the doctor into doing one? Any idea why a person would prefer this to an induction? I know they do these for non-medical reasons as my second pregnancy was induced (at full term) as my doc was going on a medical mission to Haiti and I didn’t want to be left at the mercy of whatever floor doctor happened to be around that day. But a c-section is a lot different!
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Interesting. I have read that there seems to be an increase in C-section births for whatever reason, although I have not heard of it being due to outside pressure. I remember filling out the FMLA paperwork for when my son was born in 2018 and it was asking for a date. I put the due date down, although I told HR that I couldn’t be certain of when he would actually be born, and they didn’t pressure me either way, saying that FMLA would start whatever day that I give birth, I would just have to notify them.

Coincidentally, my son ended up flipping halfway through the pregnancy, and ended up breech, so I did have a C-section and was able to later inform HR of the procedure date. But in no way did I ever feel pressured to have a C-section.

As a side note, I was part of Catholic mothers due date group on Facebook, and I remember when the topic of birth plans and types of birth (natural, induction, C-section, etc.) would come up…I remember being surprised at all the options. It was a whole new world of strong opinions and desires!
 
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It, IMO, is a wonderfully peaceful way to have a baby. At least that was my experience. I highly recommend it, when available.

Of course, I was in my 20’s and recovery was a snap.
 
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I’m opting for one. (NHS) I am and have always been terrified of ‘natural’ childbirth and psychologically been thru enough the past few years not to have be fretting about severe pain, post partum complications etc. It’s against the law In the Uk for an employer to indirectly pressure people like it sounds as tho is happening with the OP. I was told ‘oh the doctors will try and talk you out of it’ but quite the opposite they said it’s your birth your decision. Been very blessed
 
redal said:
The CNMs are carefully trained to determine if intervention by MDs is required.
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As are Licensed Professional Midwives (LPM), licensed to practice in many, but not all, states.
 
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That’s really strange to me, because most women I know worry about c-sections for the very same reasons! All three of my children were delivered vaginally and none of them involved what I’d call “severe pain”. My first two were induced, so the drugs were at the ready from the beginning. If I was terrified of pain, I’d definitely go for an induced vaginal delivery before abdominal surgery because I know from my mom and sister that recovery from that IS painful. I actually slept through most of my first labor and they had to wake me up to start pushing! And surgery has a much higher rate of complications, not to mention the fact that I find the idea of laying there, fully awake, while they slice me open, unpack my internal organs and set them on my stomach, slice me open again, then stuff it all back in pretty darn horrifying. I mean, of course I’d do it for my child if that’s what’s best, but it’s not something I’d sign up for for kicks!
 
But not everybody has the same experience or desires you do. Labor can be nightmarish, and it is totally unpredictable. Every woman considering an elective cesarean should be fully and accurately informed about the risks and benefits of elective cesareans AND trials of labor, then allowed to deliver as she wishes.
 
I am aware that you can choose an elective c section in your contry. Yes an elective c section will prevent any labor, but the recovery pain can be much more difficult. It is also difficult, according to many women who have had c section to care for themselves in the immediate post partum, let alone to care for their newborn and breasteed them without any help.The receovery of this surgery is longer, that’s why they usuallu stay longer in hospital after.

And the risk for the mother and the newborn such as difficulty to breath alone at first are much more important than in natural birth.

Labor is not always so painfull and so difficult, but anticipated fear and stress can be a negative factor.
 
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