Note in the debate. According World Helath Organization, the acceptable rate of caesarians
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heidi_storage
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That number isn’t evidence based, nor is it current. About 19% seems to be best, according to this study:
Also, as I pointed out earlier, even purely elective cesarean deliveries may prevent some surgeries later in life, for incontinence, prolapse, and fistula.
I’ll agree that the recovery for an uncomplicated . . . natural . . . delivery is better than the recovery for a cesarean–but add that “uncomplicated” can turn to “yikes” very quickly.
Look, again, my own three vaginal deliveries (with epidurals, in a hospital) were fine. If I’m blessed with another little one, I hope to deliver . . . naturally. . . . But this isn’t the same as saying that attempting . . . natural . . . delivery is best for all women–I just don’t think that’s true.
Also, as I pointed out earlier, even purely elective cesarean deliveries may prevent some surgeries later in life, for incontinence, prolapse, and fistula.
I’ll agree that the recovery for an uncomplicated . . . natural . . . delivery is better than the recovery for a cesarean–but add that “uncomplicated” can turn to “yikes” very quickly.
Look, again, my own three vaginal deliveries (with epidurals, in a hospital) were fine. If I’m blessed with another little one, I hope to deliver . . . naturally. . . . But this isn’t the same as saying that attempting . . . natural . . . delivery is best for all women–I just don’t think that’s true.
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blackforest
Well-known member
We don’t have such a credential in my state. Is this the same as CPM, (Certified Professional Midwives)? CPMs train largely through apprenticeship. They’ve started teaming up with CNMs so that they can take on both low and slightly higher risk cases.
All of my births were attended by a CPM. I chose the out-of-hospital route.
All of that said, properly applied cesareans save lives and prevent those horrible double headstones of yesteryear.
It gets hair-splitting. I’d be comfortable with a 15-19% rate for primiparous women. Right now, there’s a national initiative to lower it to 23.9%. Women can research their counties and even individual hospitals here. New! State Dashboards — Cesarean Rates
The research on this is actually variable, quite dicey, and not at all black and white.
https://www.researchgate.net/public...mode_of_delivery_and_pelvic_floor_dysfunction
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gracepoole
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Um, the word “elective” here is what’s confusing to some. I had three breech babies – my c-sections were technically elective but I wouldn’t have wanted to go natural given the circumstances. So I guess I’m part of the “rampant” explosion in elective c-sections.Allegra:
I don’t know why you find this suspicious. Elective c sections have been rampant for years.
Honestly, OP, you aren’t pregnant so you don’t even need to think about this. When you are pregnant, choose a great doctor and you won’t have anything to worry about.
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gracepoole
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Enjoy the recovery – if I could have been up and walking around the same day as giving birth, I definitely would have gone that route. BTW, each subsequent c-section is usually harder on your body.
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Pattylt
Guest
I am really amazed at the choices women have these days. I gave birth to my children in the mid 1970’s when c-sections were only performed due to emergencies or previous c-sections. I was a kind of hippy mom in those days and was one of the first to demand no drugs during labor or delivery. I wanted no episiotomy unless I was actively tearing. Most moms were knocked out for the delivery and I was adamant I wanted to be awake. I had to scream at the nurses for trying to put me under at one point.
I lucked out in that I had very normal deliveries and quickly recovered. If things had gone south, I’m not sure I would have handled it very well. I was so determined to do natural childbirth, I would have felt like a failure if anything had been different. Looking back on it, I would have been much better to realize that I had preferences but not been so demanding!
Having witnessed so many friends and family go through various different scenarios of childbirth you tend to realize that healthy baby is worth whatever you go through and whatever complications you have to later deal with. I still look upon my “glow in the dark” stretch marks as my battle wounds of baring babies. I wouldn’t give up a single one of them!
I lucked out in that I had very normal deliveries and quickly recovered. If things had gone south, I’m not sure I would have handled it very well. I was so determined to do natural childbirth, I would have felt like a failure if anything had been different. Looking back on it, I would have been much better to realize that I had preferences but not been so demanding!
Having witnessed so many friends and family go through various different scenarios of childbirth you tend to realize that healthy baby is worth whatever you go through and whatever complications you have to later deal with. I still look upon my “glow in the dark” stretch marks as my battle wounds of baring babies. I wouldn’t give up a single one of them!
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heidi_storage
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The study shows that mortality increases up to 19%, so I don’t think a lower rate is optimal. The study you describe–which I also cited–doesn’t seem to be too contradictory about the lowered incidence of pelvic floor dysfunction. Certainly a woman may prefer vaginal delivery if possible–I do! But I don’t think that cesareans are this great bugaboo to be avoided at all costs.
blackforest
Well-known member
The lower incidence in PFD is only temporary and mitigated by age, rendering itself irrelevant.
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heidi_storage
Guest
In SOME disorders, that’s true–and I wouldn’t call it irrelevant to develop incontinence at 65 vs 45, for example! That’s a lot of quality of life lost.
blackforest
Well-known member
It would nonetheless be disingenuous to sell women on cesareans as a PFD preventative, especially when you factor in pregnancy itself, (after 20 weeks), as a contributing factor. Does cesarean delivery prevent anal incontinence? - PubMed Note that there are some commonsense measures to take during delivery to prevent both vaginal and anal fissures. The stronger predictive factor for post-partum UI would be BMI. The prevalence of urinary incontinence 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery - PubMed
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F_Marturana
Guest
I think it might be explained this way.
The first c-section decided in the delivery room due to complications is deemed medically necessary.
The following ones that the doctor thinks are necessary are deemed elective, because they are scheduled. A v-bac could be possible, but doctor and patient rule it out for various medical reasons,
The first c-section decided in the delivery room due to complications is deemed medically necessary.
The following ones that the doctor thinks are necessary are deemed elective, because they are scheduled. A v-bac could be possible, but doctor and patient rule it out for various medical reasons,
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JanetF
Guest
Me too! My only delivery was cesarean due to baby being in frank breach position (her feet were up by her head and her fingers were down tickling my bladder), and she wouldn’t budge. Her head was stuck up under my breast bone and the doctor had to wiggle her free (what a strange feeling that was). Up until age 2 she would often sleep in her “fetal” position which freaked out her babysitter and she would move her…but I digress.I had three breech babies – my c-sections were technically elective but I wouldn’t have wanted to go natural given the circumstances. So I guess I’m part of the “rampant” explosion in elective c-sections.
Cesarean is not something I would consider if not medically necessary (first baby in breach position made it medically necessary 22 years ago). The recovery is harder and longer. I was 33 years old and had no complications, but complications can and do happen. I also wouldn’t have induced for convenience as I was told that labor is more difficult (again that was 22 years ago, so take that with a grain of salt)
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JulianN
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I was strongly pressured into a VBAC – let’s just say I’d never recommend that.
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babochka
Guest
Licensed midwives are licensed by the medical board in their state, which sets the criteria for a license for a direct-entry midwife (someone who doesn’t have a RN). Being a CPM is one path to get there. In my state they can qualify though a combination of rigorous coursework and apprenticeship or they can challenge complete a challenge by exam. Each state that allows this varies it its licensing requirements.
Amen! I have had 5 c-sections and one vbac. While I firmly believe that my first c-section was unnecessary, I firmly believe that my next two were necessary. (One was an ear presentation that my very skilled midwife could not turn.) The next two were because it would have been foolish to attempt another vbac, even if a doctor of midwife would have taken me on.
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halogirl
Guest
There’s risks and pain with it all though, but for me, c section risks and pain are the sort I feel psychologically able to manage. Plus I’ll have husband looking after me after the operation he will have a month off so it’s all good
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gracepoole
Guest
Had my first c-section at 33, too!gracepoole:
Me too! My only delivery was cesarean due to baby being in frank breach position (her feet were up by her head and her fingers were down tickling my bladder), and she wouldn’t budge. Her head was stuck up under my breast bone and the doctor had to wiggle her free (what a strange feeling that was). Up until age 2 she would often sleep in her “fetal” position which freaked out her babysitter and she would move her…but I digress.I had three breech babies – my c-sections were technically elective but I wouldn’t have wanted to go natural given the circumstances. So I guess I’m part of the “rampant” explosion in elective c-sections.
Cesarean is not something I would consider if not medically necessary (first baby in breach position made it medically necessary 22 years ago). The recovery is harder and longer. I was 33 years old and had no complications, but complications can and do happen. I also wouldn’t have induced for convenience as I was told that labor is more difficult (again that was 22 years ago, so take that with a grain of salt)
I actually missed feeling my girl’s head just under my breastbone once she was delivered. Haha. I, too, wouldn’t have done a c-section if it weren’t necessary.
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halogirl
Guest
Very unlikely to be more pregnancies but I’ll bear that in mind xx
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heidi_storage
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I don’t think women should be “sold” on cesareans at all! That said, I don’t see why we shouldn’t disclose the risks of attempting vaginal delivery and the benefits of cesarean delivery along with the benefits of attempting vaginal delivery and the risks of cesarean delivery.
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heidi_storage
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Anecdata here: My induction was the easiest of my three deliveries. Looooooved it. Hardly any pain to speak of; no staying up all night to wait on Baby; I walked out of the hospital 30 hours after I walked in, reasonably refreshed because I didn’t have the all-night labors I had with my first two. Of course, I was past 40 weeks and it wasn’t my first time delivering, so I’m sure I couldn’t generalize. Two of my coworkers were induced for their first kiddos, and those inductions sucked hard.
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halogirl
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Yep this is what I want to avoid. I cannot cope with the idea of that much pain, simple as. And the fear of the unknown as another post said it can be going fine then really not in a very short space of time. After the last couple of years I need some control back
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