Cesarean or (natural) birth

catchery · 24-02-2011 5:57pm

ktod wrote: »

If a woman has an epidural at all, then some - but only some - can get into the baby's systerm. It is regarded as being very low risk, and with no long term problems.

There's information all over the internet about it, but from personal experience, neither of my two c-section babies were sluggish (far from it) or had trouble latching on.

hi to anyone who is pregnant at the moment ,and hope whatever way your baby comes into the world you will both be fine ! every pregnancy is different as is every birth ! these stories are all individual and what works for some might be hell for someone else.
i listened to all the stories on my first and was very confused as to what threshold of pain i had , and so what to do ?
i ended up asking for an epi and could not feel a thing , which sounds great but could not push baby out, ended up with a forceps delivery and months of recovery ! i never realised ,or read, or was told, that epi births have a much higher risk of assisted delivery!!
obviously i was told it kills the pain and you just push out the baby ! not so!
i would not wish anyone to go what i went through so many stitches!
so i wanted to go completely natural on my second ( yes i did it again , even though i was offered trauma conselling after my first)
i read a hypnotherapy book and looked at ways to relax , i had my 10lb son natural with no pain relief , but i knew what was ahead of me , also i had told anyone who listened that no forceps was to be used ever , i wanted a section if there was any problems. and no my vagina did not turn into a saddlebag after my first if anything it was smaller !
i think its fear of your pain tolerence and the unknown .
that was my experience, but i can never have another natural birth as i reopened all old wounds on my second , and still it wasnt as bad as my first . so if we do go again it will be by section and thats the way it is !
just try not to get to negative about what you can and cannot do , you will surprise yourself! and my god when you get to hold your baby nothing takes away from that it is the best feeling in the world and you dont care about anything else!!;)

Grawns · 24-02-2011 8:02pm

SanFran07 wrote: »

This is a bit of a stretch - there is no evidence to show elective surgery is safer for healthy babies.

This isn't of particular signifiacnce but there is plenty of evidence. There's a higher risk with vaginal delivery and emergency sections ( takes place after failed labour) of problems including , cerebral palsy, birth injuries, neonatal infection and stillbirth. In addition placental failure is a risk when going overterm while waiting to be either induced or go into sponataneous labour.

When you go to have a planned elective section you have a statistically higher chance of having an unharmed baby then any other form of delivery. However conversely there are additional risks for the Mother associated with abdominal surgery including hysterectomy ( which is also a risk of vaginal birth). These risks are not significant ( but scary all the same) just as the risk to the baby of a vaginal birth are not statistically significant unless the method of delivery contravenes medical advice.

I really do believe that every women should be aware that labour can go wrong and often does. It's not anyone's fault! Before medial advances women and babies used to routinely die and we are very lucky to live in such a safe and modern society where such outcomes are very rare. For the most part babies are born safely without incident.

SanFran07 · 25-02-2011 11:33am

Grawns wrote: »

This isn't of particular signifiacnce but there is plenty of evidence. There's a higher risk with vaginal delivery and emergency sections ( takes place after failed labour) of problems including , cerebral palsy, birth injuries, neonatal infection and stillbirth. In addition placental failure is a risk when going overterm while waiting to be either induced or go into sponataneous labour.

When you go to have a planned elective section you have a statistically higher chance of having an unharmed baby then any other form of delivery. However conversely there are additional risks for the Mother associated with abdominal surgery including hysterectomy ( which is also a risk of vaginal birth). These risks are not significant ( but scary all the same) just as the risk to the baby of a vaginal birth are not statistically significant unless the method of delivery contravenes medical advice.

I really do believe that every women should be aware that labour can go wrong and often does. It's not anyone's fault! Before medial advances women and babies used to routinely die and we are very lucky to live in such a safe and modern society where such outcomes are very rare. For the most part babies are born safely without incident.

I'd really like to read the evidence you refer to so if you can reference it I'd appreciate it. There is no evidence comparing spontaneous normal birth outcomes and elective cesareans that show it is the safer option for healthy babies. If it was then why are Midwife Led units being promoted by the HSE? Why not just plan elective sections for all Mothers and skip labour altogether?

Only a small percentage of CP is associated with normal birth (think it's around 10%). The majority of problems happen during pregnancy or during the first 3 years of life. In a normally progressing spontaneous birth (around 80%) birth injuries are rare. Birth injuries happen during cesarean sections including scalpel injuries, broken limbs and forceps injuries. Neonatal infection is not always prevented by caesarean section - group b strep can also be found in amniotic fluid. Stillbirth is a risk in every pregnancy and not limited to any particular mode of delivery. Although a risk might not seem significant to you it's very significant to the mother/baby it occurs to and it's well documented that cesarean birth is associated with a statistically significant maternal death rate.

Labour is more likely to go 'wrong' when it is interferred with without a medically compelling reason which happens quite often in Ireland.

I agree that we are very lucky to have all of the expertise, equipment etc available to us if a Mum and baby need it compared to other countries but we have a long way to go when it comes to providing safe, evidence based care to Mums to be as there are no national maternity guidelines (Cuidiu will have their new consumer guide published soon which will again show how different hospitals fare).

Grawns · 25-02-2011 3:47pm

I think we are both biased as I fail to see your point. You restate the risks in pregnancy but fail to mention how certain risks are minimized by an elective section. You compare an elective section with an uncomplicated vaginal delivery but as you know this is not a likely outcome due to severe pressure on Maternity services. You acknowledge CP is associated with normal birth, and say 10% but you don't acknowledge that this risk is specific to vaginal birth and minimal in elective sections. You mention that stillbirth is a risk in every pregnancy but not the additional risk of placental failure due to going over 40 weeks - again not a risk in a planned section at 39 weeks. Strep b infection should be tested for, and I don't know why it's not but HIV+ mothers and those carrying viral infections such as herpes will have sections to prevent transfer of infections.

Essentially you are only comparing a spontaneus uncomplicated vaginal delivery with an elective section and as you must know yourself this is a happy outcome but unlikely. The outcome is more likely to be a so-called natural childbirth, (so called because of the intervention of modern medicine (induction, episiotomies, assisted delivery, fetal monitoring, epidurals etc)

Why are Midwife Led units being promoted by the HSE? Why not just plan elective sections for all Mothers and skip labour altogether

I have nothing against midwives but they are very biased against the encrouchment of elective sections into their sphere. I can't blame them- it's their work being undermined and compromised howeverI think it would be great if they could help all mothers rather than specializing in vaginal deliveries. Women should always be there for each other.

As to why not plan elective sections for all mothers and skip labour altogether. Well Sections are more expensive (not a lot but still!) and as I mentioned they are more risky for the mother while being margianally safer for the baby. I think if Men gave birth thay would have abolished labour centuries ago.

I will go through all my research and pm the links to you. You will find some citations in my earlier postings.

mumtoe&e · 26-02-2011 12:06am

Grawns wrote: »

I think we are both biased as I fail to see your point. You restate the risks in pregnancy but fail to mention how certain risks are minimized by an elective section. You compare an elective section with an uncomplicated vaginal delivery but as you know this is not a likely outcome due to severe pressure on Maternity services. You acknowledge CP is associated with normal birth, and say 10% but you don't acknowledge that this risk is specific to vaginal birth and minimal in elective sections. You mention that stillbirth is a risk in every pregnancy but not the additional risk of placental failure due to going over 40 weeks - again not a risk in a planned section at 39 weeks. Strep b infection should be tested for, and I don't know why it's not but HIV+ mothers and those carrying viral infections such as herpes will have sections to prevent transfer of infections.

Essentially you are only comparing a spontaneus uncomplicated vaginal delivery with an elective section and as you must know yourself this is a happy outcome but unlikely. The outcome is more likely to be a so-called natural childbirth, (so called because of the intervention of modern medicine (induction, episiotomies, assisted delivery, fetal monitoring, epidurals etc)

Why are Midwife Led units being promoted by the HSE? Why not just plan elective sections for all Mothers and skip labour altogether

I have nothing against midwives but they are very biased against the encrouchment of elective sections into their sphere. I can't blame them- it's their work being undermined and compromised howeverI think it would be great if they could help all mothers rather than specializing in vaginal deliveries. Women should always be there for each other.

As to why not plan elective sections for all mothers and skip labour altogether. Well Sections are more expensive (not a lot but still!) and as I mentioned they are more risky for the mother while being margianally safer for the baby. I think if Men gave birth thay would have abolished labour centuries ago.

I will go through all my research and pm the links to you. You will find some citations in my earlier postings.

Could you pm your citations to myself as well please - as I am somewhat interested in your "findings" :rolleyes: - Thank you

axel rose · 26-02-2011 12:22am

Ok this is stupid. Grawns and I have both admitted to deciding to have our children bu CS. We are not stupid people, we both discussed the issue with our consultants who knew our medical histories and our reasons for our decision.

I assume that like myself, grawns was advised by her consultant to go and do some reaearch. We decided to have our children by CS.

Is this debate the new pro-choice topic? How someone chooses to give birth is no ones business but their own.

Grawns has already stated that she will throw up the links- why the smart arse :rolleyes:?

I would have thrown up my own research but I ditched them when I knew I wasn't having any more babies. Its stressful enough facing childbirth and rearing children- why not put your judgypants back in the drawer and support each other eh?

mumtoe&e · 26-02-2011 12:39am

axel rose wrote: »

Ok this is stupid. Grawns and I have both admitted to deciding to have our children bu CS. We are not stupid people, we both discussed the issue with our consultants who knew our medical histories and our reasons for our decision.

I assume that like myself, grawns was advised by her consultant to go and do some reaearch. We decided to have our children by CS.

Is this debate the new pro-choice topic? How someone chooses to give birth is no ones business but their own.

Grawns has already stated that she will throw up the links- why the smart arse :rolleyes:?

I would have thrown up my own research but I ditched them when I knew I wasn't having any more babies. Its stressful enough facing childbirth and rearing children- why not put your judgypants back in the drawer and support each other eh?

I have not witnessed any "smart arse" on this thread - I will refrain from stating what I have however witnessed.
I think many of us are merely interested in reading all this research - could come in handy for our own research purposes

vanessamee · 26-02-2011 12:43am

Congrats! I ave had both and for a fast recovery def natural labour as danting as it may seem its not dat bad i think anyhow plus alot of different drugs now to ease the pain! All the best

axel rose · 26-02-2011 12:45am

then please explain your use of "......" when you referrred to Grawns findings, also would like know why you used the :rolleyes:?

I read your initial post as you dismissing grawns' research.

Glad everything went well vanessamee- hope the wee one sleeps till the big hours!

Babyblessed · 26-02-2011 12:57am

Grawns wrote: »

I think we are both biased as I fail to see your point. You restate the risks in pregnancy but fail to mention how certain risks are minimized by an elective section. You compare an elective section with an uncomplicated vaginal delivery but as you know this is not a likely outcome due to severe pressure on Maternity services. You acknowledge CP is associated with normal birth, and say 10% but you don't acknowledge that this risk is specific to vaginal birth and minimal in elective sections. You mention that stillbirth is a risk in every pregnancy but not the additional risk of placental failure due to going over 40 weeks - again not a risk in a planned section at 39 weeks. Strep b infection should be tested for, and I don't know why it's not but HIV+ mothers and those carrying viral infections such as herpes will have sections to prevent transfer of infections.

Essentially you are only comparing a spontaneus uncomplicated vaginal delivery with an elective section and as you must know yourself this is a happy outcome but unlikely. The outcome is more likely to be a so-called natural childbirth, (so called because of the intervention of modern medicine (induction, episiotomies, assisted delivery, fetal monitoring, epidurals etc)

Why are Midwife Led units being promoted by the HSE? Why not just plan elective sections for all Mothers and skip labour altogether

I have nothing against midwives but they are very biased against the encrouchment of elective sections into their sphere. I can't blame them- it's their work being undermined and compromised howeverI think it would be great if they could help all mothers rather than specializing in vaginal deliveries. Women should always be there for each other.

As to why not plan elective sections for all mothers and skip labour altogether. Well Sections are more expensive (not a lot but still!) and as I mentioned they are more risky for the mother while being margianally safer for the baby. I think if Men gave birth thay would have abolished labour centuries ago.

I will go through all my research and pm the links to you. You will find some citations in my earlier postings.

What is normal labour?? Well what is normal pregnancy?

Normal pregnancy as defined by the WHO is 37-42weeks gestation. Therefore 40 weeks is not early or late its sort of in the middle!

varying different studies discuss the merits or lack there of of induction; these might include how scanning can often be inaccurate and does not take into account the individual womans menstrual cycle. Induction itself carries an increased risk of more painful labour (therefore more chance of epidural), instrumental birth... etc Continuous fetal monitoring itself has risks as the most recent studies will prove.... Infact one of the most awkward positions for a baby to be in; OP or back-to-back is proven to be more common today and probably cos of our more sedentary lifestyles.

Anyway, Im sure its called the cascade effect...........

The severe pressure isnt on maternity services its on mums. Maternity services/midwives will perform to their best whatever and where-ever. Optimal care for mam and babe is the foremost concern whatever your mode of birth!

Sections are probably 3 times more expensive than normal hospital birth and infinately more expensive than normal home birth........ which I admit is certainly not for everyone.

Natural spontaneous birth is safer for mum and baby.

January · 26-02-2011 10:36am

If people have a problem with posts, please report them and stop the on thread bickering.

Grawns · 26-02-2011 9:24pm

Huge can of worms! :eek:. Anyways! Chillax guys! I will pm the people who asked a load of links and they can read away to the hearts content

. Most are on my iphone at the moment so it may take a day or two.

It's very easy to google evidence to back up your point of view as well as to dismiss others. So I don't expect people to change their views but perhaps be more educated about the bigger picture. As I mentioned earlier -ask your doctor ( not your midwife - they are not impartial in this area).

The doctor will tell you what I keep repeating that it's safer for the baby but riskier for the mother. However a section being safer for the baby doesn't make vaginal birth dangerous, just statistically less safe. For example if there is a less than 1% chance of shoulder dystocia occuring, this is 0% in a planned section.

I don't want to post a load of random evidence here that may make people fearful of vaginal birth. Women have been doing it forever and now thanks to emergency sections, forceps, ventouse etc, very few mothers or babies die or are terribly injured. Likewise the likes of me who choose to have sections are inviting other complications but they are uncommon and we are doing it with our eyes wide open.

I am a huge fan of planned sections for people who want them just as I think water births, hynobirths, epidurals etc are great if that's what you want. The birth of your choice is a human right. However all women should be aware of the risks involved in birth ( whether section or vaginal) and the liklihood of medical intervention and injury so that it does not come as a huge shock. A bad labour can be linked to poor bonding and an increased risk of post natal depression.

I'm definitely more in the knowledge is power school of thought than ignorance is bliss..

I really hope that everyone has a positive experience of childbirth. I certainly did.

mumtoe&e · 26-02-2011 10:48pm

Grawns wrote: »

Huge can of worms! :eek:. Anyways! Chillax guys! I will pm the people who asked a load of links and they can read away to the hearts content . Most are on my iphone at the moment so it may take a day or two.

It's very easy to google evidence to back up your point of view as well as to dismiss others. So I don't expect people to change their views but perhaps be more educated about the bigger picture. As I mentioned earlier -ask your doctor ( not your midwife - they are not impartial in this area).

The doctor will tell you what I keep repeating that it's safer for the baby but riskier for the mother. However a section being safer for the baby doesn't make vaginal birth dangerous, just statistically less safe. For example if there is a less than 1% chance of shoulder dystocia occuring, this is 0% in a planned section.

I don't want to post a load of random evidence here that may make people fearful of vaginal birth. Women have been doing it forever and now thanks to emergency sections, forceps, ventouse etc, very few mothers or babies die or are terribly injured. Likewise the likes of me who choose to have sections are inviting other complications but they are uncommon and we are doing it with our eyes wide open.

I am a huge fan of planned sections for people who want them just as I think water births, hynobirths, epidurals etc are great if that's what you want. The birth of your choice is a human right. However all women should be aware of the risks involved in birth ( whether section or vaginal) and the liklihood of medical intervention and injury so that it does not come as a huge shock. A bad labour can be linked to poor bonding and an increased risk of post natal depression.

I'm definitely more in the knowledge is power school of thought than ignorance is bliss..

I really hope that everyone has a positive experience of childbirth. I certainly did.

Thank you - I shall await your pm

SanFran07 · 27-02-2011 10:40am

Grawns wrote: »

Huge can of worms! :eek:. Anyways! Chillax guys! I will pm the people who asked a load of links and they can read away to the hearts content . Most are on my iphone at the moment so it may take a day or two.

It's very easy to google evidence to back up your point of view as well as to dismiss others.

Grawns yes I totally agree that you will find evidence to support every argument on Google so I'm hoping when you PM me your evidence they are peer reviewed RCTs along the lines of the Cochrane database. I'm sure you'll reference internationally recognised studies referenced by UK and US obstetricians.

Grawns wrote: »

As I mentioned earlier -ask your doctor ( not your midwife - they are not impartial in this area).

Can you elaborate on this? There is no financial gain for a Midwife no matter how a baby is born.....Midwives are trained to facilitate normal birth which is a different speciality to obstetrics (complicated birth). You mentioned in an earlier post that the only reason why all women aren't giving birth by caesarean is because of the cost....so to follow the logic of your reasoning you are saying that the HSE, NHS etc etc are knowingly putting babies at risk every day by not finding a way to facilitate caesarean births for all of these women? Would that be accurate?

Grawns wrote: »

The doctor will tell you what I keep repeating that it's safer for the baby but riskier for the mother. However a section being safer for the baby doesn't make vaginal birth dangerous, just statistically less safe. For example if there is a less than 1% chance of shoulder dystocia occuring, this is 0% in a planned section.

Your Doctor told you this. The Royal College of Obstetricians would not agree.

Likewise you could also say that in a spontaneous vaginal birth there is a 0% risk of your baby being cut by a scalpel....and an x% change in a caesarean....

Grawns wrote: »

I don't want to post a load of random evidence here that may make people fearful of vaginal birth.

I think that horse has already left the barn...

Grawns wrote: »

I am a huge fan of planned sections for people who want them just as I think water births, hynobirths, epidurals etc are great if that's what you want. The birth of your choice is a human right. However all women should be aware of the risks involved in birth ( whether section or vaginal) and the liklihood of medical intervention and injury so that it does not come as a huge shock. A bad labour can be linked to poor bonding and an increased risk of post natal depression.

I agree with most of what you've said here - but a bad pregnancy can also increase PND - there are a multitude of factors.

The birth of your choice is a human right but I would like to see elective caesareans (caesareans that are not medically necessary) not paid for by the taxpayer and taking place in private hospitals so the already over stretched maternity units can care for women who have not opted for unnecessary surgery.

It's interesting that according to AVIVA etc every single caesaren that has taken place in the last few years for any of their members has been an 'emergency'.....so it looks like there are in fact no elective (maternal choice) caesareans happening in Ireland so this discussion is really a non event....

metrovelvet · 27-02-2011 12:46pm

grawns - a section can also lead to poor bonding and all sort of troubles and they are very expensive, in the US about $30,000 so don't tell me there isnt a financial interest in pushing the section.

Given the mrsa rate in Irish hospitals I would not be so keen to have one here. Also a woman I know was cut open for a section with a dirty instrument in an IRish hospital and had to get the infection, pus sucked out of her every day for six weeks after wards.

FutureMom2Two · 27-02-2011 1:11pm

Just to back up what you said SanFran07 there practicly are no 'elective sections' without medical reason happening in the public system.
I regard those who had a choice as lucky to have it.
I'm pregnant with twins from IVF.
I don't have a choice in my delivery method
If my twin 1 is head down that means I'm automaticlly supposed to have a vaginal birth even though its risky for both me and my babies and carries up to 50% chance of emergency section(or so I'm told)

My twin 2 is transverse/breech and is bigger than twin 1.
I have anterior placentas so they shouldnt attempt external manipulation increasing the risk one twin will be delivered vaginally and the other by section.
To top all this I've battled with vaginal infections all this pregnancy including strep so for me antibtiotics or not I'd feel safer having on elective section
They want to force epidurals on twin deliveries because of the risk of section but why put me through labour if I can't have the choices I want anyway which would be a labour where I could move around.

However I feel for the safety of my babies on elective section would be best but because the government wants to save money I have to suffer a labour of medical interventions with a high risk of section anyway.

metrovelvet · 27-02-2011 1:15pm

I would also say the term 'elective' is misleading. I had an 'elective' section but after a 23 hour failed induction, an infection and the baby's head stuck mid contraction, where the contraction stuck and did not uncontract, and a risk of cerebral palsy I chose my 'elective section'.

Babyblessed · 27-02-2011 2:09pm

Grawns wrote: »

Huge can of worms! :eek:. Anyways! Chillax guys! I will pm the people who asked a load of links and they can read away to the hearts content . Most are on my iphone at the moment so it may take a day or two.

It's very easy to google evidence to back up your point of view as well as to dismiss others. So I don't expect people to change their views but perhaps be more educated about the bigger picture. As I mentioned earlier -ask your doctor ( not your midwife - they are not impartial in this area).

The doctor will tell you what I keep repeating that it's safer for the baby but riskier for the mother. However a section being safer for the baby doesn't make vaginal birth dangerous, just statistically less safe. For example if there is a less than 1% chance of shoulder dystocia occuring, this is 0% in a planned section.

I don't want to post a load of random evidence here that may make people fearful of vaginal birth. Women have been doing it forever and now thanks to emergency sections, forceps, ventouse etc, very few mothers or babies die or are terribly injured. Likewise the likes of me who choose to have sections are inviting other complications but they are uncommon and we are doing it with our eyes wide open.

I am a huge fan of planned sections for people who want them just as I think water births, hynobirths, epidurals etc are great if that's what you want. The birth of your choice is a human right. However all women should be aware of the risks involved in birth ( whether section or vaginal) and the liklihood of medical intervention and injury so that it does not come as a huge shock. A bad labour can be linked to poor bonding and an increased risk of post natal depression.

I'm definitely more in the knowledge is power school of thought than ignorance is bliss..

I really hope that everyone has a positive experience of childbirth. I certainly did.

Im absolutely concerned about your obvious lack of knowledge of the role of the Midwife. Its very clear you view these degree level professionals very poorly.

From ABA .....

"Definition of a Midwife
An Bord Altranais endorses the definition of a midwife as adopted and amended by the International Confederation of Midwives in 2005.
The definition states that: "A midwife is a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practise midwifery. The midwife is recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice
during pregnancy, labour and the postpartum period, to conduct births on the
midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures. The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care. A midwife may practise in any setting including the home, community, hospitals, clinics or health units."
Adopted by the International Confederation of Midwives Council meeting in Brisbane, Australia, on 19 July, 2005."
(ABA 2010 Practice Standards for Midwives ABA Dublin p4)

I guess that reference wont suit because its from the regulatory board for nurses and midwives........

Midwives are trained to deal with the normal and 'abnormal'.

Babies born by cs are more at risk of TTN and RDS, therefore more at risk of a stay in Neonatal...... Also they are at risk of being cut by a scalpel as mentioned above.

Mums are at risk of an unnecessary scarring, infection, DVT, problems following epidural, urinary tract infectons, bladder damage, increased blood loss (and associated risks there after)

I'd also like to see this reference list!

As I was posting I caught someone (sorry it flashed up at the bottom of my scree so didnt get name) posting about the use of the word 'elective. If you experience labour and you end up with a section then thats not an elective thats an emergency.

If you choose to not have experience of labour and choose to have a caesarean section prior to labour beginning (for whatever reason) then thats an elective. By their nature they are undertaken before 40 weeks (which means some women might start to labour before they come in for their ELECTIVE section) which means babies may be early and therefore at increased risk of prematurity and of course associated risks there of. We generally judge ESTIMATED delivery date by scan rather than mothers menstrual cycle and scans can be inaccurate and see us all as 40 week incubators rather than see us as individuals.
For example, my cycle might be 35-40 days, I might not ovulate til late in the cycle. My scans might show my baby as being inaccurate for dates and my EDD might change. I then end up needing a CS, because of placenta praevia grade 4 (for example and a legit reason for CS). They decide to do this at 38+5 going on my scan dates but infact my baby should wait a little longer to allow for development................. baby well and delivered by the best method but needs a 10days stay in NNU because he was actually premature......

There are reasons to do CS, legitimate ones but if they were the safest overall then the HSE would section every woman, especially if as you suggest its as cheap or nearly as cheap! They certainly wouldnt be concerned and holding study days on how to reduce the section rate.

Babyblessed · 27-02-2011 2:23pm

FutureMom2Two wrote: »

Just to back up what you said SanFran07 there practicly are no 'elective sections' without medical reason happening in the public system.
I regard those who had a choice as lucky to have it.
I'm pregnant with twins from IVF.
I don't have a choice in my delivery method
If my twin 1 is head down that means I'm automaticlly supposed to have a vaginal birth even though its risky for both me and my babies and carries up to 50% chance of emergency section(or so I'm told)

My twin 2 is transverse/breech and is bigger than twin 1.
I have anterior placentas so they shouldnt attempt external manipulation increasing the risk one twin will be delivered vaginally and the other by section.
To top all this I've battled with vaginal infections all this pregnancy including strep so for me antibtiotics or not I'd feel safer having on elective section
They want to force epidurals on twin deliveries because of the risk of section but why put me through labour if I can't have the choices I want anyway which would be a labour where I could move around.

However I feel for the safety of my babies on elective section would be best but because the government wants to save money I have to suffer a labour of medical interventions with a high risk of section anyway.

I think what SanFran is saying is that figures are squewed (?sp). Thats my understanding of what was posted anyway!

Congrats on your twins.

From what Ive read the docs prefer the 2nd twin to be breech/transverse these days. If you have 2 anterior placentas I can understand why they would prefer vaginal delivery as the 'may' be a risk of haemorrhage if they cut into them during a cs. As for your infections if you are on ab's you should be safe. The risk is also present during pregnancy that strep can pass into the amniotic fluid so they are probably very carefully weighing up the risks not costs.

lynski · 27-02-2011 5:52pm

The birth of your choice is a human right but I would like to see elective caesareans (caesareans that are not medically necessary) not paid for by the taxpayer and taking place in private hospitals so the already over stretched maternity units can care for women who have not opted for unnecessary surgery.

It's interesting that according to AVIVA etc every single caesaren that has taken place in the last few years for any of their members has been an 'emergency'.....so it looks like there are in fact no elective (maternal choice) caesareans happening in Ireland so this discussion is really a non event....

Totally agree re tax payers as above, but i think you are wrong on elective sections. I know at least 2 women who have had them when they could have had vbacs, but did not want to.
I do not know anyone who has had a truly elective section, ie non-medical reason.

Babyblessed · 27-02-2011 7:00pm

lynski wrote: »

Totally agree re tax payers as above, but i think you are wrong on elective sections. I know at least 2 women who have had them when they could have had vbacs, but did not want to.
I do not know anyone who has had a truly elective section, ie non-medical reason.

If the could have had VBAC's, but did not 'want' to, then their sections were for non-medical reason; they were for personal choice......... obviously we dont know every detail.

I have seen sections scheduled because the woman wants one (usually private patients). She wants to have her baby when it suits her family arrangements, these type of sections are completely without medical basis. What SanFran is saying, is that in order to get paid the consultant must write something of medical importance on the claim form or the insurance company wont pay out. SO lets just say a woman wants a caesarean bacause her hubby will out of the country on business at her due date and she wants him there....... the consultant might agree to do a section on these grounds but cant write that on the VHI form so s/he will have to write something of medical importance. I doubt (I dont know) very much that VHI ask to see test results/scans etc, they really wont question the docs they just pay out.

Therefore VHI, AVIVA, etc have no records of social caesareans because they wont pay for them (even tho they are by default.)

I hope Sanfran can confirm I am understanding her right!

SanFran07 · 27-02-2011 7:04pm

http://www.independent.ie/national-news/too-tight-to-pay-too-posh-to-push-1206653.html

Seems like it's a can of worms even the health insurance companies don't want to open...

metrovelvet · 27-02-2011 8:23pm

Babyblessed wrote: »

Im absolutely concerned about your obvious lack of knowledge of the role of the Midwife. Its very clear you view these degree level professionals very poorly.

From ABA .....

"Definition of a Midwife
An Bord Altranais endorses the definition of a midwife as adopted and amended by the International Confederation of Midwives in 2005.
The definition states that: "A midwife is a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practise midwifery. The midwife is recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice
during pregnancy, labour and the postpartum period, to conduct births on the
midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures. The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care. A midwife may practise in any setting including the home, community, hospitals, clinics or health units."
Adopted by the International Confederation of Midwives Council meeting in Brisbane, Australia, on 19 July, 2005."
(ABA 2010 Practice Standards for Midwives ABA Dublin p4)

I guess that reference wont suit because its from the regulatory board for nurses and midwives........

Midwives are trained to deal with the normal and 'abnormal'.

Babies born by cs are more at risk of TTN and RDS, therefore more at risk of a stay in Neonatal...... Also they are at risk of being cut by a scalpel as mentioned above.

Mums are at risk of an unnecessary scarring, infection, DVT, problems following epidural, urinary tract infectons, bladder damage, increased blood loss (and associated risks there after)

I'd also like to see this reference list!

As I was posting I caught someone (sorry it flashed up at the bottom of my scree so didnt get name) posting about the use of the word 'elective. If you experience labour and you end up with a section then thats not an elective thats an emergency.

If you choose to not have experience of labour and choose to have a caesarean section prior to labour beginning (for whatever reason) then thats an elective. By their nature they are undertaken before 40 weeks (which means some women might start to labour before they come in for their ELECTIVE section) which means babies may be early and therefore at increased risk of prematurity and of course associated risks there of. We generally judge ESTIMATED delivery date by scan rather than mothers menstrual cycle and scans can be inaccurate and see us all as 40 week incubators rather than see us as individuals.
For example, my cycle might be 35-40 days, I might not ovulate til late in the cycle. My scans might show my baby as being inaccurate for dates and my EDD might change. I then end up needing a CS, because of placenta praevia grade 4 (for example and a legit reason for CS). They decide to do this at 38+5 going on my scan dates but infact my baby should wait a little longer to allow for development................. baby well and delivered by the best method but needs a 10days stay in NNU because he was actually premature......

There are reasons to do CS, legitimate ones but if they were the safest overall then the HSE would section every woman, especially if as you suggest its as cheap or nearly as cheap! They certainly wouldnt be concerned and holding study days on how to reduce the section rate.

Sorry bsbyblessed, I did start out in labour but they still wrote down elective on the med forms. I guess they made a mistake. Lol they also forgot to put down Kidney failure.

Ive had one baby and the whole experience has led me to believe that obstetrics is experimental medicine. I never had a dating scan because the rotunda was backed up to the hilt, but I had a viability and an abnormality scan during which a due date was estimated. I am absolutely convinced my son was premature because they got it so wrong. I even think he has some pre-me conditions.

January · 27-02-2011 8:41pm

metrovelvet wrote: »

Sorry bsbyblessed, I did start out in labour but they still wrote down elective on the med forms. I guess they made a mistake. Lol they also forgot to put down Kidney failure.

Ive had one baby and the whole experience has led me to believe that obstetrics is experimental medicine. I never had a dating scan because the rotunda was backed up to the hilt, but I had a viability and an abnormality scan during which a due date was estimated. I am absolutely convinced my son was premature because they got it so wrong. I even think he has some pre-me conditions.

Even now, the Rotunda don't offer a dating scan, just your anomaly scan at 19+ weeks (mine was 19 weeks). I organised a private scan for myself at 12 weeks on number one.

metrovelvet · 27-02-2011 8:56pm

January wrote: »

Even now, the Rotunda don't offer a dating scan, just your anomaly scan at 19+ weeks (mine was 19 weeks). I organised a private scan for myself at 12 weeks on number one.

I really should have done that too, but I was not long in the country and I didn't have a GP here nor registered with a hospital either. I had assumed that a dating scan is normal because in the US they make such a big stink about it that I thought there would be no problem here. WRONG. ANd I ended up back in the US anyhow. I had two very wrong dates, one from a viablilty scan in the US and one from the abnormality scan at 23 weeks in the rotunda. When I went back to the US they decided to go with the earlier one.

Babyblessed · 27-02-2011 8:59pm

January wrote: »

Even now, the Rotunda don't offer a dating scan, just your anomaly scan at 19+ weeks (mine was 19 weeks). I organised a private scan for myself at 12 weeks on number one.

2 questions I suppose from that............

1) did they take note of the private scan? and
2) Do they date pregnancy by the 19-20week scan...... or if there is a variation between LMP dates do they accept them?

January · 27-02-2011 9:16pm

Babyblessed wrote: »

2 questions I suppose from that............

1) did they take note of the private scan? and
2) Do they date pregnancy by the 19-20week scan...... or if there is a variation between LMP dates do they accept them?

Well I had my scan in the RCSI unit in the Rotunda so the sonographer sent a copy of it to my file in the Rotunda no problem and they had it there when I went for my booking in appointment at 19 weeks, and they didn't question it.

I take it they either date it at the 19 week scan or if there is a question of dates they may offer an earlier scan then... I never asked... I attended the Coombe on my second child and they gave a dating scan.

Hannibal Smith · 28-02-2011 10:03am

If elective sections are so unsafe, how come the 'too posh to push' celebrity gang are opting for them all the time?

My sis in law had pericarditis about 6 years ago. She recovered reasonably well, still has scarring on her heart, but was given the all clear by her hospital consultant that she could try for a baby. So now she's 7 months pregnant and for some reason her heart is acting up again and she was admitted to Holles Street two weeks ago with chest pains and difficulty breathing. After being sent to Vincents for tests (but with no test results given to her) she was discharged from Holles Street after 2 days.

She's now absolutely petrified about going into labour and her heart and lungs not being able to withstand it. She has begged Holles Street for an elective section but they won't organise it for her. They pat her on the head and say 'don't worry we won't let you or the baby go into distress'. The fact that she's totally stressed out about it now, means nothing to them. She's petrified that Holles Street will let her go into labour, admit her to the labour/vietnam ward and only when things go wrong will they take action.

It just seems a bit cruel to me. I don't know why they just don't give her a date for her section and give her a bit of peace of mind. This stressing out isn't doing her any good at all.

Squiggler · 28-02-2011 11:30am

Hannibal Smith, my heart goes out to your sister. I can only imagine her distress and I hope that everything will go well for her and for her baby.

Regarding your comment about "too posh to push celebs", plastic surgery can be dangerous, and result in all kinds of complications, hideous deformities and even death, and many of them don't even think twice about going through it either.

But there is a growing move to more natural birth, especially homebirth, among the celebrity set (the non C and D list ones). Even Pamela Anderson, who certainly shows no fear of going under the knife, had her children at home.

I can't imagine having a more stress-free pregnancy experience than I've had, even though this is my first baby. Not having to keep hospital appointments, sit in waiting rooms, worry about packing a bag, stress about making it to the hospital in time or worry about whether my wishes will be respected during the birth or not is so nice.

I remember how stressed my sister was at this stage in both her pregnancies, having to drag herself to clinic appointments and then wait for up to 4 hours to be seen. Being screamed at by her consultant for not keeping one of them (she left after waiting 3 hours - she was 38 weeks and in major pain as a result of a hip injury, and to make matters worse the woman sitting beside her with a rowdy toddler had just proudly announced that said child had the measles!).

At the end of the day every woman should have the right to the support she needs to promote a stress-free pregnancy and labour. Scaremongers (including mothers and sisters) should be fined heavily and unbiased advice should be made freely available. The labour and birth is going to be, at most, 2 days out of close to 10 months, spending those months worrying about it is counterproductive at best.

Grawns · 28-02-2011 9:56pm

metrovelvet wrote: »

grawns - a section can also lead to poor bonding and all sort of troubles and they are very expensive, in the US about $30,000 so don't tell me there isnt a financial interest in pushing the section.

Given the mrsa rate in Irish hospitals I would not be so keen to have one here. Also a woman I know was cut open for a section with a dirty instrument in an IRish hospital and had to get the infection, pus sucked out of her every day for six weeks after wards.

The private charges for a section in the rotunda are listed as €1645 and a vaginal delivery as €1498. That just covers the operation and obviously you will have to stay longer than someone who had a textbook delivery and can leave more or less immediatley . I left the morning of day 4, nobody wants to hang around.

I asked to be swabbed to test for MRSA a few weeks before the section. That's all I could do really as you have to trust the staff to practice best hygiene. You can get infected with MRSA in a vaginal birth too - episiotomy comes to mind. I know where I'd rather the pus be leaking from.

Cesarean or (natural) birth

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