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» The Ornery American Forum » General Comments » scheduled c-section vs. "kind of" natural child birth

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Author Topic: scheduled c-section vs. "kind of" natural child birth
edgmatt
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I'd like to tap the vast knowledge here at Ornery to anyone who is so inclined.

We are expecting our second daughter on April 8th, the doctor has recommended a scheduled c-section for somewhere between April 1st and April 7th depending on how things look as we get closer.

The reasons why she is having a c-section at all:

-She had one with our first baby. The doctors told her she could have a natural child birth because they cut her abdomen in a way that would allow it, but...

-Her cousin just recently had a baby, and was insisting on natural birth. She had a very hard time delivering, she tore, she had internal bleeding, the baby went into stress, and she ended up having a c-section anyway because off all those complications and she seemed unable to be physically strong enough to finish the delivery.

-I believe, as does my wife, that if she tried to deliver the baby naturally, there is a high risk of a similar scene.

-A scheduled c-section doctor and team would be better prepared than they would be if the c-section was an emergency, or needed to be done on short notice for any other reason. This would decrease the chances of something bad happening during the operation.

Reasons why we would prefer a natural child-birth:

-Things happen during child-birth that benefit the baby. The pressure squeezes out the lungs, less chance of asthma and other breathing issues, among other things.

-I don't want my child to miss out on any of the benefits of child birth for the convenience of the doctor.

My wife and I are a bit at odds with the solution. The doctor has convinced her that a scheduled c-section is the best choice, and that the risks are minimal.

I would prefer it if we allowed my wife to go into labor, then at some point between her water breaking and delivery, she has a c-section. Probably before she gets to the third level of contractions.

Do any of you here have any reason why my solution is inferior to a scheduled c-section?

As I noted above, the only thing I can think of is the level of preparation would be higher with a scheduled c-section. I don't think this outweighs the benefits of getting as close to a natural child birth as reasonably possible.

All of your advice and information will be extremely appreciated.

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TomDavidson
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quote:
I would prefer it if we allowed my wife to go into labor, then at some point between her water breaking and delivery, she has a c-section. Probably before she gets to the third level of contractions.

Do any of you here have any reason why my solution is inferior to a scheduled c-section?

From the hospital's perspective, this is certainly the highest-cost approach. It is also the one likely to cause your wife the most total discomfort.

Honestly, though, if your wife has a strong opinion on it, I think you should probably let her go with what she wants.

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Adam Masterman
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My wife had an emergency/last minute c-section with her first daughter, and a scheduled c-section with out youngest. The difference was astounding; she had priaclampsia with the former, and extreme reactions to the medications, which put her in agony for weeks. With the most recent birth, she had minimal pain, no complications at all, and was fully lucid (with me there with her) during the entire process.

I'm just going on memory here, but I believe that emergency c-sections require different medications and procedures than scheduled ones. Basically, a scheduled c-section allows the doctors to have everything ready and be fully prepared; whereas doing it on the spot requires a lot of different decisions to bring it about without any preparation. For my wife, it was a night and day difference.

You two should make your own choice, obviously (and I agree with deferring to your wife's wishes), but I couldn't recommend the scheduled option more highly.

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vulture
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Bear in mind that labour rarely progresses in the nice planned text-book labour - it is entirely possible for waters to break far too late for you to then have a c-section. My daughter had less than 20 minutes between waters breaking and being born.

I think that doctors have a tendency to over-medicalise birth at the best of times. American doctors particularly so (the to unbelievable point that midwives are illegal in some US states, which is just bat**** crazy - the best births involve a midwife and no doctors). Childbirth is a normal process, not a medical problem.

There is a slight risk of complications, as per the cousin, but it is far from guaranteed. One friend of mine had a natural birth for her 6th child after 5 c-sections, and it went fine. But yes, there is a higher risk of tearing and other unfortunate possibilities if your wife has had a c section preciously.

Conversely, there are also a lot of risks with the c-section itself - epidurals are not a risk free proposition for example. And there are a lot of physiological process in and around birth that help the mother and baby that you lose entirely if you go down the c-section route.

Ultimately though, the single best factor in a good birth is a mother who is (relatively) relaxed, confident and in control of what is going on around her (most home births actually end up delivering in the bathroom where women feel private and safe). Being safe, being able to move around as you want to, get into whatever position feels best, and stay in control of the situation with a bare minimum of strangers intruding is the way to a low stress birth. If she is really worried about a natural birth and convinced it is all going to go pear shaped, then she is going to be stressed, and stress if an absolutely massive inhibitor to labour progressing. Which means getting tired out, and all manner of bad things. Stress is in some ways a self-fulfilling prophecy.

If your wife can genuinely adopt the view that a natural birth is desirable, no more risky that a c-section (you are trading one set of risks for another really), and is confident and happy (and supported) in that, then odds are you can have a natural birth with no problems. If you have to fight against idiot doctors and everyone telling her she is doing it wrong, then you'll likely end up in a medicalised crap-hole either way.

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edgmatt
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Tom - yes, all of that is along the lines of what we think too. She is willing to sacrifice some comfort if it means positivity for the baby. It's a matter of: how much of each are we looking at? If it's little to medium discomfort/pain to have a much lower risk of asthma (for example) we'll take it. If it's a huge amount of pain for a small drop in an already low risk of something, we might forgo it.

Adam - what, if any, were the differences with the baby in each instance?

Vulture - thank you, that was very helpful, particularly the part about the mother being relaxed and confident being a big factor. I am trying to pin-point the risks on each side of it, if you have that information. The internet has a host of bad and good info on this subject, and I can't seem to filter it with confidence.

[ February 17, 2013, 05:18 PM: Message edited by: edgmatt ]

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Adam Masterman
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quote:
Originally posted by edgmatt:

Adam - what, if any, were the differences with the baby in each instance?

The first, with the emergency c-section, was a bit premature, and low birth weight. The latter had no issues at all. Doubtful that either says anything about the method of birth, though.
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edgmatt
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Were there any problems whatsoever with the second child? How is the child's breathing, eating habits, vitals, etc, today? (If you don't mind me asking. I realize this is very personal, and I don't expect you to share this information if you don't want to.)
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scifibum
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Just please try to remember that anecdotal evidence about how various babies did after various types of birth might not be very useful at all; you can find aggregate information about various risks that will be more informative.
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Adam Masterman
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quote:
Originally posted by edgmatt:
Were there any problems whatsoever with the second child? How is the child's breathing, eating habits, vitals, etc, today? (If you don't mind me asking. I realize this is very personal, and I don't expect you to share this information if you don't want to.)

I don't mind sharing, but I would echo Scifi's caution. Our daughter is totally healthy at 2 and 1/2; no allergies, no respiratory issues, perfect size and weight, no concerns whatsoever. But that's likely true of most babies born to either method; aggregate risk is what's going to give you useful information.

One thing I just remembered; when she was born (number 2), she had labored breathing, which the doctor told us was due to not being squeezed like normal. Her nostrils were flaring, and you could see a little sucking in under the ribs. However, the hospital was very on top of it; they monitored her blood oxygen content until all the signs of labor went away (about 10 minutes for the sucking in under the ribs, and a few hours for the nostrils). Made me nervous at the time, until they showed me that they could read her blood oxygen levels, and it went away at about the speed they expected. Today, as I said, no health issues at all.

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Funean
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A C-section is invasive surgery with definite risks to the mother and poorly understood effects on the baby. The risks are not minimal and it is irresponsible for any medical professional to say so, unless comparing them to the risks of not acting during an actual emergency situation. It should be avoided unless absolutely medically necessary to preserve either life, or to prevent irreparable damage. It is also not true that a VBAC (vaginal birth after caesarian) is inherently more risky than a planned c-section (and not at all more risky when the previous surgery was performed such that a future VBAC was not made impossible). And maternity wards in hospitals are basically c-section factories at this point, so it isn't the case that they'd be better prepared if it were scheduled.

I can refute all the points "pro" c-section one by one if you like, but it sounds very much to me like your doctor is recommending what is most convenient for him (i.e., a birth he can schedule as opposed to one that wakes him up in the middle of the night. there are also probably hospital administrators hassling him), not what is best for your wife or child.

Also, there is a place in between natural childbirth and a c-section--she can have pain meds, and as much monitoring as you could ever want, with all kinds of emergency services at your fingertips, and still have a vaginal birth.

As with any other surgery, you and your wife should seek at least one second opinion before agreeing to elective c-section (btw, insurance might not pay for it if it's not medically necessary). If you can, meet with another OB and with a midwife as well, to get both a comparable opinion and one from a slightly different point of view.

Finally, this is YOUR WIFE'S BODY, not the physician's. Doctors have a tendency to be peremptory about their patients' bodies, which is understandable to a degree, but nowhere is it more pronounced and less justified than in obstetrics. Keep in mind that your wife isn't sick! This is an essentially normal process, and you've already been assured that the previous surgery hasn't altered the landscape sufficient to change that substantively.

And congratulations! Wasn't it just a couple of weeks ago that you had your first?? [Smile]

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edgmatt
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Ha! Seems like it. (She'll be two on the 24th.) And thanks.

Scifi - yes, I am aware of the anecdotal evidence, but I still wanted to see what Adam's experience was. I researched a little on both sides, but I am going to do more.

Funean - My sister is a high level nurse that works in the incu unit. She ran a few units in NJ, and traveled to several hospitals in NJ to review and advise those units to help improve their own work. She now does the same out in Texas, and she has told me almost exactly what you have just posted.

I am going to get a second opinion, and I am going to investigate whether or not the insurance will pay for a c-section, thanks for mentioning that.

quote:
I can refute all the points "pro" c-section one by one if you like
I might take you up on that tomorrow after I talk to my wife a little more.

Adam - thanks for the info, and I am very happy to hear your children are healthy and happy. [Smile]

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G3
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My 2 cents, I am not a doctor nor do I play one on TV.

Get a second opinion (as you've already planned to do). Never hurts to have that.

The only thing I notice that would concern me is the prior c-section. Every medical professional I ever knew told me that once you have one that you're almost certainly going to have another for every delivery after that. I don't think it's a 100% guarantee on that but from what little I've seen it's become SOP.

Good luck!

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edgmatt
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Vbac's (Vaginal Birth After Caesarean)are fairly new, and from what I understand the concern was over the incisions from the first c-section, and the scar tissue left over. Scar tissue isn't as flexible and the baby might not be able to squeeze through as well. If the incisions are a certain way, then the risk of tearing is very high with the second baby. They told us they made the incisions in such a way that a Vbac would be fine. (I think they made one incision up and down, the other left to right, and this prevents tearing with the second delivery.)

Both of these things are definitely concerns for us, my wife is very concerned over the scar tissue. I haven't talked to the doctor directly yet, but I am on the next visit and we will go from there.

Thanks, all of you, it has been very helpful.

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AI Wessex
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Not altogether new. One of our friends when our older daughter was born in 1979 was having her second child via VBAC. It was during a time when people were agitating against the "medical state" where hospitals were driving care choices for both doctors and patients. We wanted our children to be born at home, but the doctors were afraid of losing their hospital privileges if an emergency came up and we had to get an ambulance, so we went to the hospital when my wife went into labor and came home a few hours after the birth. Our friend's birthing also went fine, and she had a 3rd child vaginally a couple of years later.

What your wife (and you) want is paramount when there are no health issues driving the decision. My caution is to be as clear as possible what the basis of the advice you get is.

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Pyrtolin
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My wife recommends:
http://ican-online.org/
as a good source of information on the issue.

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scifibum
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My mother had 2 VBACs after 4 caesarian sections, in the 80s. I think her OB thought she was completely insane.
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Greg Davidson
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VBACs were also new in the early 1990's... basically, all the same stuff about natural childbirth keeps being re-discovered, at least for the past two generations.

Funean's thorough (Bradley-themed) discourse is just what my wife would counsel as well. But probably I would also add that in areas like this you should also honor whatever choice that you as a couple make. Both choices are very, very low risk - whichever you pick is a good, safe choice for your baby.

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vegimo
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My wife delivered twins and got the best of both worlds. The first was vaginal and the second decided to spread out and enjoy the room - transverse. The doctor couldn't get her turned and had to do an emergency C-section. The first had an Apgar score of 9, the second was 2 and didn't take her first breath for nearly a minute...the longest minute of my life (I was in the room and got to watch everything). They are now 22 and have never had any health problems. We had another a year later VBAC, with absolutely no issues during the delivery or since.
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edgmatt
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Thanks for that link Pyrt, very informative.

Everything I have read and hear, not just here, points me towards going VBAC and then if there are any serious issues that arise, having the C-section. I am glad to hear so many of you say how little risk there is either way, that really eases my mind.

"My caution is to be as clear as possible what the basis of the advice you get is." Yes, that's been in my head, I am glad you articulated it the way you did.

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OpsanusTau
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Okay, I'll be a little bit contrary here.

Caveat: I have not (obviously) attended the births of human babies, but I have at this point attended the births of a pretty substantial number of mammalian infants.

I guess there's no way to know if your wife's OB is lying to you and doesn't really think that c-section is a safer option, but in fact thinks it is a more convenient option for the OB. I do know a bunch of OBs, and all the ones I know are pretty dedicated to the idea of preserving the life and health of the mom and the baby more so than getting home to dinner on time.

I also know that in basically every mammal, the riskiness of birthing methods goes like this, ranked from lowest to highest:

spontaneous, uncomplicated vaginal birth
planned caesarian section
emergency caesarian section

What that means is that if there's a reasonable chance that an uncomplicated vaginal birth can happen, it's a good thing to shoot for. If it probably can't happen and it's likely you'll end up in an emergency c-section, it's safer to plan the c-section from the beginning. The hard part is that it's never possible to know when an uncomplicated vaginal birth is going to happen.

Complications of a vaginal birth (or an attempted vaginal birth) for the baby can include distress, brain damage due to lack of oxygen, nerve and muscle and skeletal damage due to trauma from not fitting out, and death. Complications for the mom can include really major tears to the cervix, vagina and all the tissue surrounding it and even into the rectum, damage to the pelvic floor, damage to the bladder and urethra, and of course extended periods of excruciating pain. (Do you know anyone who's been rendered incontinent by childbirth? I do. You only get one pelvic floor in this life.)

I will offer this veterinary perspective on birth, which cuts through to some basic considerations that don't often get spoken aloud in human medicine. When I show up at a farm and a cow or whatever has been trying and failing to give birth vaginally for a while, and I can tell that the calf is still alive, I ask the question: "Who's more valuable, mom or baby?" Sometimes, especially with an embryo-transfer calf or a high-producing cow, one's life is easily more important to the farmer than the other. If we want to save the baby, we tend towards an assisted vaginal delivery, knowing that we potentially compromise the mom's quality of life and future fertility in a major way, and she might even die, but it gives the calf the best chance. If we want to save the mom, we let her push naturally, knowing that the calf may very well die in the process but the cow will have the best chance at a long life with good future fertility. If we really want them both to come through not only alive but healthy, we do a c-section. It's that easy.

Obviously women are not cows; but then again, women have a much, much dicier time with pregnancy and parturition than cows do, so if anything even MORE caution is indicated.

In conclusion, I would recommend not taking medical advice from unqualified strangers on the internet (that would be all of us). Birth is a medical event. The day you are born is the most dangerous day in your life. The day a woman gives birth is a day when some bad, bad things can happen to her. Your doctor (who knows your wife's medical history and current status) is in the best position to give you medical advice. If you feel unsatisfied with your doctor's priorities, personality, skill level, or anything else, get a different doctor. But don't take medical advice from unqualified yahoos on the internet.

And in post-conclusion, your wife is the one who is pregnant, the one who will be potentially laboring, and the one who will potentially face a lifetime of incontinence and/or sexual dysfunction. If she is satisfied with the doctor's advice, I'm not sure why you would want to change her mind.

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edgmatt
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Well, for one, I believe that her satisfaction is based on faulty information. I am also aware of the financial and convenience incentives the doctor has for potentially pushing for a C-section. This is not to say she is, but that the incentives ARE there.

My priority is the maximum health and least risk for the baby, followed immediately by the same for my wife. If I believe that a scheduled C-section is not the *best* option for the baby, don't I have not only a right, but an obligation to at least attempt to explore other options and present them to my wife?

Now, you are absolutely right about taking advice from unqualified strangers. I am not doing that blindly. I have already investigated, made phone calls and talked to qualified people. I basically *knew* what the optimum choice was before I posted this thread, but I wanted to see if anyone here had something to say that would contradict the advice I already heard. I respect the minds here at Ornery, we are all well-above average in intelligence and thoughtfulness, as evident by the content of all the above posts. Those posts were weighed against what I already knew and thought.

Part of why I thought my wife's inclination towards a scheduled c-section was flawed, was that I knew it came from another woman who, IMO, isn't the "ideal" mother. She is self-centered, and I see her sacrifice her kids health, both mentally and physically, for her own convenience very often. In the way of the food she gives them, attention, the kind of attention...etc. She is the kind of person that would do a scheduled C-section, simply to avoid the pains of child birth, and nothing more.

Anyway, we went to the doctors yesterday, and I spoke to the doctor for the first time. My original thoughts of her were wrong. I was under the impression that she was attempting to push for a C-section a little, but nothing could be father from the truth. A month ago, the doctor had presented the option to her, and my wife had made the choice (influenced, as I said, by this other woman she knows). When I politely voiced my concern yesterday, the doctor took a minute to review my wife's history, and then with a confused look, asked my wife why she HAD in fact chosen to go with a scheduled C-section. Long story short, the doctor, who was very professional and patient, confirmed my thoughts and reasoning and told my wife that she could most certainly have a VBAC with probably no issues whatsoever. We left the date for the scheduled C-section open, in case something comes up or my wife changes her mind, but as of right now, we are going to just let nature take it's course.

Again, I thank all of you for your input, it was very helpful and insightful.

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OpsanusTau
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That sounds like a great outcome, and I'm glad you're all happy. Good luck with everything!
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OpsanusTau
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I realized there was something bothering me about the last post, and then I realized what it was, so I came back to say so.

Understand that I don't know anything about your wife or your wife's cousin (I think that's who you said this woman was).

But I have to say, insistence on "natural" childbirth as an indicator of ideal motherhood, and ideal motherhood as an indicator for being a success as a female person, is a kind of biological essentialism that I find very distasteful.

If a woman wants to have an elective caesarian because she doesn't want the (often excruciating) pain of childbirth, or for any other reason, that is fine. It doesn't mean she will be a bad mother, and it doesn't mean she is a failure as a woman or as a person.

If a parent makes choices that prioritize some of his or her own needs and desires above some of the needs and desires of a child, that doesn't make him or her a bad parent - even if the parent is a mother. Parents who teach their children boundaries and how to be self-sufficient and respectful of others are also good parents.

And prioritizing the health and safety of an unborn infant above the health and safety of the woman gestating the infant (instead of equally) strikes me as somewhat bizarre, especially when the woman in question has other children to parent.

These are my opinions. Other adults are welcome to structure their interpersonal relationships in whatever way works for them and leads to a fulfilling life. I find biological essentialism and the reduction of women to an "ideal mother" role an extraordinarily oppressive and also repellant aspect of patriarchy in the present day.

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edgmatt
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I understand your concerns here, but let me clarify.

It is not *just* the insistence of a c-section that makes me think this other woman is *less* of a mother. There are a host of things she does on a regular basis that I consider to be selfish. I see her kids getting the short straw very often, simply for the sake of her convienence and in my opinion, these things make her less of a good mother than she could be. The elective c-section also fits into this profile I have of her. If I met another woman who had an elective c-section, I wouldn't hold it against her in anyway; there are a host of reasons to have one. But if I had to bet, I would bet that this woman would do it for the slightest convenience, because of the other things she does for the same reason.

To be clear, I don't believe that having an elective c-section makes any woman a bad mother.

"And prioritizing the health and safety of an unborn infant above the health and safety of the woman gestating the infant (instead of equally) strikes me as somewhat bizarre, especially when the woman in question has other children to parent."

It is essentially equal. But if I were pressed, and if my wife were pressed, to pick one or the other, we both would pick the baby. I would do the same (and so would my wife) if the choice were between me and the baby as well. I really don't see this as bizarre. You yourself said you ask cow owners "Who's more valuable, mom or baby?"

Yes, if "both" is an option then both would be the answer. But I think most parents would choose the health and safety of the baby over the health and safety of themselves more often than not.

You said: "If a parent makes choices that prioritize some of his or her own needs and desires above some of the needs and desires of a child, that doesn't make him or her a bad parent - even if the parent is a mother. Parents who teach their children boundaries and how to be self-sufficient and respectful of others are also good parents."

I agree, and apologize if I led you on to think that I believe otherwise. The key word there is the one I put in bold. If we change that to "all" or even "most", then my opinion changes. I am not talking about teaching the kids self-sufficiency, I am talking about making poor choices for them, in the instances where they cannot make the choices themselves. Food, for instance.

"I find biological essentialism and the reduction of women to an "ideal mother" role an extraordinarily oppressive and also repellant aspect of patriarchy in the present day."

This makes me very sad. I do not oppress my wife, and I think you ought to take that back.

I am the childs father. I have made significant sacrifices in my personal life since way before the child was born up to the present to optimize her health and well being. I have been planning and thinking about my child since I was in my late teens, and I am deeply insulted that you have just labeled my love and care for my child as 'oppressive'.

I hold myself to an extremely high standard as a father. My wife knows this, and knew this when she married me. She also doesn't let me slack on this. Is that matriarchal oppression?

My wife holds herself to a very high standard as a mother, and she relies on me to help her make the right choices. I'll ask you again, If I believe that a scheduled C-section is not the *best* option for the baby, don't I have not only the right, but an obligation to at least attempt to explore other options and present them to my wife?

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OpsanusTau
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Because we are an evidence-driven community here and I do not see that anyone has presented actual studies from the medical literature, I will share the following:

1)
A study showing that trial of labor (TOL) after a previous surgical delivery increases perinatal mortality (PMR) but decreases maternal mortality when compared to elective caesarian (ERCD).

quote:

While rare for both TOL and ERCD, compared to ERCD, the overall risk of maternal death associated with TOL is significantly lower (RR, 0.33, 95 percent CI: 0.13 to 0.88; p=0.027). Using 0.0134 percent as the baseline risk for ERCD, the calculated risk difference is −0.0090 percent (95 percent CI: −0.0117 to 0.0016 percent), translating to 9.0 less deaths per 100,000 (95 percent CI: 1.6 to 11.7 less deaths per 10,000) from the TOL group…

quote:

The combined PMR for women undergoing a TOL was 0.13 percent (95 percent CI: 0.06 to 0.3 percent), translating to 1.3 per 1,000 (95 percent CI: 0.6 to 3 per 1,000). There were 46 perinatal deaths/35,686 births for women undergoing an ERCD. The combined PMR for ERCD was 0.05 percent (95 percent CI: 0.007 to 0.38 percent) this translates to 0.5 per 1,000 (95 percent CI: 0.07 to 3.8 per 1,000 (Figure 27)). The risk of perinatal mortality was significantly higher for TOL as compared with ERCD (RR 1.82; 95 percent CI: 1.24 to 2.67; p=0.041). Using 0.05 percent as the baseline risk for ERCD, the calculated risk difference was 0.41 percent (95 percent CI: 0.012 to 0.08 percent) which is equivalent to .41 more deaths among women who attempt TOL.

If anyone wants the whole pdf, it is here:
http://www.ahrq.gov/downloads/pub/evidence/pdf/vbacup/vbacup.pdf

The authors draw the conclusion that because the absolute risk of an adverse outcome is low in either case, either option can be a good one depending on circumstances.

2) For fun, anyone can use the VBAC calculator. Ought not to be substituted for a consultation with a medical professional.

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OpsanusTau
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Unrelated to evidence and data:

I will not be "taking back" anything. I don't know if you oppress your wife, I don't know you or your wife or what your relationship is like or whether either of you oppresses the other one or to what extent. If you read my words as implying that I think you personally oppress your wife, I'm sorry; that's not what I meant.

I think that biological essentialism is oppressive to women, both in interpersonal relationships and on a societal scale. It reduces women to reproduction machines, and it confines women in roles they are often personally unsuited for and unhappy in. Among other problems.

It is also, less directly, oppressive to men in that men are often excluded from nurturant roles with their children in favor of resource-providing and/or disciplinary roles. Among other reasons.

You asked this:
quote:

If I believe that a scheduled C-section is not the *best* option for the baby, don't I have not only the right, but an obligation to at least attempt to explore other options and present them to my wife?

I think that if you believe that your wife's doctor is presenting her with misinformation or misunderstood information, you have an obligation to either clarify with the doctor or seek an alternate medical opinion. That's what you did, so that's great.

I don't think that laypeople can be relied upon to have a better grasp of medical risk assessment than doctors.

I also don't think that it's reasonable to assume in the absence of evidence that a doctor is making irresponsible recommendations that will lead to patient harm, and is making these recommendations in order to further his or her own convenience. People do not generally make it through a medical education and a residency in obstetrics if their highest priority is keeping a regular schedule while making money hand-over-fist. That's just a waste of effort; anyone with the intelligence and drive to make it through that education could have chosen a much easier and even more lucrative career path, so I think it's safe to assume that the number of obstetricians bent on exploiting their patients for a wealthy, easy life is low.

Conversely, if you actually have evidence that a doctor is making irresponsible recommendations to a patient in order to make more money and have an easy life, I encourage you to report this to the relevant medical board, because that sort of thing ought not to happen and that is why we license doctors.

****
I also want to say something about the cattle c-sections I was talking about before, because I kind of think you misunderstood. When I ask someone whether the cow or the calf is more important and they say "Cow", what that means is that they actually don't care if the calf dies. Likewise, if they say "Calf" because the calf is worth $10,000 and the cow carrying it is worth $250, saving the life of the cow is no longer very high on the priority list, or maybe even not on the priority list at all. In both cases, there are radical interventions that I can do that an obstetrician just wouldn't consider. We do not usually think of this as being an acceptable choice to offer women in labor. I accept that you and your wife might both choose the baby's life over hers; that's your business, whether or not I think it is strange. The point I was trying to make is that at a decision point where a dairy farmer might choose to sacrifice a cow for the sake of a calf, that's generally a point where an obstetrician would perform a surgical delivery and save both. Because it's more expensive, and it might be a slightly less optimal delivery method from the fetus's perspective, but it's a much better overall outcome.

Anyways, clearly this analogy failed at making my point, so maybe we'd better let that one go.

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velcro
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If I may jump in here...

edgmatt,

I think when Ops said
quote:
I find biological essentialism and the reduction of women to an "ideal mother" role an extraordinarily oppressive and also repellant aspect of patriarchy in the present day.
he wasn't accusing you of biological essentialism. He was simply warning against judging women purely on their proclivity for "good" mothering attitudes and skills. You didn't really do that either, but I think people who do make that mistake would overlap with your views in this case.

So I wouldn't take it personally, it sounds like you and your wife have struck a very healthy balance.

FWIW, my wife had an emergency c-section with my son. We tried for a VBAC with my daughter, but she had trouble coming out too, so that ended up an emergency c-section. Both were fine - my daughter had a little asthma, almost completely outgrown.

Good luck!

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edgmatt
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Baby came early. [Cool] Ended up having a C-section because my wife's anatomy won't (reasonably) allow for a natural birth. Even though she's three weeks early, there were 0 complications, 0 issues, and she was born healthy and hale. Started breathing instantly, started eating quickly after that, mom and baby all doing fantastic. Coming home tomorrow probably.
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Pete at Home
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Congratulations!
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Funean
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Congratulations, indeed! Glad both (and you!) are doing well.
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edgmatt
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Thanks guys.
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scifibum
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[Big Grin]
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Ben
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Congrats to you all, glad all went well.
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