Doctors warn of alarming C-section 'epidemic' • Hacker News Board

Re: Doctors warn of alarming C-section 'epidemic'

#31

Post by marmaduke » Sat, Oct 13, 2018, 8:00 AM UTC

grecy wrote: post #7

My sister-in-law just had her first baby, and got very into all of these statistics and the "medical industrial complex take on childbirth" I believe the WHO recommends around 10-15% of births should be C-Section in a healthy population, but the figures in first world countries are at least 3-5 times that. There are about 3 million stories of ladies "booking in" their birth a month or three in advance. I.e. I want my…

The lack of mention of epidural or not is a big thing I think. Among the mothers I know, epidural makes everything but the pain worse.

Re: Doctors warn of alarming C-section 'epidemic'

#32

Post by colechristensen » Sat, Oct 13, 2018, 8:01 AM UTC

Synaesthesia wrote: post #27

jobigoud wrote: post #18

Earlier quoted context omitted.

If we perfect the art of surgery to a point where it's painless/seamless/benign it won't even be a question, it seems so much more efficient and clean. Open, extract, close.

There are a number of factors which make natural childbirth better, the mother recovers much quicker, a day or two vs weeks. There are things that happen during vaginal childbirth with hormones released by mother and child which do not happen with c-sections, like the bacteria which transfers from mother to child which is essential for gut function. The baby is also prepared for birth during the process and is more a…

A lot of that seems like unsupported woo which appeals to the sort of people wishing to rebel against the science / chemical / medical mainstream. That doesn't make it true or untrue. It reads exactly like someone who has decided what is true went to find evidence to share to support the claim.

You can pick any position at random and find a wealth of evidence to support your claim.

From a source in the above article:

>Although these new findings and proposed potential mechanisms are novel and exciting, further exploration and replication in larger cohorts of children ... are needed.

Most scientific results are not intended to be consumed by ordinary folks to instruct their final decisions. They are almost always only evidence, not containing any decisive conclusions.

Re: Doctors warn of alarming C-section 'epidemic'

#33

Post by isostatic » Sat, Oct 13, 2018, 8:02 AM UTC

paavoova wrote: post #16

harry8 wrote: post #8

Ok so no mention of the health implications of so called "natural" childbirth, which aren't trivial and have an increasing risk as your age. No mention of the rising age of mothers in wealthy countries. No mention of different trade offs for fit 19 year olds and less active 35 year olds. A lot of 30+ women decide they don't want to piss their pants and have painful intercourse for the rest of their lives. Word gets a…

Women have been giving birth since creation with minimal enough problems for humans to survive and succeed as a species - it absolutely is natural, no idea why you put that in quotations. Why stop at C-sections? Raise them in test tubes a la Brave New World, skip the biological process entirely. After all, it's much safer, quite possibly even zero risks on the woman's part. The thing with C-sections is that until fai…

At a species level yes, childbirth works fine.

Before the modern era deaths of both child and mother were very high (10%+) when giving birth.

That said, the U.S. approach to childbirth is clearly not working, with childbirth deaths at 3 times that of Canada, and higher than the rest of the developed world.

Re: Doctors warn of alarming C-section 'epidemic'

#34

Post by marmaduke » Sat, Oct 13, 2018, 8:04 AM UTC

DoreenMichele wrote: post #24

vladgur wrote: post #19

Earlier quoted context omitted.

I would imagine the recovery times for c-section are longer

Possibly not always true. Women are fairly frequently given episiotomies. This is intended to prevent vaginal tearing, which is far more harmful than a clean cut and much harder to repair and much more likely to leave a bad scar. Scars in the genitals can be pretty unpleasant. Scar tissue in female genitals tends to not want to cooperate with that whole sex thing. Furthermore, sutures in the genitals make it impossib…

Is an epidural assumed in all this discussion? The mothers I know who didn’t have the epidural didn’t have these nightmare symptoms, while those who did or had a C section were worse off.

(I’m assuming competent medical staff and follow up, but I realize that’s a difficult one in the US and elsewhere)

Re: Doctors warn of alarming C-section 'epidemic'

#35

Post by KaiserPro » Sat, Oct 13, 2018, 8:05 AM UTC

paavoova wrote: post #16

harry8 wrote: post #8

Ok so no mention of the health implications of so called "natural" childbirth, which aren't trivial and have an increasing risk as your age. No mention of the rising age of mothers in wealthy countries. No mention of different trade offs for fit 19 year olds and less active 35 year olds. A lot of 30+ women decide they don't want to piss their pants and have painful intercourse for the rest of their lives. Word gets a…

Women have been giving birth since creation with minimal enough problems for humans to survive and succeed as a species - it absolutely is natural, no idea why you put that in quotations. Why stop at C-sections? Raise them in test tubes a la Brave New World, skip the biological process entirely. After all, it's much safer, quite possibly even zero risks on the woman's part. The thing with C-sections is that until fai…

> There's an growing body of evidence that suggests early microbial exposure is required for proper immune development

Yes. But that's not linked to "seeding" which doesn't have any conclusive evidence to back that up(yet) compared to colostrum/breastfeeding[1] I'm aware of one study that has tried seeding. It's hypothesised, but needs much more research before being counted/discounted

> Women have been giving birth since creation with minimal enough problems for humans to survive and succeed as a species

Yes, but up until decent, clean deliveries with the option of c-section, and anti-biotics child birth killed 5% of mothers[2]. Bear in mind that without birthcontrol (pills or condom) most women would have about 6 pregnancies in their life time. [3] my bad maths makes that a ~1/4 chance of dying in childbirth/complications arising from.

The study that link obecity and asthma to c-section is small[4] however it is worth widening and expanding to more than scotland. Brazil would be a good target as 50+% of births are c-section.

[1]https://www.nhs.uk/news/pregnancy-and-child/breast-milk-rais... The only link I could find that wasn't selling something (either hippy nonsense or a drug)

[2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1633559/

[3]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865739/

[4]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055095/

TL;DR: 5% of child births were fatal to the mum, modern medicine has made that drop to <0.1%. There is some evidence that you might be fatter if you were born by optional c-section. However this is a limited study in one country.

Re: Doctors warn of alarming C-section 'epidemic'

#36

Post by sambe » Sat, Oct 13, 2018, 8:06 AM UTC

Tuna-Fish wrote: post #25

vladgur wrote: post #19

Earlier quoted context omitted.

I would imagine the recovery times for c-section are longer

You would imagine wrong. Smoothly cut, cleaned and expertly closed up wounds heal a lot faster than ripped tissue that doesn't even get properly cleaned because it's in there somewhere.

Don’t be so sure. I can’t find good research comparing the two, but it seems generally held that CS recovery times are longer. I see NICE quoted as saying no risk difference between the two methods but longer recovery times for CS (https://www.theguardian.com/politics/reality-check-with-poll...).

Re: Doctors warn of alarming C-section 'epidemic'

#37

Post by sambe » Sat, Oct 13, 2018, 8:09 AM UTC

jsoc815 wrote: post #2

Find it interesting that the article seems to place the blame on the women, when it's long been said that the docs and hospitals, ever in search of time compression and profits, were encouraging c-sections versus vaginal birth. That, to my knowledge, is the likely cause of the procedure appearing "fashionable" and "modern."

Are you talking about the US? Many countries with state/cheap healthcare also have high rates (Europe).

In the UK, I’d say there’s a bias towards “the natural way” (not offered epidural, counselling for elective CS, NCT antenatal courses tend to focus on natural methods etc). Eg https://www.rcm.org.uk/news-views-and-analysis/analysis/mate...

Re: Doctors warn of alarming C-section 'epidemic'

#38

Post by KaiserPro » Sat, Oct 13, 2018, 8:10 AM UTC

Synaesthesia wrote: post #28

harry8 wrote: post #13

Earlier quoted context omitted.

"natural" like half of women dead in childbirth natural?

When there are problems, you operate. Otherwise it’s preferable for natural birth for mother and baby, for reasons mentioned above.

no.

There are a whole host of reasons for having a c-section. The risk of having a massive tear (ie vag to arse(4c tear), or literally tearing a new arsehole) is 1 in 4. This has long term life altering consequences.

An "elective" c-section is not the same as "booking in". The less "identity politics" that are wrapped up in this, the better.

Re: Doctors warn of alarming C-section 'epidemic'

#39

Post by sambe » Sat, Oct 13, 2018, 8:20 AM UTC

harry8 wrote: post #8

Ok so no mention of the health implications of so called "natural" childbirth, which aren't trivial and have an increasing risk as your age. No mention of the rising age of mothers in wealthy countries. No mention of different trade offs for fit 19 year olds and less active 35 year olds. A lot of 30+ women decide they don't want to piss their pants and have painful intercourse for the rest of their lives. Word gets a…

The second paper of the series does review and compare several aspects in comparison to natural birth:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Re: Doctors warn of alarming C-section 'epidemic'

#40

Post by acjohnson55 » Sat, Oct 13, 2018, 8:22 AM UTC

marmaduke wrote: post #34

DoreenMichele wrote: post #24

Earlier quoted context omitted.

Possibly not always true. Women are fairly frequently given episiotomies. This is intended to prevent vaginal tearing, which is far more harmful than a clean cut and much harder to repair and much more likely to leave a bad scar. Scars in the genitals can be pretty unpleasant. Scar tissue in female genitals tends to not want to cooperate with that whole sex thing. Furthermore, sutures in the genitals make it impossib…

Is an epidural assumed in all this discussion? The mothers I know who didn’t have the epidural didn’t have these nightmare symptoms, while those who did or had a C section were worse off. (I’m assuming competent medical staff and follow up, but I realize that’s a difficult one in the US and elsewhere)

What would an epidural have to do with tearing and episiotomies?