Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Doctors warn of alarming C-section 'epidemic'

dw.com

Post reply on HN
Print view View original

61–70 of 194 posts

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

#61

Post by dabbledash »

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…

Real natural childbirth involves “minimal enough problems” if you don’t particularly value the lives of individual babies, a significant minority of whom would die during birth or late pregnancy if we just let nature take its course.

And putting “natural” in quotes is entirely appropriate when discussing most vaginal births, even drug free vaginal births, in the first world. There’s nothing natural about 9 months of prenatal care and monitoring, careful observation of the fetal heartbeat during labor, prophylactic administration of antibiotics to women with group B strep, early delivery of women with gestational diabetes or pre-eclampsia, and the availability of c-section any time labor starts to go south. The women who end up delivering vaginally have very good outcomes, in part because a bunch of “unnatural” interventions before the moment of delivery weeded out all the women and babies who would not have done so well. If you want to see what real natural childbirth looks like, you can look at the maternal and neonatal outcomes in countries without modern health care. It’s not pretty.

We need to stop using the world “natural” as some kind of signifier for goodness. “Nature” doesn’t care that lots of tadpoles or lion cubs, or salmon fry don’t make it, and it doesn’t care that lots of human embryos miscarry or lots of babies die in birth. WE care about human babies, and so intervene.

Also, is there some reason we wouldn’t gestate fetuses in artificial wombs if that was safer for women and babies? Are we just obliged to suffer and risk our lives for no benefit? Because it’s “our place”, I guess?

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

#62

Post by acct1771 »

jkestner wrote: post #58
cellis wrote: post #6

Earlier quoted context omitted.

Actually historically, we foraged and hunted. After reading Sapiens I’m convinced that farming actually set humans on the path towards this very suffering. Large scale war, famine and pretty much every post agrarian revolution ill, is a direct consequence of having food surpluses.

This was also the theme of Ishmael , a terrible book wrapped around an interesting idea—that the native Americans practiced the right balance with the rest of nature.

What made it terrible?

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

#63

Post by acct1771 »

DanBC wrote: post #29
Synaesthesia wrote: post #27

Earlier quoted context omitted.

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…

There's no evidence for bacteria transfer, and some children have been harmed by mothers taking vaginal mucus to transfer bacteria after a c section.

Don't bother pointing out that those cases are abnormal, and the mothers have diseases...

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

#67

Post by epmaybe »

Interesting article. I also thought that encouraging cesarean sections was something obstetricians did often to avoid the time spent waiting for delivery. However, in my training I witnessed quite the opposite. My resident and attending physicians were very cautious with going forward with cesarean sections, and would do whatever they could to continue with vaginal delivery when the mother wanted that, and also encouraged patients that wanted cesarean to consider vaginal delivery.

Obviously this is one hospital, but it did help me not be as cynical of the profession, and will probably help serve as a reminder to do what's best for my future patients.

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

#68

Post by e40 »

epmaybe wrote: post #67

Interesting article. I also thought that encouraging cesarean sections was something obstetricians did often to avoid the time spent waiting for delivery. However, in my training I witnessed quite the opposite. My resident and attending physicians were very cautious with going forward with cesarean sections, and would do whatever they could to continue with vaginal delivery when the mother wanted that, and also encou…

With the birth of my son, we switched obgyn's because she basically told us it was pretty certain we'd have a c section, because she didn't have time to wait. We switched doctors and it was the first question we asked when interviewing prospective doctors. This was in 2000.

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

#69

Post by gdubs »

rayiner wrote: post #64

Relevant counterpoint: http://www.skepticalob.com/2018/03/what-if-c-sections-are-be... . The article doesn’t actually say why C sections are bad, it presupposes that fact, and assumes that rising C section rates must indicate some sort of “epidemic.”

This page from the university of Utah suggests that C sections have a higher mortality rate, and are more expensive — while necessary in roughly 15% of deliveries:

https://healthcare.utah.edu/the-scope/shows.php?shows=0_w7uq...

Edit: This Time article points out that while maternal mortality rates have dropped significantly worldwide, they have actually risen in the US by 27%. They list numerous possible factors, a rise in unnecessary C Sections being one of them:

http://time.com/4508369/why-u-s-women-still-die-during-child...

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

#70

Post by dabbledash »

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…

We don’t have a great way of knowing the optimal c-section rate. But plotting national c-section rates against perinatal outcomes (an obviously imperfect approach) shows that increasing c-section rates are associated with significantly better outcomes until about 20% after which there is no real effect one way or another.

http://www.skepticalob.com/2015/12/world-health-organization...

I’m not sure why it would be “horrifying” what kind of birth a hospital labels natural. It’s all bullshit anyway. No births in a hospital are like births in nature, which is why so many more babies survive the experience these days.

Post reply on HN