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

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

#111

Post by deialtrous » Sat, Oct 13, 2018, 4:17 PM UTC

KaiserPro wrote: post #35

paavoova wrote: post #16

Earlier quoted context omitted.

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…

>Yes, but up until decent, clean deliveries with the option of c-section, and anti-biotics child birth killed 5% of mothers[2]

But you are conflating very different issues. You can't give c-sections the credit for the benefits we gained from learning what bacteria are. Most women who died during childbirth died from infections, c-sections don't stop infections, hygiene and antibiotics do. You need to compare modern normal births to modern c-sections, not pre-germ theory normal births to modern c-sections.

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

#112

Post by ertand » Sat, Oct 13, 2018, 4:19 PM UTC

dabbledash wrote: post #105

ertand wrote: post #4

I wonder what its correlation with induction is. Artificially inducing labor does not tend to give the body enough time to adjust and progress.

Elective induction of labor at 39 weeks results in a lower c-section rate than expectant management (waiting to see if labor will start naturally). https://www.nih.gov/news-events/news-releases/induced-labor-... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049989/ Normally though, induction happens because there is some problem or because the pregnancy has gone past the due date, and in these cases your risk of a c-…

Makes sense. As mentioned in the comments, there are different ways of inducing labor. I was referring to usage of pitocin or similar too early in the process, instead of gradually inducing the labor with other medications. We had success with just misoprostol during our labor, but the process was quite long.

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

#113

Post by SolaceQuantum » Sat, Oct 13, 2018, 4:19 PM UTC

jayalpha wrote: post #50

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…

Sorry for being naive but: "A lot of 30+ women decide they don't want to piss their pants and have painful intercourse for the rest of their lives. " Is this a real risk of vaginal child birth? And how risky is it?

This is a real risk of vaginal birth. Long term complications of vaginal birth are not usually studied (this may be related to an ongoing issue in the medical community in failing to address women’s health). For example, painful sex has been reported in a quarter of women 18 months after birth. Painful sex is common in 90% of women in the shorter term after giving birth. Women overwhelmingly experience at least one complication within 6 weeks after birth and are recommended to wear adult diapers as the uterus continues to expel. Women also report at least one long term health complication about a third of the time. (https://en.m.wikipedia.org/wiki/Postpartum_period)

(Edit: this doesn’t differentiate between vagina and c-section, but for example I’ve seen in passing that vaginal birth causes more issues with incontinence and painful sex)

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

#114

Post by stordoff » Sat, Oct 13, 2018, 4:31 PM UTC

aklemm wrote: post #94

SigmundA wrote: post #59

This really seems like one obvious way in which we are effecting our own evolution and would not be surprised if in a short time (on an evolutionary scale) that humans will require c-sections for successful birth. This may not be a bad thing, the reason child birth is so difficult for humans vs most other animals is our head size vs the female pelvis. C-sections bypass the evolutionary constraint allowing more large…

Do babies with too-big heads regularly die at birth if C-section isn't available?

As far as I know, no, because emergency Caesareans are available (I was an emergency Caesarean - my mother was told I was 'small', and I ended up being close to 13lbs[1]), but it can cause other complications - my sister still has a small scar from a forceps birth, and the recovery time was longer for my mother.

[1] The entire pre-birth care was flawed - at one point they couldn't find a pulse for over 24 hours and they were telling my mother to induce labour (because I was dead...).

Edit: spelling fix

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

#115

Post by civility » Sat, Oct 13, 2018, 4:33 PM UTC

JoshMnem wrote: post #104

SigmundA wrote: post #59

This really seems like one obvious way in which we are effecting our own evolution and would not be surprised if in a short time (on an evolutionary scale) that humans will require c-sections for successful birth. This may not be a bad thing, the reason child birth is so difficult for humans vs most other animals is our head size vs the female pelvis. C-sections bypass the evolutionary constraint allowing more large…

I think it's more likely that it's a bad thing. Babies are supposed to get seeded with microbes, which probably affects the immune system. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110651/

There's probably some truth to this, but it doesn't take much imagination to imagine how the babies could be "seeded" after a C-section birth.

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

#116

Post by DoreenMichele » Sat, Oct 13, 2018, 4:36 PM UTC

v_lisivka wrote: post #90

DoreenMichele wrote: post #42

Earlier quoted context omitted.

I have had two vaginal deliveries. They both involved an episiotomy. I have never had an epidural. Both deliveries were completely drug free. Episiotomy: A surgical cut to the vaginal tissue to prevent tearing. Epidural: Spinal pain block. Totally unrelated procedures.

What you think about artificial womb? Would you prefer to make forced birth one month earlier, when baby is small, and then raise it in artificial womb for month or two? https://gizmodo.com/for-the-second-time-researchers-have-use...

I have never heard of this before. I'm not going to give an opinion off the cuff on something I know nothing about.

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

#117

Post by gpderetta » Sat, Oct 13, 2018, 4:43 PM UTC

dsfyu404ed wrote: post #92

ineedasername wrote: post #84

Earlier quoted context omitted.

You would think this is true, but the mortality rate for c-sections tends to be higher because they are often performed in the presence of other extreme complications that contribute to the higher mortality rate. The mortality rate for non-complication (elective) ceasarian is actually lower. The Birth Trauma Association found that mortality rates are lowest for women who have elective caesareans. [0] https://amp.theg…

>The mortality rate for non-complication (elective) ceasarian is actually lower. Lower than popping the kid out the pre-existing hole that is there specifically for that purpose under similiar conditions (i.e. in a hospital)?

Except that, without C-sections, the natural path tend to be fatal for either mother or child in a non trivial percentage of cases, even in an hospital.

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

#118

Post by TheCoelacanth » Sat, Oct 13, 2018, 4:46 PM UTC

Angostura wrote: post #71

danw1979 wrote: post #30

Women feel enormous pressure (at least here in the UK) to give birth naturally, from both their peers and health professionals. How a baby is delivered is none of anyone's business but the mother herself. My wife (an epidemiologist) deliberated for months over having our second by VBAC (vaginal birth after csection) and opted to go for it, due to the overwhelming expectation from everyone around her that she should d…

> How a baby is delivered is none of anyone's business but the mother herself. I'm sorry for your loss. Caesarian's costs the NHS around £1,700 a time compared with £750, for a normal childbirth and women also stay in hospital for twice as long on average. There is a general presumption in the UK that avoiding what is an invasive operation is preferable for both baby and mother alike, in the absence of other factors.…

£950 for something that occurs once per lifetime seems extremely negligible.

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

#119

Post by tree_of_item » Sat, Oct 13, 2018, 4:50 PM UTC

exotree wrote: post #110

dsfyu404ed wrote: post #92

Earlier quoted context omitted.

>The mortality rate for non-complication (elective) ceasarian is actually lower. Lower than popping the kid out the pre-existing hole that is there specifically for that purpose under similiar conditions (i.e. in a hospital)?

Let’s not call the anatomy of females “holes.”

The fact that it is a hole is relevant to this discussion. The physics and safety of a large object passing through a relatively small hole are the entire thing in question.

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

#120

Post by dabbledash » Sat, Oct 13, 2018, 4:57 PM UTC

ertand wrote: post #112

dabbledash wrote: post #105

Earlier quoted context omitted.

Elective induction of labor at 39 weeks results in a lower c-section rate than expectant management (waiting to see if labor will start naturally). https://www.nih.gov/news-events/news-releases/induced-labor-... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049989/ Normally though, induction happens because there is some problem or because the pregnancy has gone past the due date, and in these cases your risk of a c-…

Makes sense. As mentioned in the comments, there are different ways of inducing labor. I was referring to usage of pitocin or similar too early in the process, instead of gradually inducing the labor with other medications. We had success with just misoprostol during our labor, but the process was quite long.

These inductions would have been primarily pitocin and / or cervical ripening agents like cirvidil.