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

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

#121

Post by bluejekyll » Sat, Oct 13, 2018, 5:06 PM UTC

tptacek wrote: post #80

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.”

Caesarians are way more dangerous than vaginal births. A C-section patient can die of pulmonary embolism from the blood clots from the procedure, directly from bleeding (the surgeon can nick an artery or the incision can lacerate during the actual birth), the wound can get infected (it's quite a large wound), and, of course, it's major surgery, so the anaesthesia can kill you (even if you're not all the way under; my…

This depends entirely on why you’re getting c-section in the first place. When my son was born, we luckily detected that the umbilical cord had velamentous cord insertion, which basically means it’s not completely connected to the placenta. This can often lead to detached cord during vaginal birth, and cause still-birth and worst case also kill the mother. We also discovered after the fact that the pregnancy was also suffering vasa previa. Luckily the first was discovered before birth with modern ultrasound equipment that also tracks blood flow (not all hospitals have this apparently). And we were extremely luckily that we didn’t risk vaginal birth even though with just the first condition the risk was still within decent margins.

You can read some horror stories about these conditions when they go undetected. Luckily for us they were detected, and so we scheduled a c-section and everything was smooth. If we had listened to the peer pressure, which there was a lot, it’s possible that neither would be around today.

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

#122

Post by jaclaz » Sat, Oct 13, 2018, 5:14 PM UTC

In 2015 the WHO has issued this [0] [1]:

>Conclusions

Based on the available data, and using internationally accepted methods to assess the evidence with the most appropriate analytical techniques, WHO concludes:

1. Caesarean sections are effective in saving maternal and infant lives, but only when they are required for medically indicated reasons.

2. At population level, caesarean section rates higher than 10% are not associated with reductions in maternal and newborn mortality rates.

3. Caesarean sections can cause significant and sometimes permanent complications, disability or death particularly in settings that lack the facilities and/or capacity to properly conduct safe surgery and treat surgical complications. Caesarean sections should ideally only be undertaken when medically necessary.

4. Every effort should be made to provide caesarean sections to women in need, rather than striving to achieve a specific rate.

5. The effects of caesarean section rates on other outcomes, such as maternal and perinatal morbidity, paediatric outcomes, and psychological or social well-being are still unclear. More research is needed to understand the health effects of caesarean section on immediate and future outcomes.

[0] https://www.who.int/reproductivehealth/publications/maternal...

[1] (PDF) http://apps.who.int/iris/bitstream/10665/161442/1/WHO_RHR_15...

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

#123

Post by AlexandrB » Sat, Oct 13, 2018, 5:15 PM UTC

pbhjpbhj wrote: post #78

Angostura wrote: post #71

Earlier quoted context omitted.

> 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.…

Vaginal delivery is associated with better outcomes for the child too. IMO that makes it not strictly the mother's choice. Indeed surgical procedures should never be entirely elective.

> Vaginal delivery is associated with better outcomes for the child too. IMO that makes it not strictly the mother's choice.

Strongly disagree. The mother's freedom is not subservient to the child's wellbeing. Stable families are also associated with better outcomes for children, does that mean a man should not be allowed to divorce his spouse after they have children? What about second hand smoke or the psychological effects of parents' alcoholism on a child? I could go on (consider Vaccinations), but if a child's outcomes are the primary concern why stop at C-sections?

> Indeed surgical procedures should never be entirely elective.

Why not? What about plastic surgery, liposuction, or gastric bypass? This is a weird sort of medical puritanism.

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

#124

Post by jarvist » Sat, Oct 13, 2018, 5:18 PM UTC

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…

It is believed that this is already happening: "The regular use of Caesarean sections is having an impact on human evolution" https://www.bbc.co.uk/news/science-environment-38210837

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

#125

Post by ertand » Sat, Oct 13, 2018, 5:24 PM UTC

dabbledash wrote: post #120

ertand wrote: post #112

Earlier quoted context omitted.

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.

Misoprostol is also a cervical ripening agent comparable to cervidil.

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

#126

Post by tptacek » Sat, Oct 13, 2018, 5:34 PM UTC

bluejekyll wrote: post #121

tptacek wrote: post #80

Earlier quoted context omitted.

Caesarians are way more dangerous than vaginal births. A C-section patient can die of pulmonary embolism from the blood clots from the procedure, directly from bleeding (the surgeon can nick an artery or the incision can lacerate during the actual birth), the wound can get infected (it's quite a large wound), and, of course, it's major surgery, so the anaesthesia can kill you (even if you're not all the way under; my…

This depends entirely on why you’re getting c-section in the first place. When my son was born, we luckily detected that the umbilical cord had velamentous cord insertion, which basically means it’s not completely connected to the placenta. This can often lead to detached cord during vaginal birth, and cause still-birth and worst case also kill the mother. We also discovered after the fact that the pregnancy was also…

Both of my kids were delivered by c-section. I'm not arguing that they're bad. I'm arguing that they're riskier than natural birth.

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

#127

Post by Sharlin » Sat, Oct 13, 2018, 5:37 PM 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…

> 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.

Apparently 45% in China, 25-35% in many Western countries. I had no idea that the numbers in many countries are that high; Northern Europe (where I'm from) is evidently something of an outlier at 15% or so.

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

#128

Post by tinbucket » Sat, Oct 13, 2018, 5:40 PM UTC

JauntTrooper wrote: post #97

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…

French bulldogs mostly can't have natural births. 80%+ of the births are c-sections.

They've been specifically bred to exaggerate characteristics that are not healthy. The predominant result is brachycephalism which causes breathing and heat regulation issues amongst other things. This is also why they can't give birth naturally.

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

#129

Post by giardini » Sat, Oct 13, 2018, 5:53 PM UTC

C-section babies are prone to certain ailments later in life:

"Giant study links C-sections with chronic disorders" -

http://sciencenordic.com/giant-study-links-c-sections-chroni...

My guess is that this is tied to the reduced exposure to the mothers' vaginal and anal microbiome that occurs during vaginal delivery but which is absent in C-section.

Much as childhood exposure to animals reduces autoimmune disorders in later life, natural birth also likely does the same.

"Study: Children who grow up on family farms and drink raw milk have fewer allergies, autoimmune disorders"

https://www.naturalnews.com/035802_raw_milk_farms_allergies....

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

#130

Post by watwut » Sat, Oct 13, 2018, 5:56 PM UTC

kuwze wrote: post #102

I know most people on HN are guys, but I've heard a lot of women talk about the peer pressure. In fact some women look down on those that have children via a C-section. It's despicable.

C-section all in all hurts more and you heal longer after that and you need more help afterwards. Plus it limits how many kids you can have safely.

The dominance of guys shows up mostly by completely ignoring practical considerations.