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

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

#161

Post by landryraccoon » Sat, Oct 13, 2018, 8:23 PM UTC

AlexandrB wrote: post #123

pbhjpbhj wrote: post #78

Earlier quoted context omitted.

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 psychologica…

You’re kidding right? The fact that parents are legally required to care for their children for 18 years throws a wrench into the theory that the freedom of parents is paramount. I don’t think there’s any precedent in culture or our legal system that puts freedom of parents at a higher priority over well being of children - nor should it. Children have no choice whether they are brought into the world, potential parents have full volition. Thus morally it is perfectly fair that the party with zero choice - the children - are protected.

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

#162

Post by StreamBright » Sat, Oct 13, 2018, 9:11 PM UTC

gdubs wrote: post #74

StreamBright wrote: post #73

C section saved the life of my child. I do not care if there is an "epidemic" (what a heck does it mean in a context of a surgical procedure at all???).

It means that in some cases the procedure is life saving, and in other cases unnecessary and potentially riskier than vaginal delivery. (Happy for you and your family that your child made it out OK — don’t know if it was recent, but congrats nonetheless!)

Well I was kind of interested how can somebody use epidemic as a noun for a surgical procedure. There are many factors to this but c-section is often safer for the child than normal birth. I am not sure if there is any problem with c-sections, in my country it is widely used even as an elective option without issues. It is hard to see the downside.

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

#163

Post by lostlogin » Sat, Oct 13, 2018, 9:43 PM UTC

jessaustin wrote: post #160

lostlogin wrote: post #155

Earlier quoted context omitted.

Standard of care may not be relevant. Stats are great for making policies to improve population health and wellbeing, but when you are the one in a million to whom a rare and catastrophic event occurs despite best practice, where does that leave one?

My understanding is that GP poster's wife was in the same position as my relative, being pregnant and having previously had a C-section. That they got different advice, is precisely a difference in the standard of care. Problems with birth are certainly not one in a million.

It quite possibly is related to different practices but good quality healthcare still has bad outcomes. Advice on treatment has a lot of variables and previous c-section is not going to be the only factor.

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

#164

Post by [deleted] » Sat, Oct 13, 2018, 10:34 PM 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…

[deleted]

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

#165

Post by harry8 » Sun, Oct 14, 2018, 12:10 AM UTC

harry8 wrote: post #13

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…

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

This was me pointing out the word "natural" is loaded BS. Whatever one's view is on whether a baby should be delivered by C-Section or vaginally (which should depend on the circumstances, obvbiously) "natural" as a description is really silly. We aren't cave-people. We are incredibly thankful for it. We don't consider it a good thing to watch our children die and will intervene in all kinds of ways animals can't to avoid it. Anyone touting "natural" for anything, especially childbirth, should be treated with extreme caution.

Look how it's done:

If you're a fit, 19 year old mother with a healthy, correctly oriented fetus vaginal birth may be preferable to c-section.

Take "natural" the hell away from all of it. It's a sign of thinking being replaced by emotion which probably isn't a good idea if you think evidence based medicine is a good idea.

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

#166

Post by harry8 » Sun, Oct 14, 2018, 12:33 AM UTC

grecy wrote: post #53

harry8 wrote: post #13

Earlier quoted context omitted.

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

Such a great myth that our culture perpetuates. You genuinely think half of women are dying in Childbirth in undeveloped countries right now ? I'm in Africa typing this, and I can honestly say you have no idea. FWIW, my sister-in-law had her baby at home, zero medical anything, just a widwife keeping an eye on things.

Do you really think underdeveloped is the same as cave-people? That Africans have no education and expertise to do their absolute best looking after mothers and babies? I have to disagree strongly there...

As ever more money would probably lead to better outcomes still. Poor Africa is unbelievably wealth compared to pre-history. https://www.iol.co.za/lifestyle/health/africa-200-000-women-...

Is the rate of non-intervention childbirth in pre-history 50% or 1%? This is not really even an interesting question. With absolute certainty you can say it was more than 1%. In modern times we've made that massively lower. /Even/ in very poor parts of Africa interventions of many different kinds happen to get that natural rate down.

It's not "natural" to take antibiotics for infection either. Get natural out of this discussion. Childbirth is dangerous, we have made huge progress as a species so that it really shouldn't be anymore. That progress is not "natural" what it is, is actually morally good.

Prosletysation in evidence based medicine should require peer-reviewed studies with data available cited as evidence. Where is that when all these people say "natural" is better? Evidence would convince me. Really.

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

#167

Post by ant6n » Sun, Oct 14, 2018, 1:10 AM UTC

DoreenMichele wrote: post #5

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."

I actually think it is probably more insidious than that. We have a lot fewer full-time homemakers. Women are much more likely to have paid jobs. The only way to schedule the birth is by scheduling a C-section. Waiting for the baby to show up when it decides to do so is a very organic, let nature take its course, humble thing to do and it is pretty alien to how most people live these days in developed countries. Hist…

Civilized countries have parental leave, where this is not an issue.

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

#168

Post by [deleted] » Sun, Oct 14, 2018, 1:26 AM UTC

Herodotus38 wrote: post #152

gcb0 wrote: post #86

Earlier quoted context omitted.

contributing to your social critic on everyone having an opinion; why not see the first c-section as the root of the problem?

They may not have had the option to avoid the first c-section, depending on the circumstances of the first pregnancy.

[deleted]

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

#169

Post by toomuchtodo » Sun, Oct 14, 2018, 1:32 AM UTC

lostlogin wrote: post #157

e40 wrote: post #68

Earlier quoted context omitted.

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.

I had no idea that interviewing doctors for delivering your child was a thing. Do they charge for it? Is it common?

My wife interviewed several OB practices in the Chicago area before settling on one for delivering both of our children. In her group of friends, it was common. There was a small charge at each as an initial consultation.

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

#170

Post by oculusthrift » Sun, Oct 14, 2018, 1:32 AM 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.…

and that’s why we don’t want socialized healthcare in the US. because it shouldn’t be other people’s business