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Doctors warn of alarming C-section 'epidemic'

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

#171

Post by throwaway1391 »

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…

I see a lot of people in this thread idly sniping talking points on the benefits of vaginal delivery, insurance/costs, etc. - illustrating the point in your last paragraph.

My son and wife's lives were saved by a C-section three weeks ago. Watching that fetal heart rate monitor dip to zero and then slowly, unsteadily rise back up over and over again was the hardest thing I've ever done. The hospital staff pushed us to do a vaginal birth the whole time. I understand and appreciate what they did, but at the same time I hope there is a better way, because in hindsight I would have never put my wife and son through this again.

This isn't a programming language preference. If you don't know the details of clinical practices around C-section, if you're not an expert or a patient, then you really shouldn't be pushing your opinion on others. Refrain.

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

#172

Post by eridius »

tptacek wrote: post #91
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…

All the link you're providing says is that uncomplicated C-sections are less risky than complicated ones. Sure, that sounds right.

Direct quote from the very first paragraph of the article:

> The Birth Trauma Association found that mortality rates are lowest for women who have elective caesareans.

The context is comparing maternal death rate for vaginal delivery vs caesarean.

Here's a Telegraph article that goes into more detail, including giving actual numbers: https://www.telegraph.co.uk/news/uknews/1584671/Women-choosi...

From the Telegraph article, the maternal death rate for pre-planned caesareans is 3.1 per 100,000 women, whereas the maternal death rate for everyone else (natural birth plus emergency caesarean) is 3.9 per 100,000 women (and the original article gave the maternal death rate for vaginal birth at 4 per 100,000 women).

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

#173

Post by jkestner »

acct1771 wrote: post #62
jkestner wrote: post #58

Earlier quoted context omitted.

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?

The writing was awkward, lecturey, and belaboring points. I get it, it's an essay wrapped in something else, but something less palatable, not more. Like sister post, I often find that my taste wasn't great when I was younger, but this is one that I remember sucking even back when I read it. Still, the idea being explored is worthy. though only now am I trying to go mostly meatless.

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

#174

Post by [deleted] »

paulddraper wrote: post #151
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. * It's the doctor's concern because of the Hippocratic Oath * It's the baby's and therefore father's concern (but not choice), since vaginal birth is correlated with better outcomes. * If insured, it's the insurer's concern, as it's over twice the cost of vaginal delivery. (In the case of the UK, this is the government, so literally everyo…

[deleted]

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

#175

Post by dhnsmakala »

cellis wrote: post #6
DoreenMichele wrote: post #5

Earlier quoted context omitted.

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…

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.

I don't think this suffering is worse than what people lived through back then.

Imagine if your full time job was just finding food to put in your mouth and wake up the next day.

I appreciate the comforts of modern society. I doubt I'd have been a good scavenger...

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

#176

Post by kleopullin »

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…

I'm very sorry for your and your family's loss.

In the information age, there are so many irresponsible and incomplete bits supporting this, that or the other in as many superlatives as possible. What can a person do? I thought that VBAC was more dangerous for the mother than the newborn, for a healthy young woman, coupled with even a tiny amount of pressure this could easily lead people to make a decision they were not really comfortable with. The "sheer force of opinion surrounding ... childbirth in general" is astonishing; I agree with you here. The information age is badly curated and gives far too much weight to the inexpert opinion, imh (and non-expert) o. Mothers must give birth naturally, mothers must nurse their infants for x months, fathers must cut the umbilical cord.

All the modern medicine in the world coupled with the power of the information age can't make these decisions for us. Maybe, in the future, machine learning methods can pull relevant information out for people to counter some of the cultural pressures.

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

#177

Post by techsin101 »

StreamBright wrote: post #162
gdubs wrote: post #74

Earlier quoted context omitted.

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.

Again, study is pointing out that c section is being performed more than necessary, in fact so much more that it's epidemic. From data WHO calculated that about 20% deliveries should require c section. But numbers are reaching to 45%. Bad Effects in children born with c section are un clear and major surgery has risks for mother as well. Doing a surgery when not necessary is always a bad idea. So if you had a good out come, good for you. But understand you're one data point and can not be reflective of what should be.

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

#178

Post by ng12 »

isostatic wrote: post #95
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.…

Nobody gives a stuff about the cost, you'll get the same pressure if you plan to deliver privately. There's fewer than 700,000 births a year. If every one was a c-section it would cost an extra £700m a year, less than 1% of the NHS budget. NICE guidelines state that the woman should discuss the pros and cons and then it's her choice.

> then it's her choice

Well, yes, but that doesn't mean it's a choice between two roughly equivalent options. C-Sections are invasive surgeries and come with added risks. I would argue a healthcare provider's duty is to advocate against them unless there is an appropriate medical reason.

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

#179

Post by isostatic »

ng12 wrote: post #178
isostatic wrote: post #95

Earlier quoted context omitted.

Nobody gives a stuff about the cost, you'll get the same pressure if you plan to deliver privately. There's fewer than 700,000 births a year. If every one was a c-section it would cost an extra £700m a year, less than 1% of the NHS budget. NICE guidelines state that the woman should discuss the pros and cons and then it's her choice.

> then it's her choice Well, yes, but that doesn't mean it's a choice between two roughly equivalent options. C-Sections are invasive surgeries and come with added risks. I would argue a healthcare provider's duty is to advocate against them unless there is an appropriate medical reason.

That would be the discussion of the pros and cons.

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

#180

Post by pbhjpbhj »

cm2012 wrote: post #108
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.

No, you don't get to make major body and life decisions for a mom because maybe infant outcomes are 1% better in certain circumstances. Somehow I doubt you donate 90% of your income to children in need, which would actually drastically improve outcomes for 1000s of babies.

If I donated 90% of my income then my children would starve.

However, we do have a process whereby use of my wage income is not entirely elective, it's called taxation and in part is used to improve outcomes for other people's children.

In your opinion should infants have no advocacy, should mothers (parents presumably) have complete determinency over the medical needs of their children without regard for medical outcomes.

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