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Why are so many babies born around 8:00 AM? (2017)

blogs.scientificamerican.com

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Re: Why are so many babies born around 8:00 AM? (2017)

#71

Post by 1123581321 »

googlryas wrote: post #70
1123581321 wrote: post #69

Earlier quoted context omitted.

What are you talking about? This doesn’t have anything to do with the quality of individual doctors, or whether any particular procedure has value. (At least, as I understand the point of the descriptions of systems in action in the article.)

I'm responding to the butcher shop comment, not the article. The article has no reference to c sections or labor and delivery in general being butcher shoppy, unless you think scheduling a time for a c section or inductions makes it a butcher shop. I assumed OP was talking about c sections specifically, since it was in response to a comment about c sections, and c sections might use similar tools to a butcher shop(a…

I see. Sounds like you and the OP might have significant ideological differences, and you are unhappy about an idle comment by my wife because I tried to clear up confusion around OP’s metaphor. Sorry for adding to the confusion.

Re: Why are so many babies born around 8:00 AM? (2017)

#72

Post by jbn »

1123581321 wrote: post #63
Der_Einzige wrote: post #57

Earlier quoted context omitted.

The fact that epiderals aren't literally always done for women still shocks me.

Lots of women don’t want them.

Is there data on this? Specifically I wonder if women who refused it for a first birth still refuse them for subsequent births (or maybe they change their mind?).

Re: Why are so many babies born around 8:00 AM? (2017)

#73

Post by mahogany »

aaomidi wrote: post #62
mahogany wrote: post #45

Earlier quoted context omitted.

> You mean a generally-recommended-as-medically-necessary-only procedure that would result in far more complications were it not performed? A Caesarean is often performed even when it is not medically necessary. Hence "why are so many babies born around 8:00 AM"? Additionally, above a certain rate in industrialized countries, they are not even associated with better birth outcomes. > And anyway, people get surgeries…

Why should this decision not be left up to the mother? Why is this unethical?

What leads to many Caesareans is the "cascade of interventions" which might include unnecessary induced labor (e.g. if a mother is not dilating "quickly enough"), an early epidural, or continuous EFM. Many of these interventions, including the ones I listed, increase the likelihood of having a Caesarean.

In such a highly emotional situation, many mothers will feel pressured to do what their medical provider recommends. So, yes, it's technically true that it's the mother's decision, but many mothers don't realize they have the right to refuse these interventions, or are too scared to advocate for themselves in these situations, or are not fully aware of the risks -- both to the mother and the baby. In that sense, the decision is largely made by the medical provider, and this decision is often made because of an unnecessary urgency to get the birth done (or other reasons, such as a lack of experience with vaginal births or a fear of being sued, but in any case these reasons are not primarily the mother's). That is the part I was referring to as unethical.

To be clear, if it is medically necessary, a Caesarean should absolutely be done.

Re: Why are so many babies born around 8:00 AM? (2017)

#74

Post by willcipriano »

georgeburdell wrote: post #65
shiftpgdn wrote: post #35

How labor and delivery doctors treat women is criminal. A hospital should not be a butcher shop.

Wife never had a C section, but how they treat you until you get discharged would be literally torture in another context. Wife got woken up every 30 mins to 1 hour for this and that test, paperwork, questions, etc.

You are paying a lot of money to be in that hospital bed, you can tell them to pound sand and let you sleep. They will get pissy but I figured after what my wife went though having some nurses think I'm a asshole is the better part of the deal.

Re: Why are so many babies born around 8:00 AM? (2017)

#75

Post by dang »

shiftpgdn wrote: post #35

How labor and delivery doctors treat women is criminal. A hospital should not be a butcher shop.

Can you please not fulminate or post flamebait to HN? We're trying for curious conversation here and those are two of the things that most prevent that. That's why they're against the site guidelines: https://news.ycombinator.com/newsguidelines.html

Of course this doesn't mean you're wrong—it means you need to present your view thoughtfully and in a way that appeals to curiosity. That's especially important if your view happens to be right, so it's in your interest. (I'm adding this because the field around childbirth is intense and there are such strong feelings about it—justifiably.)

We detached this subthread from https://news.ycombinator.com/item?id=33437247.

Re: Why are so many babies born around 8:00 AM? (2017)

#76

Post by dang »

googlryas wrote: post #68
1123581321 wrote: post #64

Earlier quoted context omitted.

He might mean butcher shop as in being treated like a piece of meat to be handled as conveniently as possible, rather than consulted or even allowed to guide her own birthing experience. My wife had made similar remarks.

Well, I guess sorry your doctors sucked, but that isn't reason to malign the whole concept.

I understand why a phrase like that can be emotionally activating, but please don't perpetuate flamewars on HN. You made your point already. Escalating ("your doctors sucked") is unhelpful.

https://news.ycombinator.com/newsguidelines.html

Re: Why are so many babies born around 8:00 AM? (2017)

#77

Post by public_defender »

exhilaration wrote: post #9

The answer is scheduled C-sections and if you haven't read it, Atul Gawande's 2006 New Yorker article on why they've become so common is good read: https://www.newyorker.com/magazine/2006/10/09/the-score After watching The Business of Being Born , Gawande's article was really helpful in understanding why things are done the way they are.

The practice of routinely scheduling a c-section is basically a confession that birth medicine doesn't serve the patient. Any reasonable medical system would allow natural birth to progress until medical intervention became necessary.

Re: Why are so many babies born around 8:00 AM? (2017)

#78

Post by voz_ »

public_defender wrote: post #77
exhilaration wrote: post #9

The answer is scheduled C-sections and if you haven't read it, Atul Gawande's 2006 New Yorker article on why they've become so common is good read: https://www.newyorker.com/magazine/2006/10/09/the-score After watching The Business of Being Born , Gawande's article was really helpful in understanding why things are done the way they are.

The practice of routinely scheduling a c-section is basically a confession that birth medicine doesn't serve the patient. Any reasonable medical system would allow natural birth to progress until medical intervention became necessary.

Absolutely incorrect take. Also, irresponsible to spread this kind of nonsense when you are a public defender, and not remotely close to being a medical professional.

Re: Why are so many babies born around 8:00 AM? (2017)

#79

Post by bmitc »

projektfu wrote: post #53
bryanlarsen wrote: post #16

Earlier quoted context omitted.

And from anecdote, so should mothers. Early morning (~8AM) you get the A staff at their prime and are often the first case so it is usually timely. The worst time is 6:30AM (or whenever half an hour before changeover is). You either get C staff and/or people who have been awake for 24 hours. The surgeon probably called that time so they could book night rates.

Surgeons usually prefer to start operating before 8AM. They are awake, the OR is clean, the staff is fresh, and they have all day afterward to monitor for complications (and jet out early if everything goes well). The worst surgery times are probably starting around 7PM and going until 6AM. Those are usually emergencies, the OR has been in use all day, the surgeon probably has less experience as they are earlier in t…

In my experience with surgery for family members, surgeons want scheduled surgeries early because they have a shit ton to do. The brain surgeon was rallying the troops at 5:30am and was pissed they were already behind on the first surgery. He needed to do the scheduled surgeries early because he needed to have a certain amount of time for emergency surgeries. If those occurred early, then he could push the scheduled surgeries later. If the emergencies occurred later, then he’s done with the scheduled surgeries by then.

Then in the late morning and rest of the day, it was patient rounds and consultations, teaching at the local medical school, and performing research. Guy was a machine and on another level. I don’t know when he was ever able to have a non-medical or patient related thought.

Re: Why are so many babies born around 8:00 AM? (2017)

#80

Post by locutous »

aaomidi wrote: post #62
mahogany wrote: post #45

Earlier quoted context omitted.

> You mean a generally-recommended-as-medically-necessary-only procedure that would result in far more complications were it not performed? A Caesarean is often performed even when it is not medically necessary. Hence "why are so many babies born around 8:00 AM"? Additionally, above a certain rate in industrialized countries, they are not even associated with better birth outcomes. > And anyway, people get surgeries…

Why should this decision not be left up to the mother? Why is this unethical?

Many doctors nudge, or even push, decisions towards things that are convenient or good for them. Time table for the birth, treatment that enriches them... This includes unnecessary surgeries and labor inducement.

The decision is left up to the mother, sort of. Inside the hospital is an environment that the doctors are very familiar and the mother, not. It is very interested in following procedure, within which the doctors orders are held in high regard and the woman's desires not so much.

If you try to buck the desires of the hospital+doctor you had better have a will of steel and a willingness to walk out. Ornery nurses and doctors can make your stay an absolute hell.

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