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

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

#91

Post by tptacek » Sat, Oct 13, 2018, 2:52 PM UTC

ineedasername wrote: post #84

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…

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.

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

#92

Post by dsfyu404ed » Sat, Oct 13, 2018, 2:56 PM UTC

ineedasername wrote: post #84

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…

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)?

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

#93

Post by lathiat » Sat, Oct 13, 2018, 3:04 PM UTC

basicplus2 wrote: post #12

Thats nothing.. perth western australia has been the csection capital of the planet Heres 2012 figures https://www.birthsavvy.com.au/caesarean-section-rates-perth-...

Hello from Perth. Just recently had our daughter at SJOG Murdoch but was not a Caesar. However we went with our obstetrician partially because he was less likely to push towards Caesar and that ended up being our experience. He was happy to wait and deliver late.

We had some non trivial complications though from going natural.

There was however clearly a high rate of those around us but I think basically it’s one of the more well known private hospitals for people to visit where you get the choice so plenty of people are just choosing to go that way for various reasons. also we are 30 but most of the people in our prenatal class were older except one.

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

#94

Post by aklemm » Sat, Oct 13, 2018, 3:06 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…

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

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

#95

Post by isostatic » Sat, Oct 13, 2018, 3:06 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.…

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.

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

#96

Post by learc83 » Sat, Oct 13, 2018, 3:10 PM UTC

epmaybe wrote: post #67

Interesting article. I also thought that encouraging cesarean sections was something obstetricians did often to avoid the time spent waiting for delivery. However, in my training I witnessed quite the opposite. My resident and attending physicians were very cautious with going forward with cesarean sections, and would do whatever they could to continue with vaginal delivery when the mother wanted that, and also encou…

Did you find that obstetricians encouraged inducing labor as a way to avoid spending time waiting for deliver?

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

#97

Post by JauntTrooper » Sat, Oct 13, 2018, 3:12 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…

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

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

#98

Post by chongli » Sat, Oct 13, 2018, 3:15 PM UTC

v_lisivka wrote: post #87

lanius wrote: post #66

I'm surprised C-section rates are higher among wealthier, education women. I would assume educated women are more likely to understand the risks associated with C-sections.

Heads of their babies are larger, while vagina is same, so higher risk to rip vagina and die, so higher C-section rate.

It's not the size of the vagina that's the issue, it's the size of the pelvis. The vagina is extremely flexible. Bones much less so.

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

#99

Post by epmaybe » Sat, Oct 13, 2018, 3:23 PM UTC

learc83 wrote: post #96

epmaybe wrote: post #67

Interesting article. I also thought that encouraging cesarean sections was something obstetricians did often to avoid the time spent waiting for delivery. However, in my training I witnessed quite the opposite. My resident and attending physicians were very cautious with going forward with cesarean sections, and would do whatever they could to continue with vaginal delivery when the mother wanted that, and also encou…

Did you find that obstetricians encouraged inducing labor as a way to avoid spending time waiting for deliver?

Yes and no. I can only speak for this one hospital, but most of the time we would only induce if there was indication for doing so (twins is one example that comes to mind) or if the mother truly wanted induction. I don't recall specifically encouraging for reducing time, though the residents would joke about wanting to do so instead of waiting.

I wonder if this is more common at teaching hospitals, so that attendings can hand off the waiting to the residents in training.

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

#100

Post by evgen » Sat, Oct 13, 2018, 3:26 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?

In the world of modern medicine where complications like this would lead to an immediate c-section? No.

Roll the clock back a couple of centuries or so and both mother and child would die.