Thursday, July 22, 2010

When to have a C-Section... and When to avoid it like the plague.

Women do more research before they purchase a car than they do when they make decisions about the birth of their child. It's unfortunate, but it's a simple fact of the culture we live in. We trust our Doctors. They are all powerful beings who went to school for many years to become as trained as they are, how could they possibly make mistakes? We think that these horrible things we hear other women have gone through belong to them- “That's their problem,” “That won't happen to me.” but the truth of the matter is that it could.
The following, according to the International Cesarean Awareness Network, ARE reasons to have an Emergency Cesarean.

Complete placenta previa at term
Transverse lie at complete dilation
Prolapsed cord
Abrupted placenta
Eclampsia or HELLP with failed induction of labor
Large uterine tumor that blocks the cervix at complete dilation (Most fibroids will move upwards as the cervix opens, moving it out of baby’s path.)
True fetal distress confirmed with a fetal scalp sampling or biophysical profile
True absolute cephalopelvic disproportion or CPD (baby too large for pelvis). This is extremely rare and only associated with a pelvic deformity (or an incorrectly healed pelvic break). Fetal positioning during labour and maternal positioning during second stage, most notably when women are in a semi-sitting position, cause most CPD diagnosed in current obstetrics.5
Initial outbreak of active herpes at the onset of labor
Uterine rupture
These Next Points, according to ICAN, ARE NOT reasons to have a Cesarean.
“ Many reasons given for cesarean, especially prior to labour, can and should be questioned. This includes:
macrosomia (large baby)
maternal age and parity,10
assisted reproductive technology,
failure to progress
fetal distress or even prolonged second stage.
There are very few true indications for a cesarean section in which the risks of surgery will outweigh the risks of vaginal birth.
A cesarean poses documented medical risks to the baby’s health.41 These risks include respiratory distress syndrome (RDS),iatrogenic prematurity (when surgery is performed because of an error in determining the due date), persistent pulmonary hypertension (PPH), and surgery-related fetal injuries such as lacerations. Preliminary studies also have found cesarean delivery significantly alters the capability of cord blood mononuclear cells (CBMC) to produce cytokines. An elective cesarean section significantly increases the risk to the infant of premature birth and respiratory distress syndrome, both of which are associated with multiple complications, intensive care and burdensome financial cost. Even with mature babies, the absence of labor increases the risk of breathing problems and other complications. Far from doing better, even premature and at risk babies born by cesarean fare worse than those born vaginally.
A cesarean poses documented medical risks to the mother’s health. These risks include infection,19 blood loss and hemorrhage, hysterectomy, transfusions, bladder and bowel injury, incisional endometriosis, heart and lung complications, blood clots in the legs, anesthesia complications, and rehospitalization due to surgical complications, rate of establishment and ongoing breastfeeding is reduced, and psychological well-being compromised and increased rate emotional trauma. Potential chronic complications from scar tissue adhesions include pelvic pain, bowel problems, and pain during sexual intercourse. Scar tissue makes subsequent cesareans more difficult to perform, increasing the risk of injury to other organs and the risk of chronic problems from adhesions. One-half of all women who have undergone a cesarean section suffer complications, and the mortality rate is at least two to four times that of women with vaginal births. Approximately 180 women die annually in the United States from elective repeat cesareans alone.”
It's scary as hell, but it's the truth.
Next time, I'll try to discuss the definitions of many of the words used above.

More Information and References for information collected from ICAN:

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