Saturday, September 30, 2006

Babies On Demand ? Should We Accept It As A Sign Of The Times?

Everyone in Hollywood is doing it: Britney, Posh Spice, Madonna,
Gwyneth Paltrow. They have all made arrangements for unnecessary
scheduled cesarean sections to bring their children into the world.

Are these women so important, so busy? Are their lives and schedules so
strictly regulated and planned out that they were simply unable to let
nature take its course, instead opting to put themselves and their
babies in danger in order to plan and control the moment of their
children's births?

And just because there are women who are rich and powerful enough to do
so, does that make it okay? What about the rest of the women in the US
(44% more in fact than in 2001) who chose elective c-sections as an
option to deliver their children last year?

The fact is, aside from the issues of convenience and a woman?s right
to control her body, which as far as I?m concerned should not even be
considered in this discussion, the risks to both the mother and the
baby, of scheduled c-sections far outweigh the benefits.

C-section is major abdominal surgery. As safe as it has become in this
day and age, there are still many risk factors. Any time we undergo
anesthesia, there can be complications. Additionally there is the
possibility of hemorrhage or even death in some cases. Women who have
c-sections have longer recovery times and an increased risk of post
partum depression.**

There is no disputing that Cesarean today is much safer than it was 50
years ago, however, the mortality rate for babies born by Cesarean is
higher as well, even in cases where the surgery is not medically
necessary due to infant distress. In addition, natural childbirth and
labor produces hormones that strengthen the babies lungs and babies
born vaginally are able to breastfeed sooner.**

The bottom line is that if the procedure is not medically necessary, it
should not be performed. We all need to take a step back from this
subject as an issue of women?s rights and focus on what is best for
ourselves and our children.

In an effort to avoid pain and control a process that should not be
controllable, women are missing out on the miracle of childbirth as it
was intended. Because we live in a society of instant gratification, it
has become acceptable to manipulate and control a process that should
occur on its own time. Women who choose this option will never know
what they are capable of and that is the real tragedy.

Nature has been bringing babies into the world without the assistance
of surgery for thousands of years. We need to trust that. Yes, there is
pain and inconvenience involved. There will be pain of one kind or
another and inconvenience in every aspect of parenting from the moment
your child is born for the rest of your life.

Just because surgeons are willing to perform these operations, which
they do by the way for their own convenience and monetary gain, doesn?t
mean that we should comply. And just because there are spoiled, lazy,
selfish celebrities setting the trend, do we need to follow? As a
society, we need to take a step back and look at our motivations.

What are we becoming with regard to the way we bring our children into
the world? And why?

**All medical information taken from medical abstracts found online at
the following urls.

http://tinyurl.com/lnera (from midwife.org)

http://www.medscape.com/viewarticle/441201

http://64.233.187.104/search?q=cache:9fprSmTv0ggJ:ethicsjournal.umc.edu/ojs/include/getdoc.php%3Fid%3D119%26article%3D7%26mode%3Dpdf+Elective+Cesarean+Section&hl=en&gl=us&ct=clnk&cd=9

***************

Tammie writes online at http://soulgardening.typepad.com. She is
pregnant with her first child and hopes to be able to have a water
birth using the Bradley method and hypnobirthing techniques sometime
next April. Be sure to visit there to see Karen's take on this issue.

For this month's blog exchange, we're doing a series of debates on issues that matter. Click here for the other op ed pieces (and their opposing sides) today. And if you'd like to participate next month, send an email to kmei26 at yahoo.com.

21 comments:

Jerri Ann said...

Hello, your friendly blog exchange peer here, thought I would add some excitement to the whole thing. I have a heart shaped pelvis, every doctor I've ever seen in my life agree's that it is heart shaped, not oval and that it would be very difficult if not impossible for me to have a birth vaginally. If that is the case....and it is in my case...did I not deserve to just have my c-section and get on with healing instead of laboring for 12 hours and pushing for 2? I think I did, but insurance dictates otherwise and so....I did the whole labor thing and pushing and still had the c/section that we knew was coming. Just curious where that fits in with your "side" of this story!

Tammie said...

Hi Jerri Ann, I'm sorry you had to go through so much needless pain in labor.
This issue is definitely hot button but my take on the subject is based on medically unnecessary c-sections and does not in any way reflect my feelings about surgery that is needed to help ease labor for the mother or the child.
The trend that I am writing about is for women who have no medical need for surgery having it becuase it is easier and more convenient.
Also let me say that I have no idea what is going to happen when I have a child. I may end up needing surgery too. If I do, I will be disappointed to some degree, but if I don't that will in no way make me feel superior to anyone who has had to have surgery during labor.

PS Karen, thanks so much for letting me share your space today!

Carol said...

I remember hearing that one of the Berman and Berman sisters was electing a C-Section because she wanted to avoid damaging her vagina. She didn't want to chance stretching her precious vagina and possibly having sexual/unirinary problems caused by vaginal birth. That was the last time I ever watched Berman and Berman. Sad

Sandy said...

I can relate to your feelings about this issue, but I feel compelled to tell you my side of this story.

My first child was 9 days late. After being induced and laboring just under 48 hours, we decided on an elective C-section. I was both exhausted and devastated, and the doctor did not make me feel any better. He had few kind words (he told me I wasn't trying hard enough) and I was required to sign a form saying that I requested this procedure. After Annika was born, he later apologized. She was 9 lbs. 11 oz. and she was so crammed in me the doctor tore my uterus trying to get her out. Two years later, when I became pregnant with my twin boys, I was hesitant, but I was still willing to try a VBAC. Once I was in the hospital, however, the OB told me that Twin B was turned. He said that I could try to have Twin A naturally, and hopefully Twin B would turn in the process. Otherwise, I could just have a C-section on the second child. Most likely I would end up laboring AND having a C-section (just like my first). So I elected on the C-Section. Turns out, the babies were 8lbs 7oz and 8lbs 5 oz, respectfully. Twin B remained horizontal, and that OB told me I had made a good choice, as a C-section would have been imminent in that particular case. (A sidenote: I breastfed all 3 of my children successfully).
I guess my point is that we must be careful with the statistics we read. Because although both of my C-sections were inevitable, they were BOTH elective C-sections.
Also, your discussion about pain is really a moot point. BOTH types of delivery are painful -- the pain is just experienced at different times. I have experienced labor pains AND pain from recovering from the surgery, and both pains are equally valid.
I do really understand your concerns about such a disturbing trend, but I have to admit that reading this post brought back some painful memories, and it most certainly brought on guilt about something I HAD to elect yet had no control of.

TB said...

Sandy, I would argue that both of your surgeries were medically necessary based on the circumstances. You didn't ELECT to have surgery in a vaccum before even knowing if you would have problems.

What really stinks is that when women have to have surgery, like you did, they are made to feel guilty. What about the women who are just choosing it for no good reason? Do you think they are losing sleep at night over their decisions? I don't.

mothergoosemouse said...

Another mother who "elected" both times. First was after 30 hours of pitocin-induced labor (made it to 3cm - woo hoo!). Second was truly elective, but also recommended by my OB. And that second birth was a much MUCH better experience than the first.

ECR said...

I take a more laissez-faire approach to elective c-sections--as in, let them do what they want. But, that being said, what I want is a natural birth. It's what I wanted when I delivered my daughter, but I ended up with an emergency c-section for which I had to be knocked out. I was adamant that I did not want an epidural, which is ironically what contributed to the need for general anaesthesia when the emergency arose, because there was no time to insert a spinal. I am going to advocate very passionately for a VBAC next time around, and can only hope that my own confidence and the baby's safety makes it possible.

chelle said...

After reading all the comments, I am a little shell shocked. I never really considered those already in the labour process as "electing" to do anything but try to make the best decision possible for their babies.

I always thought of this issue as those Moms that when discover they are pregnant look at their blackberry and decide when to give birth or the doctors that do not want to be called at midnight to deliver so schedule the birth in.

Kristen said...

I have to say that when I think of elective I think of not even going through labor at all - and not because your baby is breech etc. but because you don't want to damage your vagina OR because you don't want to be in pain.

I tend to think that your c-sections Julie and the other folks, were elective for intelligent medical reasons.

And perhaps, if people don't want to stretch their vagina out, then feel free. But be informed. From what my friend's have said, C-sections are no walk in the park.

TB said...

Chelle, that's exactly the way I see it too. Elective means not medically necessary. I took it to mean women who choose surgery regardless of extenuating circumstances and that is how I approached my essay.

Christina said...

I also see elective c-sections as those decided on long before any possibility of complications is known, and selected to avoid the pain/trauma of labor.

My daughter was a scheduled c-section, because she was breech. It wasn't elective, it was decided on because the risks to her health were greater if I went into labor.

Having been through a c-section, I find it hard to understand why some would willingly sign up for it without giving labor a chance if they have no complications. Some of my friends had vaginal births and were up and walking right afterwards, while I was dealing with terrible pain. Any movement hurt.

I plan on a VBAC with this one, as long as there are no complications. While women have the right to make their own decisions, I think those who want elective c-sections should really consider what they're signing up for.

Heather said...

I had an emergent section with my daughter.

I chose to have a 2nd section with my son. They said there was a 70% chance I could have a successful VBAC, but the literature I had been reading swayed me to choose a section. Why? Because there is a high risk of brain damage to a baby born during a VBAC. Uterine rupture...I wanted to be awake to see my baby born. At the time I had the repeat section, the pendulum of medical thought was swinging toward "once a section, always a section".

Now that I've had 2, that definitely holds true. I'll never be allowed to labor.

I'm sure that you know the difference between someone "choosing" to have a first section without medical neccessity, and someone choosing a repeat section based on medical opinion and study.

Or, at least I hope you do.

Mayberry said...

I'm a 2-section veteran and I see a big difference between scheduling a repeat because of concerns over uterine rupture, and scheduling a section for a 1st birth because "it's just easier." Uh, not necessarily. There are lots of medical reasons for c-sections. But when there aren't, it's riskier to do it--so why would you?

Izzy said...

I had a c-section because my doctor, after looking at x-rays of my pelvis from before I got pregnant, felt like I would end up having one anyway. He gave me the choice to try laboring or schedule and I scheduled BUT I bitterly regret it and wish I'd not been so scared of labor, episiotomy etc. My second was a VBAC and it was a fantastic experience, even with 36 hours of labor, 2.5 hrs of pushing and an episiotomy.

Binkytown said...

Having had a non-elective C section, I can't understand why anyone would opt for that. It's painful and the recovery is so much harder. I too hope for a VBAC the next time around, but fear I'll have to go under the knife again.

Hippie Mama said...

I never even realized, before getting pregnant, that you COULD have a c-section for no medical reason. I was shocked to find out you could. It just seems to me like major surgery should only happen when it's medically necessary.

Anonymous said...

I had two c-sections, but the first one was after not progressing after over 24 hours of labor, and the second was recommended by my doctor. I agree with your comments that these would be considered "medically necessary" (or at least recommended) because there seemed to be a medical reason for them. However, I do wonder if only "medically necessary" c-sections were allowed, would people who could afford it go ahead and come up with a medical reason anyway (find a doctor who would sign off on it as medically necessary?)

I guess to me it's like certain types of plastic surgery, like face lifts and tummy tucks. I don't agree with them, but I do think people have a right to pay big bucks to have them done.

Nancy said...

I had two c-sections, but the first one was after not progressing after over 24 hours of labor, and the second was recommended by my doctor. I agree with your comments that these would be considered "medically necessary" (or at least recommended) because there seemed to be a medical reason for them. However, I do wonder if only "medically necessary" c-sections were allowed, would people who could afford it go ahead and come up with a medical reason anyway (find a doctor who would sign off on it as medically necessary?)

I guess to me it's like certain types of plastic surgery, like face lifts and tummy tucks. I don't agree with them, but I do think people have a right to pay big bucks to have them done.

Kara said...

I disagree on Nancy's comment of it being like a type of plastic surgery. C-sections don't improve your body in that way.

I agree that you should do it naturally when you can, just like the Higher Power intended it to be.

Jennifer said...

I'm chiming into this late, but just wanted to add my voice to the "beware of the 'elective' statistics". I've had 3 c-sections. The first was after going into labor naturally at 41.5 weeks pregnant. 18+ hours of hard labor, including at least 4-5 hours of contractions 2 minutes apart, later, I still had not dilated AT ALL. Zero dilation. My OB was concerned about uterine rupture and I had the c-section. *Statistically* speaking, that was an elective c/s, even though it was NOT my first choice. Later, it was determined that due to some scar tissue there from a surgery I'd had, my cervix would *never* be able to dilate. So my next two babies were also "elective" c-sections. The statistics are easy to manipulate.

I do wish I'd been able to give birth naturally, but I couldn't. And in the end, a healthy baby was all that mattered to me. Probably as a result of my experiences, I really don't have strong feelings about even truly elective c-sections, one way or the other. But if a woman elects a c-section to "avoid" pain, she will be very unpleasantly surprised. Recovery is very slow and very painful.

Tandy said...

A girlfriend of mine went the route of c-section after not dialating beyond 3cm. She was out the next day, very little pain... keep in mind though, this was not her first option. However, everyone heals differently.

So it's a choice a woman can make and why judge. I've got better things to do then judge a woman who decided to go the route of a c-section.