# Childbirth



## ElaineG

An item in La Repubblica today got me thinking about this very important, and (I hope) usually happy subject.

The news item reported two things that were of interest to me:  1) that 30% of births in Italy are now Caesareans, with the figure as high as 80% in some hospitals, and 2) that while 30% of the women in Italy who go through childbirth request an epidural, only 4% of women succeed in getting one.

New government initiatives seek to reduce the number of Caesareans and increase the avaibility of epidurals, which was termed by one women's leader in Italy an achievement of "justice for women."

I was curious about a few things about this:

The number of Caesarians has gone way up in the United States too.  Has this happened in your country?  Do you know why?  Here, people joke about doctors not wanting to miss their golf games and preferring the scheduling covenience of a Caesarian.  

What is the attitude in your country towards epidurals and other pain relief medications?  In my mother's day, there was a huge movement towards doing it all naturally, with no drugs, but most of my contemporaries have opted for drugs, as I expect I will when the the time comes.  My mother tells me that in the early 70s it was seen as almost shameful and unnatural to want an epidural.  Does this attitude hold true where you are?  Is this what influenced their availability in Italy?


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## french4beth

When I had my children in Canada, the stats were: 20% of all births end in a Caesarian.  I don't know if this has increased or decreased...

Epidurals were available, but my doctor insisted on a certain level of cervical dilation prior to administering the epidural (since you're basically on your back afterwards, and hooked up to a fetal monitor until you deliver). I had back labor & gave birth to very large babies, so thanks to the epidural, I didn't have to have any c-sections (but still came close).

I believe that 1 reason that the US caesarean rate is going up is due to the proliferation of medical malpractice lawsuits, particularly against obstetricians. I have heard anecdotally that if the doctor performs a c-section, you cannot sue if their are complications before/during/after delivery... And of course, the mom's recovery is much harder and longer after a c-section than after a vaginal delivery.

In our pregnancy prep course, we were encouraged to avoid painkillers if at all possible, but there was no shame if you did get one.


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## Bettie

I think in Mexico there are a lot of c-sections that are not really a necesity, but sometimes the doctor advices that and sometimes women want that.

Now I am 32 weeks pregnant and my doctor doesn't once has asked me if I want a c-section, I haven't asked for one either, we both are waiting for the baby coming the natural way, but I do want an epidural, for that I have to go to the hospital where I will have the baby and sign some papers where I will say that I know and understand the risks of that.


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## Poetic Device

When I had Savanna, I was originally thinking of an underwater birth.  I was told that procedure was the least stressful on the baby and that since they are still attached to the cord  they are able to breathe under water.

The doctors wanted to do a c-section on me because--just as with the rest of the pregnant women in this side of the country--they just simply do not want them to go full term for some reason.  My doctor wanted me to deliver two weeks early (I wound up delivering a month early naturally) because he just simply did not want me to go full term and that was that.  As far as the epiderral is concerned, I unfortunatelly was one of the ones that asked yet did not recieve.  As it was explained to me the reason for this was because the hospital was very under staffed.


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## Bettie

Really, and where you ok with that??? I mean why wouldn't he want you to be full term??? 

I have a cousin who asked for the epidural too late, so the next time she asked for it the minute she got there!!!!


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## Poetic Device

I was very upset that they wanted to take Savvy out early.  I always believed that the woman should go full term (unless major complications surfaced).  It wound up not mattering what happened because she tourned out to be a premi (if you can't handle a little kid crying there is no way you would ever be able to handle seeing a premature infant.  They are so heartbreakingly helpless.)  With my next one I am making it VERY clear that he/she is going full term and are not to be forced out.


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## ElaineG

> I believe that 1 reason that the US caesarean rate is going up is due to the proliferation of medical malpractice lawsuits, particularly against obstetricians. I have heard anecdotally that if the doctor performs a c-section, you cannot sue if their are complications before/during/after delivery...


 
I have heard that the increase in caesareans is related to medical malpractice suits also, but it doesn't make a lot of sense to me.  You can absolutely sue for malpractice before/after/during a c-section, and I thought I had heard that complications were more likely to occur with a c-section than with natural birth.  But maybe that is what I have wrong; maybe these days less complications happen with a C-section.


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## ILT

In Mexico it is common for patients to come to an agreement with the doctor. My sister had to have a C-Section because the baby was very big; he was born at 36 weeks already weighting somewhere around 7-8 pounds! There are also ladies who want to program a C-Section for a number of reasons: maybe they already have another kid and want to make sure they have the best care possible, maybe their husbands travel a lot and they want to make sure the husband is present, some ask for it just because that way they will not feel any pain (I'm personally not so sure about that - I also think that the recovery from a C-Section is harder than recovering from a natural birth).

What I recall is that when I used to work at a bank (with one of the best medical services anywhere) doctors would usually tell women that a C-Section would be required, on appointment 1 or 2! We used to joke that doctors knew the insurance would cover that and that they could charge more without affecting the pocket of their patients.

I agree that the baby has to be full-term whenever possible, and I wouldn't let a doctor decide to force the baby out or have a C-section unless I was given the medical facts.

As for the epidural, it's very easy; you want it, you get it. Most doctors will explain the advantages and disadvantages and let the patients decide. I think that's the best way to go. 

Well, at least that's what happens here in my town in the north of Mexico, I'm not so sure it is the same everywhere.


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## french4beth

ElaineG said:


> I thought I had heard that complications were more likely to occur with a c-section than with natural birth. But maybe that is what I have wrong; maybe these days less complications happen with a C-section.


I believe that the trend these days is not to wait as long to do a c-section, whereas in the past, doctors may have let the labor progress further (since a vaginal birth is desirable for both the baby and the mother). That's just my educated guess, though.

Also, there's a much greater trend both here in the US and in Canada to allow the baby to "room in" with the mother, rather than isolating the babies in the nursery.  I was much more comfortable having my babies in the room with me (except when I was bathing, etc.) just so that I could get used to them and also to nurse them more easily.

And just after I had given birth to my youngest (and shut down production), the Quebec hospital where I had given birth installed jacuzzi's in all of the labor rooms! Too late for me, though...


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## ILT

french4beth said:


> I believe that the trend these days is not to wait as long to do a c-section, whereas in the past, doctors may have let the labor progress further (since a vaginal birth is desirable for both the baby and the mother). That's just my educated guess, though.


 Not so past past, I had a friend give birth in Texas just five years ago, and after being almost fully dilated the doctor decided a C-Section was in order  That's the worst of both worlds!



> And just after I had given birth to my youngest (and shut down production), the Quebec hospital where I had given birth installed jacuzzi's in all of the labor rooms! Too late for me, though...


Where do I sign in? I'm not pregnant nor will be, but that's nice! I haven't seen anything like that here.


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## ElaineG

> And just after I had given birth to my youngest (and shut down production), the Quebec hospital where I had given birth installed jacuzzi's in all of the labor rooms!


 
I've seen that advertised at some of the fancier hospitals in NYC lately.  But we are seriously behind the times -- one of my best friends worked on a maternity ward in Stockholm about 15 years ago, and it was already standard equipment there!


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## Alicky

As ILT said 





> What I recall is that when I used to work at a bank (with one of the best medical services anywhere) doctors would usually tell women that a C-Section would be required, on appointment 1 or 2! We used to joke that doctors knew the insurance would cover that and that they could charge more without affecting the pocket of their patients.


; doctors charge more for the c-section. And I've heard a lot of women wanting one because they claim is less painful, you can schedule it, is a swift procedure. 
And doctors encourage "old" women to have c-sections to avoid possible complications.
Personally, I don't like them. I'd like to have my future babies the natural way, and, if possible, avoid the epi. 
But sometimes the caesarean and the epidural are needed.

ps: Poetic Device: I loved the name Savanna. Just beautiful. 
Underwater birth are now becoming increasingly popular as it is the least stressful birth metod in my country; just as you were told.


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## maxiogee

Our son's birth was a bit of an ordeal for my wife. Officially 'early' according to the hospital, she was in labour for about 23 hours, with epidurals and other pain-relief. Eventually the senior Gyneacologist was called, after they had tried forceps and several other methods. It was absolutely horrible, and I was only an 'interested party', as it were. When the top dog arrived he was furious with the medical team and rushed Mrs Maxi into a theatre for a section. At this point I was told to make myself scarce. As I left I heard him bawling out one of the staff for "the botch job" they had done.
Our son was delivered some time later and taken straight to the 'special baby unit' which, although normally reserved for really premature babies, meant that he was monitored for several days to ensure that everything was alright. The suction they had tried had distorted his head and he looked really strange. And as he was full term, surrounded by all the really tiny premature babies, he looked huge - that coupled with the shape of his head made the poor thing look deformed. The suction had had some affect on the blood-vessels in his head as his head was very purple for several days after.
The worst thing of all was that although I got to see him later that day, it was three days before my wife got to see him. He wasn't allowed out of his ward, and she wasn't allowed to leave her floor. It was traumatic for her.
The whole event did nothing for my opinion of 'experts'.


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## Bettie

I have a friend who had to have a c-section because she would not have contractions and dilate after 24 hours after her water broke in her due date.


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## ElaineG

> *Originally posted by Mr. Maxiogee: *It was absolutely horrible, and I was only an 'interested party', as it were.


 
That raised another interesting question for me.  When my Mom gave birth to me back in the Year 0, men were not allowed in the delivery room, and my father waited anxiously in a "fathers' room" for the whole 23 hour ordeal.  Just a short time later (in the Year 4  ), mores had changed, and when my brother was born, my father was allowed in to hold my mom's hand, tell her to breathe, look panicked and all that good stuff.

Are there any cultures where men are still not welcome during delivery?


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## .   1

I was present during the birth of my baby and wouldn't have missed it for quids.
Mrs. .,, avoided drugs for the sake of our child and relied on the gas which seemed to take the edge off the pain.
I consider that my presence was of enormous benefit to my wife.  She held my hand and yelled at me and made all the bad jokes about men and smiled when I wiped her sweat away and gave her water and such.
I saw my baby come out bit by bit and it was wonderful.
I have experienced high levels of physical pain and the times when my wife was present to help me were the least traumatic for me and so I suspect was the case for my wife at that time of staggering pain for her.
I am suspicious of doctors who routinely deliver before 'full term'.  I can not see even one valid reason for such behaviour.  It sounds like an excuse to run a hospital more efficiently without the distraction of mothers giving birth naturally at 2am.

.,,


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## Bettie

Wow, Maxioge, that is a sad story!
My mom told me that when I was born she was alone there in the hospital because she gave birth in the public hospital and they don't allow anybody there with you, well, at least in her time, I don't know how is now.


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## cherine

Maxiogee, I'm so sorry to read the story of poor Mrs Maxi and Mr Maxi Junior  I hope he grew up healthier and that the ordeal he went through didn't affect his life.

Now, for Elaine's questions :


ElaineG said:


> The number of Caesarians has gone way up in the United States too. Has this happened in your country? Do you know why? Here, people joke about doctors not wanting to miss their golf games and preferring the scheduling covenience of a Caesarian.


The number of Caesarians has gone way up in Egypt too, during the last 10 years, or maybe more.
When it first became more numerous than the average (i.e. when we started hearing this word much more often) it was said that doctors do it because it's more expensive, hence more profitable for them.
Now I think it's not really the money any more. Women are getting weaker, their health status is worsening each and every year, the number of babies born with illness is growing tremendously (I think it's all due mainly to three reasons, or maybe more: 1. pollution, 2. unhealthy diets and 3. poor health care)
Another reason, which I honestly find silly, and that is another growing number of women wants to "avoid pain". Ok, we all know that giving birth is painful, very painful, but that's the way it has always been, and I heard several times (heard, because I don't have personal experience with pregnancy, delivering babies..) I heard that once the "new" mother hold her baby, she just forgets about all the pain.
Why I hate taking painkillers ? because it seems like obstruing the work of nature, and -even more- I heard it can affect the baby.


> What is the attitude in your country towards epidurals and other pain relief medications? In my mother's day, there was a huge movement towards doing it all naturally, with no drugs, but most of my contemporaries have opted for drugs, as I expect I will when the the time comes. My mother tells me that in the early 70s it was seen as almost shameful and unnatural to want an epidural. Does this attitude hold true where you are? Is this what influenced their availability in Italy?


General attitude : it's ok to take pain relief medicatios, it's ok to make Caesarian even the mother's status can allow her to give natural birth. All this wasn't that common in the time of my mother, of course , I think it's a matter of generation more than a regional one


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## Bonjules

Well, 
since I have participated in a bunch of them, I might as well stick
my 5 cents worth of wisdom in.....
For most women, luckily CB is a positive happy experience, esp when it's over. But few medical situations can turn disastrous that quick or be as 
stressful on the doc: You just never know and everybody has horror stories to tell; also we don't accept 'bad outcomes' anymore which used to be part of life.
It is true that many docs will push for C-sec.'s with the slightest risk factors (big baby, what have you)and not only for fear of lawsuits. After waiting up on a long, difficult labor you are almost as worn out as the woman (imagine several of these a week) and if you can settle the matter
quickly (some have it down to 1/2 hour) and cleanly, this is very tempting.

And now I will let you in on a 'dirty little secret', very hard to admit for s.o. like myself who wants to do everything 'naturally': C-sections are good
for you. Especially with a large baby or a small lady the traumatic stretching of the entire pelvic floor is not to be taken lightly. And worse with every birth. Nature was not 'planning' for us to live for so long and many women have problems with incontinence later on in life - very little distance between bladder and outside, and this is on top of the naturally occurring relaxation and loosenig of the tissues- not to speak of vaginal, uterine prolapses etc...
So things are not that clear cut, unfortunately.


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## ElaineG

Bonjules said:


> And now I will let you in on a 'dirty little secret', very hard to admit for s.o. like myself who wants to do everything 'naturally': C-sections are good
> for you. Especially with a large baby or a small lady the traumatic stretching of the entire pelvic floor is not to be taken lightly. And worse with every birth.


 
Very interesting, Bonjules.  Food for thought!  And it does seem that babies are getting bigger all the time -- I was 5 pounds 8 ounces and not abnormally small for my era (sorry I don't know what that is in kilos), but now babies are always much bigger, 8 pounds and more.  I guess it's the education about alcohol, smoking, prenatal nutrition....



cherine said:


> The number of Caesarians has gone way up in Egypt too, during the last 10 years, or maybe more.


 
It's fascinating to me that this is really a very widespread phenomenon.  I always thought the predominance of C-sections in America had to do with spoiled American culture, but you guys are saying it's so widespread.  Very interesting!


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## maxiogee

Mrs Maxi is fine.
Maxi Junior is so healthy it's despicable!

One last point I forgot to mention - having been cast out of the arena, none of the staff saw fit to tell me when I could go back to be with Mrs Maxi! It was only some time later when one of them passed me in a corridor that they said "How's your wife?" I said I hadn't seen her since I was bundled out - only to be told that she was back in her ward.

====

I believe that sections are very popular nowadays as they help in getting one's figure back more quickly than after regular births.


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## whattheflock

I would like to advance the idea that in the last thirty or so years, the trend in baby size for the more "advanced" countries has been increasing. I wonder if it has to do with nutrition habits, since even I at my short age can see that my children (and their generation) seem bigger and more developed than "we" were at their age. Maybe another factor could be that women's hips might be decreasing in span a little bit. So, bigger baby, smaller birth canal, and a change in the medical protocols (probably based on the likelyhood of lawsuits, but I'd like to think that it is also a change brought about by a culture of "patient safety"), all these factors might contribute to the changes in labor practices.
But I'm only speculating. All I know for sure is that I was present during both my kids' births (vaginal delivery, poor wifey, the epidural didn't work both times), and I think that provided me with a way to bond even more with my children and wife.


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## Chaska Ñawi

In Canada the numbers are rising slightly, but we aren't big on medical malpractice suits so there isn't the same impetus for the physicians to be in complete control of every twitch and push.  

We had planned on an intervention-free birth, but our first child turned breech two weeks before delivery.  We then opted for epidural anaesthetic, and the epidural didn't work .... so they tried opening me up with local anaesthetic.  My reaction to abdominal surgery performed under local anaesthetic was such that they had my husband out of the room and me unconscious about 60 seconds later.

Two years later we tried again.  This time I went into labour a month early.  The doctors assumed that labour would stop .... so I endured 97 hours of full labour before delivering our son.  After about 40 hours you can't really practice pain control techniques effectively.  It was apparently as traumatic for our son as for me, since he slept for the next four days, barely waking to nurse.  The doctors apologized afterwards and said that if they'd known that the labour was for real, they would have accelerated the birth.  However, even in the middle of this endless labour I wasn't yearning for another c-section and it wasn't suggested.  The two just aren't comparable.

Conclusion:  In Canada, you can plan all you want, but the best laid plans of mice and men .... etc etc.

A side note:  When I was living in Mexico, I worked with a number of children who had cerebral palsy.  The reason:  malnourished mothers in labour for too long, with children deprived of oxygen during the long labour.  Decent nutrition would have been the first option, of course .... but access to an equipped hospital for childbirth would have been helpful too.


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## Gianna_7

Each birth is a miracle and blessing.  I completely agree with Chaska Nawi that you can plan and plan but you certainly cannot control all of the events of the birthing process.  Each situation and each birth is completely different.  I haven't read any mention of alternative birthing methods and I would also like to contribute on that topic.

Regarding OB/GYN's in the U.S., I have friends who no longer practice in the OB portion of their speciality b/c they cannot afford it. Some states have such high malpractice insurance rates that many OB's decide to practice only in GYN or choose another specialty all together.   I wouldn't doubt that malpractice rates must have something to do with the amount of C-sections as well.  Doctors simply cannot afford to take on much risk.

AFter saying all this, I am grateful for the many options and conveniences our modern society offers.  And each individual birth has its own needs.  I do not believe in one method for all. 

I my particular case, I was not convinced that the epidural was the best or only option for pain or to put the mother at ease.  I have friends who have had permanent complications from the epidural, others who were too far along to have it, and others for whom it didn't work at all.  STill, I was glad it was an option and even ready for the option if I needed it.  

My experience was rather ideal in that my son was head down, we had a slow labor, and I was able to give birth without intervention.  I practiced hypno-birth for 4 months prior to giving birth.  I attended a class and also practiced with my husband.  I wasn't entirely consistent with my practice, and intend, God-willing,  to use the method to its fullest potential if I am blessed to have more children in the future.  I was able to let my body do the work of labor without fear and was even able to relax as I had practiced in class and at home.  I wasn't out to get a medal or against the conveniences of modern medicine, but hoped to use as few interventions as possible or on an as-needed basis.  

The uterus, without ever having its own work-out, is the strongest muscle in a woman's body.  It's a strange concept that one has to relax to let it be most effective....that a person can actually inhibit the work it will naturally do by trying too hard.  

My husband and I had a tremendous experience in that he could contribute to much of my relaxation and  practiced this in advance with me.  I think  the hypno birth method is increasing in popularity b/c it can be used in so many situations both before, during and after birth--even for deep relaxation in difficult nursing situations or after c-sections.

If anyone has any further questions please feel free to send me a message.


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## tvdxer

ElaineG said:


> An item in La Repubblica today got me thinking about this very important, and (I hope) usually happy subject.
> 
> The news item reported two things that were of interest to me:  1) that 30% of births in Italy are now Caesareans, with the figure as high as 80% in some hospitals, and 2) that while 30% of the women in Italy who go through childbirth request an epidural, only 4% of women succeed in getting one.
> 
> New government initiatives seek to reduce the number of Caesareans and increase the avaibility of epidurals, which was termed by one women's leader in Italy an achievement of "justice for women."
> 
> I was curious about a few things about this:
> 
> The number of Caesarians has gone way up in the United States too.  Has this happened in your country?  Do you know why?  Here, people joke about doctors not wanting to miss their golf games and preferring the scheduling covenience of a Caesarian.
> 
> What is the attitude in your country towards epidurals and other pain relief medications?  In my mother's day, there was a huge movement towards doing it all naturally, with no drugs, but most of my contemporaries have opted for drugs, as I expect I will when the the time comes.  My mother tells me that in the early 70s it was seen as almost shameful and unnatural to want an epidural.  Does this attitude hold true where you are?  Is this what influenced their availability in Italy?



I suppose today's time pressures have a lot to do with the popularity of Caesaerian sections.  Perhaps the fact that most women work today also provides some explanation, although that might be countered by the fact that (I assume?!) most get some form of extended leave from work.

I faintly remember reading something saying that Caeseareans are very popular in Costa Rica.

I personally was delivered by Caesearean, not because of my mother's need for precise scheduling but because I was huge (9 lbs 15 oz, or 4.5 kg).


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## Poetic Device

Wow, Maxi.  I am so sorry to hear about those difficulties.  (Personally, I hope those people lost thier jobs.)

In any event, you all know how I am notorious for looking things up.  Well, I did it again.  Here is a site that I found to be a bit interesting.

http://www.babycenter.com/refcap/pregnancy/childbirth/160.html


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## Bettie

Chaska Ñawi said:


> In Canada the numbers are rising slightly, but we aren't big on medical malpractice suits so there isn't the same impetus for the physicians to be in complete control of every twitch and push.
> 
> We had planned on an intervention-free birth, but our first child turned breech two weeks before delivery. We then opted for epidural anaesthetic, and the epidural didn't work .... so they tried opening me up with local anaesthetic. My reaction to abdominal surgery performed under local anaesthetic was such that they had my husband out of the room and me unconscious about 60 seconds later.
> 
> Two years later we tried again. This time I went into labour a month early. The doctors assumed that labour would stop .... so I endured 97 hours of full labour before delivering our son. After about 40 hours you can't really practice pain control techniques effectively. It was apparently as traumatic for our son as for me, since he slept for the next four days, barely waking to nurse. The doctors apologized afterwards and said that if they'd known that the labour was for real, they would have accelerated the birth. However, even in the middle of this endless labour I wasn't yearning for another c-section and it wasn't suggested. The two just aren't comparable.
> 
> Conclusion: In Canada, you can plan all you want, but the best laid plans of mice and men .... etc etc.
> 
> A side note: When I was living in Mexico, I worked with a number of children who had cerebral palsy. The reason: malnourished mothers in labour for too long, with children deprived of oxygen during the long labour. Decent nutrition would have been the first option, of course .... but access to an equipped hospital for childbirth would have been helpful too.


 
I don't understand how they didn't know labour was for real, weren't they the ones who should know??


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## Philippa

Hello folks!

I've found some stats for the UK:
The Caesarean rate for 2004-2005 was 23% in England and slightly higher in Scotland and Wales. It also says that the rate has increased dramatically from 9% in 1980.(source)
Also, in looking for this, I found out that the WHO has a recommended target for countries of 10-15% Caesareans. (relevant article)


I love translating said:


> ....There are also ladies who want to program a C-Section for a number of reasons: maybe they already have another kid and want to make sure they have the best care possible, maybe their husbands travel a lot and they want to make sure the husband is present, some ask for it just because that way they will not feel any pain .....


This sounds amazing to me. I can't imagine being able to go to my doctor to ask for a Caesarean. I'm sure the person would be told 'no' or at least shown so much scary data that they are effectively making the decision for you. Maybe if you had private medicine it would be different.

Congratulations, Bettie, and good luck with 'your birth'!

Saludos
Philippa


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## cherine

Philippa said:


> This sounds amazing to me. I can't imagine being able to go to my doctor to ask for a Caesarean. I'm sure the person would be told 'no' or at least shown so much scary data that they are effectively making the decision for you. Maybe if you had private medicine it would be different.


Oh Philippa, you can't imagine how many women in Egypt actually do this ! And they do it, as I Love Translation said, to avoid pain.
Unfortunately, the answer they get is most often a "yes". Doctors get paid more for Caesarians, so why would they say no  (of course exceptions exist, but that's what they are : exceptions).
I guess this is another reason why the number of Caesarians is rising in Egypt. Unfortunately I don't have statistics, but if/when I find any info about this, I'll post it here.


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## Bonjules

Philippa said:


> Hello folks!
> 
> I've found some stats for the UK:
> The Caesarean rate for 2004-2005 was 23% in England and slightly higher in Scotland and Wales. It also says that the rate has increased dramatically from 9% in 1980.(source)............
> ...........
> 
> 
> This sounds amazing to me. I can't imagine being able to go to my doctor to ask for a Caesarean.
> Philippa


Don't forget, Philippa and Cherine: A C-section is good for you. _It's prefectly fine to ask for one._
saludos


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## french4beth

Bonjules said:


> Don't forget, Philippa: A C-section is good for you.


  
Major surgery & general anesthesia are good for you ?!? It may be in the _best interest_ of the mother and/or the child, especially in an emergency situation, but _'good for you'_? I beg to differ!

From this article: 


> *Women opting for a Caesarean should be warned there is a small chance that it will jeopardise later natural births, say experts. *
> They face a slightly higher risk of serious medical problems, including tearing of the womb... The benefits of a natural birth include a faster recovery and a shorter hospital stay as well as avoiding the risks of major surgery...


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## Bonjules

Any decision will carry some risk, including 'natural childbirth' -sometimes severe risk indeed. As I tried to point out before, there are distinct advantages to the surgery which extend way beyond the birth itself.

The complication rate of C-section in skilled hands is very low. So is the
possibility of uterine rupture with subsequent natural birth. There is also
no particular reason not to do a repeat CS in this case.


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## french4beth

If C-sections are so _good_ for you, why isn't every birth a C-section?  I agree that sometimes they are medically necessary (and thus in the best interests in mom and/or baby), but wouldn't all mothers opt for them if they were so *good* for you?  I consider myself to be a good mother, but didn't choose to have them (at the time, you could not _elect_ to have a C-section - one could be scheduled for you, based on medical necessity, or you could have one if an emergency arose). Even if the option had been available to me, I wouldn't have chosen one - how can you care for your baby when you're recovering from major surgery? It's also very difficult to successfully nurse an infant following surgery.  I didn't choose to have any amniocenteses, either - I didn't want or need any (although there was a _lot_ of pressure from my US medical provider to have one). I feel the fewer invasive procedures one has, the better it is for mom & baby.


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## Bonjules

french4beth said:


> If C-sections are so _good_ for you, why isn't every birth a C-section? I agree that sometimes they are medically necessary (and thus in the best interests in mom and/or baby), but wouldn't all mothers opt for them if they were so *good* for you? .


 
Beth, nobody doubts that you are a great mother, did the best for the child as you saw it and if everything worked out great, so much for the better! May you never have reasons to regret your decisions.

Why things are done the way they are done is quite another matter.
Large areas of our medical practices (the majority, I'm afraid) have little to do with 'rational' decison-making. The way we do things ( aside from advances in knowledge and technolgy of course) is a complicated
amalgam of vested intersts ( a lot of money is involved on all sides of the CS issue), tradition, political correctness, magical belief and fear of lawsuits -do you want me to go on?


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## invictaspirit

I am an expert in this, as my wife gave birth to our son a few days ago.  

The situation in the UK as far as caesarians go is that more and more women are asking for 'elective' caesarians. This is a trend started by various air-headed celbrities such as Victoria Beckham. It is also a trend that our health system is hoping to reverse. At the moment, every stage of labour and delivery is elective...you can have what you want.

There is no limit at all on epidurals in the UK. If you want one, you get one.

My wife had a 'crash caesarian'. *Caesarians are NOT 'good for you'.* In my opinion, and my wife's, they should be treated as a last resort, as in her case. The anaesthesia involved alone carries some risk, though not a major one. But more than anything it is a major surgical procedure. The resulting discomfort, relative imobility and weeks of moderate bleeding are hardly a health tonic! In the UK, a woman is not allowed to drive for 6 weeks after her section...

I could go on.  In more or elss every respect my wife regrets having to have a caesarian.


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## Bonjules

invictaspirit said:


> I am an expert in this, as my wife gave birth to our son a few days ago.
> 
> The situation in the UK as far as caesarians go is that more and more women are asking for 'elective' caesarians. It is also a trend that our health system is hoping to reverse. At the moment, every stage of labour and delivery is elective...you can have what you want


 
Invicta, emergency procedures are never great fun or particularly safe.
That is why I am 'breaking a lance' for elective C-sections, under well
controlled conditions. Everybody has been unduly dramatizing the post-op
effects. Where the 6 week no-driving comes from I don't know, it seems
a bit ludicrous to me.
The one big caveat I have and that is a recent, but coming (and largely self-inflicted)thing are the 'Super-Bugs", the multi- drug resistant bugs causing infections
we have been raising through our over-use of antibiotics. They are a menace to any procedure, even any hospital stay nowadays.


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## Gianna_7

Bonjules said:


> Invicta, emergency procedures are never great fun or particularly safe.
> That is why I am 'breaking a lance' for elective C-sections, under well
> controlled conditions. Everybody has been unduly dramatizing the post-op
> effects. Where the 6 week no-driving comes from I don't know, it seems
> a bit ludicrous to me.
> The one big caveat I have and that is a recent, but coming (and largely self-inflicted)thing are the 'Super-Bugs", the multi- drug resistant bugs causing infections
> we have been raising through our over-use of antibiotics. They are a menace to any procedure, even any hospital stay nowadays.



I just did a search on Google *Question and Answer* regarding c-section complications for mother and child.  Wow!  The list is looooong and may continues well into childhood.  To call a c-section "good for you" assumes too much.

 I'm not saying that c-sections are not a blessing at times, but I would *hesitate *to say that everyone has been "unduly dramatizing" the effects.

In fact, I know surgeons from Johns Hopkins School of Medicine, who would not dare to think they would do something better than God.  

Now, with my personal belief aside, I don't think the statistics support elective c-sections either.  Do we need to quote the research?


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## invictaspirit

> I'm not saying that c-sections are not a blessing at times, but I would *hesitate *to say that everyone has been "unduly dramatizing" the effects.


 
I'm quite certain I wasn't.    My post was the essence of balanced sobriety on the matter.  (Apart from when I called Victoria Beckham an air-head.)


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## Kajjo

ElaineG said:


> 1) that 30% of births in Italy are now Caesareans


In Germany, the ratio is about 25% with slightly increasing tendency. Interestingly, caesareans are clearly the wish of women here and not of the doctors or hospitals as claimed for other countries in this thread.

It is generally accepted that short-time recovering from a caesarean is usually harder and longer than from a normal delivery. However, long-term recovering is much shorter and milder with regards to e.g. incontinence problems and sexual complications. When done in a planned manner, the caesarean has the lowest ratio of harm to the newborn, which is significantly lower than with natural delivery. Some statistics of caesareans are worse, because the emergency caesareans are not counted separately.

I do not know enough about epidural limitations, but I have never heard any woman complain that it was not available. My guess is, that this is no issue in German hospitals and epidural is freely available. Most women I know got it.

Kajjo


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## Bonjules

Gianna_7 said:


> I just did a search on Google *Question and Answer* regarding c-section complications for mother and child. Wow! The list is looooong and may continues well into childhood. To call a c-section "good for you" assumes too much.
> 
> 
> 
> In fact, I know surgeons from Johns Hopkins School of Medicine, who would not dare to think they would do something better than God.


 
Gianna, with statistics I could prove anything I want (like that 
CS's are the greatest thing since the upright gait), it all depends what you want to prove and how you set it up (old hat?)
I would prefer to leave God out of this, since I wouldn't want to hold Him
responsible for the countless fatalities in childbirth (today in 'Lancet" -estimated 80,000 /year in developing nations) or the huge numbers of severely impaired babies...
I surely tried to play a bit 'devils advocate' here, in order to stimulate discussion, as I often do when things get a bit lopsided - as happened here with everybody chiming in to the 'if we do everything naturally and prepare well it will be all wonderful' tune.
Childbirth is a notoriously difficult to predict, biologically 'crude' often chaotic event, as is the entire pregnancy ( docs always joke : Pregnancy is a disease..). Things are not that 'clear cut' -forgive the pun.
saludos


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## Gianna_7

Being able to prove "anything" with statistics is the realm of a politician rather than a scientist. The morbidity and mortality rate of c sections in developing countries is 36 per 1000 births as opposed to 12 per 1000 for vaginal deliveries. So if 80,000 babies die due to vaginal births, then hypothetically 240,000 babies die from c section. (though not likely due to the economics of the procedure) This is where the phrase "skilled hands" becomes important. Scientific literature needs to be taken as a whole... including the fact that csections are more dangerous in the setting of active labor than they are as an elective procedure, and that maternal and fetal readmission after elective csection is more common than NSVD. (normal spontaneous vaginal delivery) But it would also have to take into account the power of millions of years of evolution which has developed intricate hormonal and chemical triggers to induce labor, complete fetal maturation and the transition to infant life (for example clearing the fetal lungs of amniotic fluid within seconds of emerging from the birth canal) I understand that it's done regularly and safely, but  I would hesitate to undergo any surgical procedure that wasn't entirely necessary, much less interfere with the physiologic process of child birth.


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## Bonjules

Gianna_7 said:


> So if 80,000 babies die due to vaginal births, then hypothetically 240,000 babies die from c section.


Gianna, the 80,000 are women dying  -due to the lack of C-sections.
probably many mor babies die.


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## *PD*

invictaspirit said:


> ...
> There is no limit at all on epidurals in the UK. If you want one, you get one.
> ...


Not in my experience you don't!


ElaineG said:


> An item in La Repubblica today got me thinking about this very important, and (I hope) usually happy subject.
> The news item reported two things that were of interest to me:  1) that 30% of births in Italy are now Caesareans, with the figure as high as 80% in some hospitals, and 2) that while 30% of the women in Italy who go through childbirth request an epidural, only 4% of women succeed in getting one.
> New government initiatives seek to reduce the number of Caesareans and increase the avaibility of epidurals, which was termed by one women's leader in Italy an achievement of "justice for women."
> ...


I wonder what the government initiatives are and whether they'll work! I never got the epidural I asked for because the anaesthetist was busy. I ended up with an emergency caesarean and then the anaesthetist was busy with me and probably there was another woman in the hospital who wanted an epidural and didn't get one. Maybe that's why I never got my epidural, she was busy with someone else's Caesarean. So the not getting an epidural and high Caesarean rates seem to be linked, at least where there aren't plenty of staff - perhaps that's the solution in Italy - do you have private healthcare there or  a system like the NHS here?
I also read about high Caesarean rates in, I think it was, China of 50%, because, the newspaper article claimed, it was a more surgical procedure so they could charge their clients more for it compared to a vaginal birth.


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## LikeBarleyBending

*PD* said:


> Not in my experience you don't!
> 
> I wonder what the government initiatives are and whether they'll work! I never got the epidural I asked for because the anaesthetist was busy. I ended up with an emergency caesarean and then the anaesthetist was busy with me and probably there was another woman in the hospital who wanted an epidural and didn't get one. Maybe that's why I never got my epidural, she was busy with someone else's Caesarean. So the not getting an epidural and high Caesarean rates seem to be linked, at least where there aren't plenty of staff - perhaps that's the solution in Italy - do you have private healthcare there or a system like the NHS here?
> I also read about high Caesarean rates in, I think it was, China of 50%, because, the newspaper article claimed, it was a more surgical procedure so they could charge their clients more for it compared to a vaginal birth.


 
Yes, it is reported the Caesarean rate in China is no less than 50%, much higher than that required by WHO. I think this is resulted from two things:1) Women think Caesarean is safe and tend to choose Caesarean to relieve birth pain and keep their figures. 2) Hospitals do not discourage Caesarean for economic reasons, perhaps.


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## min300

In my country(Iran) the number of Caesareans has increased too. Although most of the women prefer natural birth, they end up having Caesareans birth. People complain that doctors prefer Cesareans because it's easier and they can charge more money for it.


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## EmilyD

We have a term here, "Vaginal Birth After Cesarean" ( VBAC ) pronounced:  "vee-back".  I learned it when I supported a woman in that process...

When the mother has HIV or Hepatitis (I think any of the Hep's, but I'm not sure), then a c-section may prevent the baby from becoming infected...

In some states, HIV testing of pregnant women is becoming _mandatory_.  The argument is that we can better treat the babies...There are plenty of arguments in favor of keeping the testing _voluntary...

Nomi
_


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## alexacohen

Caesarean births are indreasing in Spain too.
Necessary or not.
Some of them are performed so the doctor gets paid for the actual birth; if a natural birth takes too long, and the change shift hour draws near, the only way the on duty doctor makes sure the miney will fall into his pocket is performing an "emergency" Caesarian section.


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