First of all, here is a link to the Georgia Birth Network s website, and a little information on the rally...if you wish to see the entire press release, please let me know and I'm happy to get it to you.
Now, there has been some discussion on this topic around here recently and I just have to respond to some of the comments, questions and statements that have been made. This may not be pretty...beware, I'm a little angry. For those who are not members of the birth community allow me to give you a quick run down on what a Cesarean is...
From wikipedia ... cesarean is a surgical procedure in which incisions are made through a mother's abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies. It is usually performed when a vaginal delivery would put the baby's or mother's life or health at risk....although in recent times it has been also performed upon request for childbirths that could otherwise have been natural.
A (very) few reasons a cesarean would be necessary -
- Umbilical cord prolapse - this is when the cord comes out before the baby, if a vaginal birth can not be facilitated.
- Uterine rupture - as it sounds, when the uterus ruptures ***
- Placenta Previa - this is when the placenta covers the cervix
There are more, but like I said a very few. Now, here are some very popular reasons for having a Cesarean -
- big baby
- failed induction ***
- breech baby *
- multiples *
- post dates ***
I will address the asterisk momentarily, first I would like to address the risks that come with a surgical delivery. Both for the mother, and the child. No surgery is with out risk, but how many doctors are going to be 100% forthcoming about all of the risks. Even the wikipedia article is severely lacking in the run down of the risks.
Web MD lists -
Maternal death - in planned c-sections is about 6 in 100,000, and for emergency c-sections is about 18 in 100,000. While it is a very small risk, is it still a risk. And It should be noted that there is no way to get an accurate number for such a risk as there are far too many factors to include here. Just know that, like all surgeries, a serious risk or "complication" is death.
Infection - during any hospital say infection is a risk. This is even true with a complication free vaginal delivery. However, with the body being open, you are more susceptible to infection.
Nausea, vomiting, and severe 'spinal' headache - mostly due to the anestisa, again, this could be true for a vaginal delivery, one with an epidural or narcotic pain relief.
Heavy blood loss - I think this speaks for itself
Long term risks -
Most of the long term risks apply to subsequent pregnancies, such as placental issues.
Placenta accreta, increata, percreta - the growth of the placenta deeper into the uterine wall than normal, which can lead to severe bleeding after childbirth, sometimes requiring a hysterectomy. Sometimes the placenta can not detach from the uterine wall, as it should after the baby has been born. Also, placenta previa is a risk for subsequent pregnancies, as the placenta may not want to attach to the scar tissue, causing it to lay over the cervix.
And as I starred above, Uterine Rupture is a later risk. Again, while the risk is small, it's even smaller in an un-scarred uterus.
There are also, very little mention risks associated with the surgery, difficulty in conceiving, and carrying future children. Risks of the incision not healing and extra steps, hospital stays, medications and possibly surgeries to help push that along.
There are also a number of risks to the infant, or infants,
- prematurity - not all women follow their cycles closely, it can be very easy to miscalculate the estimated due date of the child. This is true for inductions as well.
- breathing problems
- injury from the surgery or from the infants removal from the mother
There are many more known, and no doubt unknown risks. I'd like to move on now....
"I would love to try for a vaginal birth even though my doctor immediately says that we can schedule another c-section."
Who is the doctor working for? YOU!!! Sure the doctor has their share of responsibility, but lets face it. This is your body and your child we're talking about. Who is responsible for you and said child after the birth? That's right, you are! Unless there is a medical need for a repeat c-section, you shouldn't be discussing scheduling it in the first place.
Doctors, that's to say OBs are surgeons. That's right, surgeons. They are trained to manage your labor and birth, your infant, and your immediate postpartum care. And they are trained to surgically extract the baby if they deem it necessary. That doesn't always mean they're right. If you're looking to have a VBAC (Vaginal Birth After Cesarean) and this is what your doctor tells you, perhaps it's time to shop around. Start by interviewing hospital midwives (if you're interested in a hospital birth), and if you want an OB, interview other OBs. Ask around, join your local ICAN and find out who they recommend! Call around to local doulas, talk to those who have experience working with moms who have had VBACs. Or look into a homebirth, some homebirth midwives will accept VBAC moms who are otherwise low risk.
"my concern is that your facts are incomplete and could scare a woman who was told she should consider a csection. You failed to mention that the majority of csections are performed on Hispanic women *followed by black women* which if your group was serious would spend their efforts trying to establish why minority women have higher csection rates or contacting the AMA to find out why csections have increased since 1996. I appreciate what you are trying to do and don't disagree with your message, my concern is that you qualify your statements so that moms, especially first timers, aren't afraid of their doctors. Ask questions, get a second opinion if you are uncomfortable, but don't reject a csection out of fear. Women have it hard enough, we should do all we can to help and encourage each other. I hope your demonstration is a success"
Now, please keep in mind, that this is simply a press release, this is not a flyer we're handing out to women across the state suggesting that they refuse the c-section. This was posted several places online, and sent to many media outlets yes. If you are looking for more information please come by the rally and ask your questions at the reception. We would love to have standing room only, so invite everyone you know!
The last thing we are suggesting is that any woman refuses a cesarean based on this press release, or out of fear of the surgery. Please, please, know that you, and you alone, are responsible for YOU. Take the responsibility and seek out a care provider that will listen to you, and answer your questions honestly, and openly. Women shouldn't be afraid of their doctors. Do your own research, try to answer your own questions and then collaborate with your care provider.
In 1996 the rate of cesarean births was around 21%, in 10 years had risen to 32%. One in three women are not broken. One in three infants are not broken. Something is broken somewhere. In 2007 the rate of cesarean birth for white women was about 30%, for Hispanic women was closer to 28% and for black women the rate was 32%. Now we could contact the AMA to see what they say about the rise in the rates, but the truth is, they can't tell us anything new. It depends on who you ask...some will tell you that it is the women. they're older, heavier, they asked for a c-section, they have twins or more, or because of their race or ethnicity. Or, it's the OB's fault..they're worried about being sued, or their group policy dictates they do surgery, they get rewarded financially for performing more surgeries, they just want to schedule the births to fit their ideal work hours. Or is it the system that is broken? Whatever your personal take on it, I think the problem lies with in the doctors, hospitals and obscene policies set forth by both parties. Women are made to give birth, and for those who take care of themselves and are responsible for their health......well, I have trouble faulting the women who are not asking for elective surgery.
As an organisation striving to better the birth climate in Georgia our goal with this rally is to simply get the word out. Once we spread the word, and get some kind of positive response we can start working toward more individualised goals. If we just jump in and try to reduce the cesarean rate for a group of women, we aren't helping women, which is our focus. Please, come out to the rally, talk to us and see what we're all about. Hopefully we can answer some questions and calm some fears.
There has been more said over the last few days, some of it I would like to address.
"I have never met a woman who had a c-section that had complications from it, including myself. I have met women who's children died, and a c-seciton might have saved them. Surgery and childbirth are not with out risk"
I'm so very glad that some women come through their surgery with healthy children and healed bodies, but not all women are so lucky. There are womenwhose wounds don't heal, that take extra medical attention and time. Which make it very difficult to bond with your new child. Some women don't realized they were harmed until later in life. Constant pain or tingling in the scar.Adhesion's, placental issues, trouble conceiving and trouble carrying to term. These are very real, and very related problems.
Surgery is inherently risky. There will always be a risk to any kind of surgery. Childbirth is not a medical event, childbirth is a biological event, something we were created for. I could go on and on about medical interventions being the problem with modern birth, and the reason behind a lot of our fears about birth. The very basic truth is that the medical interventions were invented for a reason, but they need not be used with such frequency. We should stop trying to tame, and manage birth, and just learn to 'go with the flow' and treat problems as they arise. This can be done safely. However strapping women to machines, and puttingchemicals in their bodies to induce a labor, and force a child's birth and then expecting it to go well. I'm sorry that's just not going to work how you want it to.
"I doubt doctors want to perform more c-sections. It's a risky procedure that takes up a lot of their time."
I must be honest. This is a difficult statement to form a response for. Very basically what I can say here is that doctors want to control everything they can about the birth so that there is a positive outcome of living mother and child. Hopefully healthy mother and child. And while the goal seems admirable, what they leave out here is the happiness of the woman, and her family. What they forget is that this is a major life event for the parents, and grandparents, siblings, etc. The details of the birth can make for wonderful, or difficult bonding, and healing.
Please come out to Northside Hospital on May 16th from 2-4 PM, afterwards we will be at Life University from 5 until 8 answering questions and discussing further how we can solve these problems.
"I really don't see how these are not needed. Besides what insurance company is going to happily pay for a surgery that was not justified? If this were really going on those companies would be denying claims left and right."
No one is saying cesarean sections are not needed. What we are saying is that this many of them are not necessary. Women are being cut open daily for no medical reason. They are being left scarred and in pain and expected to 'bounce back' and take care of their infants. Insurance companies seem to have no problem with this, they are willingly paying for these unnecessary surgeries. And yet they refuse, in many cases, to pay a Certified Professional Midwife, or Certified Nurse Midwife, a much MUCH smaller fee for a home birth. Tell me, would you rather pay $2000, or $3000 for an unmedicated home birth, or around $15,000 or $18,000 for an unmedicated hospital birth. Or around $25,000 for a c-section. That isn't including all of the little 'extras' the come with medicated or surgical births. That's the very basic fee.
If insurance companies would agree to pay the much smaller fee for midwives and homebirths, I think we would see a drastic reduction in our c-section rate. Better yet, if insurance companies would put out good and fact/evidence based information on pregnancy and birth, then we'd have a lot more woman making the right choice for them (no matter the choice) and we would still see the dramatic drop in surgical births. Far too many insurance companies happily pay for unnecessarycesareans every day. we have to start somewhere.
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