birth

I often wonder if there are so many Cesareans today in an attempt to prevent women from having "too many children".

http://www.irishexaminer.com/breakingnews/ireland/symphysiotomy-women-demand-justice-and-compensation-555222.html

Cesareans and family size

The rate of Cesarean section in the US is at an all time high, with almost 1 in 3 women haveing C-sections.  I believe that part of the reason for so many cesareans is that we are anxious.  We cannot wait to meet our babies or for labor to begin, so we induce labors.  And, let's face it, labor takes a long time...so we use medication to speed up labor, and other medicines to take away the pain of a labor that we are trying to rush through.  I think that we sometimes create problems due to a lack of patience.  There are also many ligitmate reasons for a cesarean, but whatever the reason, many women are having this common surgery.

One thing that doesn't seem to come up until after the fact is that the first cesarean can dictate your family size.  Many doctors are resistant to Vaginal Birth After Cesarean (VBAC), even thought ACOG has stated that VBAC is safe even after two previous c-sections.  And some womean are scared to choose VBAC.  I remember talking to a friend when she was pregnant for the second time, her first birth was via cesarean.  She was scared to try for a VBAC.  We hear a lot of talk about uterine "rupture" and that just sounds really scary.  One of the things that surprised me, after doing to research, looking just at the stats, the risk of a complication from cesarean was higher than the risk of a complication from a VBAC.  The risk of a uterine rupture or tear is real, but it is very small.

The point that I am getting to, is that more and more women are having multiple cesareans.  How many ceseareans are too many?  I cannot find a concrete answer.  I met a woman once, who had had 5, the last two were against her doctor's wishes.  A quick Google search, led me to a discussion board, where a woman had 9!  I know of doctor's who have limited women to 3.  There is not always a choice when it comes to needing a cesarean or not, but there is a choice with subsequent pregnancies to choose VBAC.  Choosing to have multiple c-sections can limit family size.  Even if you think you don't want more than 1 or 2 children now, doesn't mean that you won't change your mind in the future.

I feel that this is an important aspect that is too often over looked until it is too late.  A great resource on this issue is the International Cesearan Awareness Network.  http://www.ican-online.org/

Breech babies

This study says that a vaginal breech birth is safer for the mother and no more risky for baby than cesarean.

http://www.sciencedaily.com/releases/2010/10/101026141510.htm

Mountain Midwifery Center Stats

This is so exciting to read....but many women in Denver are having great births at our birthing center.  Here is the lastest:

Mountain Midwifery Center
Statistics
September 17, 2006-September 30, 2010 (48 months)

Registered for care and reach term and/or risk-out (includes AP transfers, move, etc.)
943

Antepartum transfers (financial issues, move, GDM, preeclampsia, PTL, multiples,
breech)
127

Pre-Admit Intrapartum Referral: risk factor that is found before admission that makes
birth center care inappropriate. Examples include malpresentation on admission, fever,
prolonged prodromal labor, meconium stained fluid, rupture of membranes > 24 hours
with no labor, hypertension on arrival.
49

Admitted to MMC in labor
816

Intrapartum transfers: risk factor such as failure to progress, meconium in active labor
after admission, fetal distress
104
Overall IP transfer rate 12.7%

Births in MMC
Year 1 67
Year 2 120
Year 3 265
Year 4 264
Total 716

Cesarean Section Rate: c/s divided by birth center admission
6.9% (57/816)

Postpartum transfers: PPH, retained placenta, laceration repair
23

Newborn transfers: TTN, 2 anomalies
16

GBS rate 7%

Waterbirth rate 41%

C-section rates

This is why I do what I do....
http://www.nydailynews.com/lifestyle/health/2010/09/13/2010-09-13_california_links_higher_csection_rates_to_forprofit_hospitals.html

VBAC is a reasonable choice!

Vaginal Birth After Cesarean is a reasonable choice.....

http://journals.lww.com/greenjournal/Fulltext/2010/06000/Vaginal_Birth_After_Cesarean__New_Insights_on.25.aspx

Birth by day of the week

I thought this was so interesting!!
http://peltiertech.com/Excel/Commentary/BirthsByDayOfYear.html

fetal monitor, for better or for worse?

http://www.philly.com/inquirer/magazine/20100426_Test_leads_to_needless_C-sections.html

Irony

I find it ironic that so often we induce labor before a woman's body is ready and then when her labor doesn't progress fast enough we tell her that she needs a c-section.  What if we were patient enough to let labor start on its own and to let labor progress at its own pace?