Thursday

The Score: How Childbirth Went Industrial

Excellent and fascinating ARTICLE IN THE CURRENT NEW YORKER about how C-Sections have become so ubiquitous.

The author makes many excellent points about the potential risks and benefits of c-sections.

But he(she?) completely fails to get into all the ways OTHER than pitocin and other chemical labor stimulants that can prevent c-sections by helping a stalled labor.

No doubt, many women and babies' lives are saved today because of c-sections. But most c-sections are clearly unecessary. Very few American women - including those who end up with c-sections due to "failure to progress" -- walk during labor, use birthing balls, get into warm water or do any of the other things that work far better than lying in bed to keep labor moving along.

When a baby is truly "stuck" (as the woman profiled in the article experienced), no amount of warm water is gonna help. But for slower labors or atypical labors, these things can really help.

I hope I do not end up needing a C-section. I might. Who knows. But I feel good that I am choosing a provider with a really low c-section rate whom I can trust to give me good guidance. I want to be in a position where if my midwife and/or OB tells me "You need a c-section," I can be 100% confident that this is the truly necessary option. Sadly, I think many doctors are just too quick with the scalpel.

7 comments:

KLC said...

I learned early on when preparing for childbirth that hospitals are more interested in the mom-2-be being a "good patient" than an active participant in the labor process. Meaning, their wish if for you to sit in that bed and let them shoot you up with pain relieving drugs when the pain gets bad - but otherwise, they don't want you walking, making a fuss or bothering them until they are ready for you. (This also impacts women who want to deliver babies without pain meds quite dramatically). The predominance of C-sections in this country are the natural by-product of medical philosophies which espouse "delivery on demand" and/or fail to consider the natural forces at work here that could expedite labor (warm water, walking, b-ball) and even encourage a safer delivery naturally.

Even with pitocin administered 3 times for my three different deliveries (water broke, then nothing happened), we always requested the telemetry monitor so that I could walk during contractions. It helped move the baby down and in position and certainly gave me greater control of the labor process. If you find yourself having to rely on pit for your labor - get that telemetry monitor and congrats by the way!

karrie said...

I had midwife care and delivered my son via a c/s after a very long labor and 6+ hours of pushing. My 10lb son was sunny-side up and trying to present forehead first at one point. Ouch!!

I had a heplock (strep+, ruptured membranes) and actually snuck out of the hospital and walked around Cambridge. I did end up agreeing to pitocin after natural techniques did not get things moving. Then I (foolishly) agreed to Cytotec when the pit did not work as expected. Oh was that fun without pain relief! (Nevermind the risks that I'm now aware of.)I just dragged my IV pole around--hid in the bathroom on the toilet alot--and sat on my birth ball. They did not do continuous monitoring, thank god.

I winced when I read the New Yorker article earlier this month due to the similarities between that woman's experience and mine. Right down to being unable to make breastfeeding work.

Anonymous said...

Like the mom who commented below, I too had a "sunny side up" situation. My water broke at 11:00 at night, so I was encouraged to rest. As labor failed to progress, I was forced to go for the pitocin/epidural combo. Who knows if walking might have helped? I sort of doubt it in my case. They tried to move my baby, but it didn't work too well. I have to say that I was still surprised when they told me it was time for a C-section. I was interested to see in the article that the figure for infection after 24 hours of one's water breaking was pretty high. Given the germs lurking in hospitals today, it's a wonder it's not larger. Just had a relative contract a nasty staph infection after major surgery. Anyone interested in medicine as it's practiced today should read Atul Gawande whenever his articles are published.

Leslie said...

What a fascinating article, and what sounds like a necessary section if forceps were not an option. I've had three sections and found it quite disturbing to read about the mechanics of the operation. I did not want to watch mine.

Anonymous said...

"Childbirth" - The hit new single from Rammstein.

clara said...

I agree completely that sections are overdone here. I think the author makes an excellent point though about the skill and almost unteachable artistry involved with forceps use and the same could be said for a lot of what midwives do too. Delivering a breech takes a certain skill too, and these days instead of taking the time, c/s is a first resort.

I`m a former homebirther who has no choice but to have c births now and I feel fine about it only b/c I know its an option I need. Owning your experience and enjoying it is possible no matter how you birth. It is possible to have a sucky homebirth and a fabulous c/s. I loved the author`s description of a c/s , it was beautiful.

Anonymous said...

Don't know if you are still planning to use LRBC, or if you used them in past. But be aware they have quite a few transfers to hospital for "failure to progress".