No but it increases a patient's comfort. I'm going to assume you've never given birth because it's exceptionally painful and can last over 30 hours (especially if it's the first baby). Pain management is huge in medicine and many people are willing to take risks.
FYI being able to properly manage the pain actually can save lives though those statistics are far harder to get. For instance extreme pain during child birth causes some mothers to pass out which, if the baby is in the birth canal, can be incredibly dangerous. I've seen this. It's very scary.
Absolutely false. The vast, vast majority of the time you're scheduling a c-section because the mother has a complication that could put her or her baby at risk for a normal birth (previous c-sections for instance; extremely dangerous to try a v-back for many women).
Maybe there are some doctors who schedule it just because but that's an exceptional case, statistically.
You seem to be dismissing the phenomenon of needless c-sections, but it is real. At the birth of my 2nd child the OB started complaining that the birth wasn't "making progress" even though it was only in the 5th hour and a simple analysis of the interval between contractions showed an obvious trend. The OB just wanted to go do something else.
Naturally, I asked him to leave, and the birth was attended by some quite reasonable nurses. The only way to survive American health "care" is to know your facts and advocate for your own interests. The average physician in this country is mostly interested in billing you and moving on.
> You seem to be dismissing the phenomenon of needless c-sections, but it is real.
I never said it wasn't real I simply said it's in a minority of cases because it is. I've met dozens of OBGYNs who all think needless c-sections are simply unethical and who would never do them. But just as your experience mine is yet another anecdote.
c-sections in general are not a majority of births. Needless ones should be a subset of that (though because of the way reporting is done it's hard to determine which ones are and are not needless).
Sure they aren't the majority, but even having 25% of births be primary cesarean is ridiculous. The rate of cesarean for low-risk births is driven by policy, tradition, and unfortunately also profit motive. Simple changes in policy have dramatic influence on the cesarean rate, which strongly implies that the procedures were not medically indicated. For example the rate of cesareans for ordinary full-term, low-risk births in the US declined 6 percentage points after 2009, simply because the ACOG put out a statement about them. WHO says that the rate should be 15%, leaving half of US cesareans unexplained by medical necessity.
I don't know dude, where I lived (New Jersey), some of the hospitals have insanely high c-section rates - much, much higher than could be justified by mothers having complications. Here's 2015:
Hospital Name City State Rate
-----------------------------------------------------------
Hackensack Medical Center Hackensack NJ 41.8%
HackensackUMC Mountainside Montclair NJ 29.8%
Holy Name Medical Center Teaneck NJ 16.1%
Morristown Medical Center Morristown NJ 30.1%
Did this statistic control for how people select certain hospitals (where applicable)?
Obviously, if a hospital is specializing in C-sections, it will handle cases where the likelihood of having a sectino is much higher.
(Similarly, hospitals are very dangerous places if you compare the death rate in a hospital to the death rate at any other place where people stay. Of course it's mostly not because hospitals kill people, it's mostly because people go to hospital when they are sick.)
True, Hackensack Medical Center is actually one of the best hospitals in NJ, so I wouldn't be surprised that people who might experience complications would go there.
I think a slightly higher propensity to give c-sections leads to much higher total numbers because if you get one for birth X you are generally going to get another for birth X+1.
These are also all hospitals in higher-income areas that can be considered part of the larger NYC metro region, as it is home to many of the bridge-and-tunnel commuting workers. I would not be surprised if this demographic has a statistically significant deviation from the national norm when it comes to seeking certain medical services and attitudes on desired level of medical intervention during childbirth.
Furthermore, very-high-income areas (North NJ must have the highest furriers-per-capita in the US) tend to have a far higher median maternal age, which raises the likelihood of c-section.
Also, the US has generally higher rates than the rest of the first world, and it's not entirely clear that this actually leads to better outcomes. I think more in the medical field are starting to rethink this.
> Maybe there are some doctors who schedule it just because but that's an exceptional case, statistically.
In actuality, measuring the C-section rate is one way to measure the quality of a hospital. Of course, the morbidity of the population must be taken into account, but it is worth noting that a C-section is a surgical intervention with much higher associated costs and pay.
I would also guess that pain management during labor and birth leads to reduced maternal stress which leads to reduced fetal stress, healthier fetus, less odds of complications, healthier baby and healthier mother. Just a guess though.
The opposing viewpoint might be the known risks of the epidural directly to the baby.
* Epidurals may cause your blood pressure to suddenly drop. For this reason your blood pressure will be routinely checked to help ensure an adequate blood flow to your baby. If there is a sudden drop in blood pressure, you may need to be treated with IV fluids, medications, and oxygen.
* Other studies suggest that a baby might experience respiratory depression, fetal malpositioning, and an increase in fetal heart rate variability, thus increasing the need for forceps, vacuum, cesarean deliveries and episiotomies.
There is no 'may' about it. It is generally fentanyl, one of the most powerful opioids.
Try doing a hit of fentanyl via IV and see what your blood pressure is.
I hate the way the medical community makes words like 'may', 'could' so intentionally vague. Could mean 90% chance, could mean 1%, depending on the context. It's like speaking a doublespeak.
Just curious--do you work in the medical field? My wife is 9 months pregnant and much of what you've written goes completely against what our OB and every other medical professional we have consulted with has told us.
Nope just going off what I've talked to OBGYNs about, personal experiences and statistical data I've read from studies. I'm not sure exactly what you're specifically pointing out but that's a bit concerning regardless.
The term "Scheduled c-sections" can also be referred as "planned c-sections" or "elective c-sections". Meaning they are not medically necessary, but chosen voluntarily.
Obviously c-sections that are not planned are needed
> The term "Scheduled c-sections" can also be referred as "planned c-sections" or "elective c-sections".
Um, what? So let's walk through a scenario here. A woman has an issue where she had to have an emergency c-section in a previous birth. So far you're okay with that, right?
Okay now this woman is having a second child. Conducting a v-back can be dangerous (it's at least a higher increase of complications from a vaginal delivery especially if the previous c-section had to be more invasive than normal). So the doctor schedules it, typically at about week 38 to avoid natural delivery kicking in.
So you are saying that, in my scenario, the scheduled c-section is "elective" and not "medically necessary"?
That's a really wrong viewpoint. Kinda dangerous really.
No but it increases a patient's comfort. I'm going to assume you've never given birth because it's exceptionally painful and can last over 30 hours (especially if it's the first baby). Pain management is huge in medicine and many people are willing to take risks.
FYI being able to properly manage the pain actually can save lives though those statistics are far harder to get. For instance extreme pain during child birth causes some mothers to pass out which, if the baby is in the birth canal, can be incredibly dangerous. I've seen this. It's very scary.
> scheduling c-sections don't reduce mortality rates.
Absolutely false. The vast, vast majority of the time you're scheduling a c-section because the mother has a complication that could put her or her baby at risk for a normal birth (previous c-sections for instance; extremely dangerous to try a v-back for many women).
Maybe there are some doctors who schedule it just because but that's an exceptional case, statistically.