How Big Is The Average 12 Month Old Baby Boy Elective C-Section – Would You Do It?

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Elective C-Section – Would You Do It?

It’s the latest thing. Modern as Kabbalah, without any study. Madonna did it. So does Elizabeth Hurley. C-section by choice has become almost a kind of fad. Do yoga at 8 am. Give birth to a child at 10 am. This not only suits your schedule, but also your doctors, and you get the added benefit of avoiding anything like labor pain.

Sandy, 34, had an elective C-section and often encourages other women to do the same.

“It’s so exciting to finally hear other women and members of the obstetric community say what I’ve been saying for the last six years,” she said. “I had an elective C-section in my first pregnancy because I had a wonderful birth attendant who respected my desire to avoid trauma to the vagina and pelvic floor. My C-section was great – fully awake and pain-free, I was walking in less than 8 hours.”

The differing views between doctors and mothers about the “right” way to give birth not only causes confusion among new mothers who are scared about their first birth, but also divides feminists. For many years, feminists have fought for the right to regain control of their bodies and give birth naturally without the unnecessary medical intervention that women were subjected to for most of the twentieth century. Now a new generation of feminists claims that it is also their right to decide to give birth to their child without pain. But how safe is elective caesarean section?

Some studies and doctors claim that elective caesarean section is just as safe, if not more so, than vaginal birth and that the possible side effects of vaginal birth make caesarean section even more attractive.

dr. Jennifer Berman, a urologist, author and television personality, said she chose a C-section with her second child and wished she had done so with her first.

“I had a very difficult period with the birth of my son Max in December 1999. I was in labor for 18 hours, which was complicated by the fact that I received an epidural too early, which again caused the labor process to slow down.

“Max was supposed to be a seven-pound baby, but he was actually nine pounds, eight ounces. His head and shoulders got stuck in the birth canal and he suffered fetal distress. Given my body habitus, he should have been delivered by c-section, but I persevered and gave birth vaginally.

“My other reason for choosing C-section stems from the work I did as a urologist. During a reconstructive surgery fellowship last year, I saw women suffering from the effects of incontinence and prolapse. These effects are directly related to vaginal delivery.

“In cases where women are predisposed to incontinence and prolapse, doctors are willing to perform a caesarean section. I was incontinent seven months after Max was born and it started recurring during this pregnancy.

“If I had seen patients with these problems before Max was born, I would have chosen a C-section for him as well. I decided that I didn’t want to risk any more incontinence or prolapse in the future.”

A study conducted by HP Dietz, MD (Heidelberg) and MJ Bennett, MD (UCT) and published in the August 2003 issue of Obstetrics and Gynecology, a journal of the American College of Obstetricians and Gynecologists, concluded the following: Especially vaginal delivery, operative delivery, adversely affects on the support of the pelvic organs. This appears to be true for all three vaginal compartments. All forms of cesarean delivery were associated with relatively less descent of the pelvic organs. These findings may partially explain the protective effect of elective cesarean delivery on future pelvic floor disorder symptoms.”

Dietz and Bennett studied a total of 200 women, recruited early in their first pregnancy, and examined during the first and early second trimesters, the late third trimester, and between two and five months postpartum. A total of 169 women or 84.5 percent showed a significant increase in organ mobility. In addition, the length of the second stage of labor correlated with an increase in pelvic organ prolapse, suggesting that vaginal delivery is a major cause of pelvic organ prolapse.

However, what many proponents of elective C-section fail to mention is the fact that the same study also states that the most significant damage to the pelvic floor occurred in women who experienced an operative vaginal delivery. In particular, women whose children were born using forceps or vacuum extraction experienced the greatest degree of damage. In addition, Dr. W. Benson Harer, Jr., president of the American College of Obstetricians and Gynecologists, while arguing that every woman should have the right to choose between a cesarean and a vaginal delivery, also acknowledges that many pelvic floor problems (urinary incontinence, prolapse uterus and bladder) can be prevented by improved birthing techniques.

Episiotomies are also associated with pelvic floor damage and long-term complications. They have been proven unnecessary and harmful in most births, yet most American women still undergo this surgical procedure during vaginal births.

The belief that caesarean section is much safer for the baby is also disputed. In fact, the risks to the baby can be considerable. A caesarean section is a major surgical procedure that carries with it many risks for both the mother and the child. Babies born by C-section do not receive the natural stimulation that comes from moving down the birth canal and therefore often need to be given oxygen or rubbed to help them breathe. They also lack the natural hormones that are released during vaginal birth to help the baby during its first moments of life.

According to the Mayo Clinic’s Complete Book of Pregnancy & Baby’s First Year, the risks of cesarean section are significant for mother and baby:

1. Premature birth. If the due date is not calculated correctly, the baby could be born prematurely.

2. Breathing problems. Babies born by caesarean section are more likely to develop breathing problems such as transient tachypnea [abnormally fast breathing during the first few days after birth].

3. Low Apgar scores. Babies born by caesarean section sometimes have low Apgar scores. A low score may be due to anesthesia and cesarean delivery, or the baby may have been in distress to begin with. Or maybe the baby was not stimulated as it would have been with a vaginal birth.

4. Injury to the fetus. Although rare, the surgeon may accidentally cut the baby while making the uterine incision.

Risks to the mother are more common and include:

* 1. Infection. The uterus or nearby pelvic organs such as the bladder or kidneys can become infected.

* 2. Increased blood loss. On average, blood loss is twice as high in cesarean births as in vaginal births. However, blood transfusions are rarely needed during a caesarean section.

* 3. Decreased bowel function. The bowel sometimes slows down for a few days after surgery, leading to bloating, flatulence and discomfort.

* 4. Respiratory complications. General anesthesia can sometimes lead to pneumonia.

* 5. Longer hospital stay and recovery time. Three to five days in the hospital is the usual length of stay, while it is less than one to three days for a vaginal birth.

* 6. Reactions to anesthesia. The mother’s health may be compromised by unexpected reactions (such as rapidly falling blood pressure) to anesthesia or other medications during surgery.

* 7. Risk of additional operations. For example, hysterectomy and bladder repair. Researchers at Wake Forest University School of Medicine also studied the effects of C-sections and the results were alarming. After a seven-year population-based case-control study in North Carolina, researchers concluded that C-sections cause two to four times more women to die as a result of childbirth than vaginal births. The authors looked at many factors: demographics, medical risk factors, preterm birth, use of prenatal care and health services, including mode of delivery, to determine which factors were associated with maternal mortality. Style of birth (cesarean or vaginal) was the most significant factor associated with maternal mortality, although whether or not the mother sought prenatal care also had an impact. The study found that the pregnancy-related death rate among women who gave birth by caesarean section was 35.9 deaths per 100,000 cesarean births with live birth outcomes compared with 9.8 deaths per 100,000 vaginal births without complications. The death rate for the population assumed to have had elective caesareans was 18.4 per 100,000 caesareans. They concluded: “Removing barriers and actively promoting the use of prenatal care services and reducing cesarean rates could reduce pregnancy-related deaths.”

The rise in cesarean births, either elective or physician-ordered, in the United States is staggering. The World Health Organization (WHO) states that in no region of the world is it justified to have a caesarean section rate higher than 10 to 15 percent. However, more than one-quarter of all babies born in the United States in 2002 were delivered by cesarean section; the overall cesarean delivery rate of 26.1 percent was the highest level ever recorded in the United States. While the rate of cesarean births declined from the late 1980s to the mid-1990s, it has been on the rise since 1996. Furthermore, the number of cesarean births among women who did not have a cesarean birth jumped 7 percent, and the rate of vaginal births after a previous birth increased by 7 percent. cesarean section (VBACs) fell by 23 percent.

Despite all efforts to convince mothers that cesarean section is as safe, if not safer for mother and baby than vaginal delivery, the United States still ranks 8th in infant mortality among industrialized nations (behind the Czech Republic and Cuba) as of 1998. .in the world for maternal death. However, the Centers for Disease Control (CDC) estimates that one-half to two-thirds of maternal deaths go unreported, and that half of maternal deaths in the US are preventable. The death rate from childbirth has not decreased since 1982, and it increased in 1999.

In an editorial for Obstetrics and Gynecology, Dr. Ingrid Nygaard and Dr. Dwight Cruickshank argue that while they believe offering elective C-sections to healthy women planning small families is warranted, they do not endorse such a recommendation on a routine basis.

“There are many unanswered questions about elective caesarean section at term and it is important that we try to answer them before making this part of the informed consent process. How should we manage a woman who begins labor before 39 weeks? Is there a point in labor ( dilation and descent) at what point is it too late for a caesarean section to favor the pelvic floor? At least in terms of anorectal physiology, the protective effect of a caesarean section is pronounced only if labor occurs before the cervix dilates to 8 cm. Is there a fetal size or gestational age below which the vaginal childbirth is not harmful to the pelvic floor? As more women in the US become obese, will the risks of elective cesarean section be greater than expected? Obesity itself is a risk factor for urinary incontinence, which may further reduce the value of preventive cesarean delivery in given that some racial and ethnic groups are more prone to prolapse and incontinence than others, we do we treat all patients similarly or do we take such considerations into account? How should we analyze the economics of cesarean delivery on demand? Projecting future costs should not rely on an arbitrary fee structure in place today. How to balance the costs of an elective cesarean delivery with the costs of treating pelvic floor disorders?

“Given the lack of rigorous scientific evidence, we believe that it is not currently recommended to routinely give all patients before delivery a choice of preferred mode of delivery. What appears to be a fairly low-risk proposition in healthy, non-obese women with only one or two children is probably not insignificant in obese women, women with poor nutrition or medical conditions, or women who will have several cesarean deliveries.”

What most obstetricians and midwives agree on, whether for or against elective caesarean section, is that mothers should be informed about all their options and the benefits and risks of both. Childbirth, even in the 21st century, is still a risky business and having all the information available is the only way mothers can be sure they are getting the best care.

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