C-section rates

[kwith]

Please provide some guidelines / talking points for discussing c-sections with my doctor?  My stance on the issue:  obviously, if for my health or baby kwith's a c-section is necessary, I am absolutely behind that.  But barring that situation,  I want to avoid having a c-section just because it's more convenient.  I wasn't really worried about this until someone on here (@slytherinrn, maybe?) pointed out that you could look up your hospital's c-section rate, and mine is 44%.  So almost half of their babies.  That seems crazy high to me and has me worried that I'll be forced in to a major surgery due to hospital policy, rather than medical need.  I have an appointment with my ob this week and plan to talk to her about it.  Any suggestions on things I should bring up or how to broach this discussion so I'm actually heard?  I trust my doctor and have open communication with her, but I've heard about too many circumstances of doctors dismissing concerns until it's too late and you're  being wheeled in to unwanted surgery. 

Also, thank you in advance because I think this board is going to become my personal pregnancy therapy board for the next 6 weeks or so.

[kwith]

Thanks guys! Frenchie, I totally don't mind having a c-section if necessary - I don't see that as being any less of "birth experience" and am glad that we live in an era when it's a relatively safe option.

I just get the sense from the incredibly high rate that the hospital probably does them fairly routinely, and in my mind there's nothing routine about a major surgery. I don't care how the baby comes out as long as she and I are healthy, but I'd prefer to exhaust all options for a vaginal delivery before resorting to c-section, just because of the impact on my own life and recovery time. So maybe I just need to say that to my OB and see how she responds and then go from there.

Per birth plans: I don't have one, beyond "prefer not to have a c-section", largely because I do just trust to my doctors and the nurses to do what's best. So maybe I'll just print something up that says, "Don't do a c-section unless you can explain to me why it's medically necessary" and hand that out to everyone.

[GoneFishing]

I think C-section rates are rising largely because women have the OPTION of scheduling one for convenience, not so much because Dr.'s are pressuring otherwise healthy labors into them.

I had a talk with my OBGYN before we even started TTC because I know I'll have an epidural (if possible) and my greatest fear is being awake during an emergency C-section. And I've got some physical attributes that make it slightly more likely to happen. I asked what circumstances would make him recommend a c-section and what circumstances would make him order one outright. I feel alot better now, so I'd say it's worth just asking your doctor about the high rate. I'm quite a ways away from needing to deal with this since we aren't even KU yet, but it helped put my mind at ease in a big way.

[kwith]

@slytherinrn, thanks for the information - I figured you'd be a source of knowledge on these things.
eas1223, I haven't filled out a birth plan with the doctors yet, but plan to talk about it with the one I see on Friday. I don't know what their typical policies are regarding c-sections, but I definitely want to find out. And yeah, if I have to have one, I'd want to be awake for it. I think it would feel weird to go to sleep and wake up and have a baby.

[GoneFishing]

I've actually heard mulitple horror stories about women signing consent forms for circumcision without realizing it right after the birth (like within 30 minutes), so I would make sure that your doctor and the nurses in the delivery room know ahead of time (if possible) your wishes on that. It's not something that probably happens all the time, but it's also not the sort thing they can undo once its' done.

[kwith]

I'd typed up a long response and then the proboard bear ate it. Basically just saying that I am eye to eye with others on the birth plan. The key thing for me is communication. I understand that my doctor and the nurses know WAY more about this than I do. I just really want to not be treated like a child just because I'm having one. Need to give me a c-section? Fine - take a moment to explain to me why it's necessary. Gotta do an episiotomy? Fine - just give me a heads up that you're doing it. My friends who have had what they describe as bad birth experiences are the ones who felt like they were marginalized and ignored, rather than treated like adults. I luckily don't anticipate that from my doctors, but I want to do what I can to make sure I at least get a heads up on what's going on.

[GoneFishing]

Jan 8, 2014 15:02:56 GMT -5 eas1223 said:

kwith - You should find out the c-section rate with your doctor or their clinic of doctors. Many times the overall hospital numbers are very different than the set of doctors that you will be working with.

Has your obgyn given you a birth plan template to have you fill out? Although I figured mine was easy because I knew I wanted an epidural, it was helpful to fill it out and think through how I wanted things to play out and what I wanted them to do if things went wrong.

As for being awake during a c-section, every woman I know that's had one has been awake. Obviously, they are numb from the chest down, but they are awake and are able to see (not hold) the baby right after they are pulled out.

Yes, my point is that the very idea of being awake for one freaks me out to the point of nearly having an anxiety attack.  I DON'T want to be awake or at least will need to be sedated if at all possible without endangering the baby. 

[GoneFishing]

@slytherin, thanks! That's basically what my doc said too, which helped. I know that when the time comes, if it needed to be done sans sedation, I would probably nut up and deal with it for the sake of my kid. However, the very thought of it was enough to make me not want to ever have a kid. I'm weird, but there ya go.

And, I agree it's fucked up, but none of my SIL's or close friends have had your description of a consultation before circumcision. They were all pretty much asked if they wanted it by the nurse and if they said yes, given a form to sign then the baby was taken off. One friend of mine was the one who actually has no memory of even agreeing or signing the form (though her signature is clearly on it). She's a single mom and her best friend who was with her during delivery had stepped out to call her OOT parents and let them know the baby was here. It is super fucked up, and since she had not decided if she wanted circumcision or not (didn't know the baby's sex before delivery), she has serious guilt about it now.

[kwith]

GoneFishing, if this helps at all, I was absolutely terrified of labor before getting pregnant. I told anyone who would listen that I wasn't worried about pregnancy or about caring for a newborn, but I wished the 24 or so hours between those two events would disappear in to a black hole that I didn't have to be aware of. As soon as I actually got pregnant, though, that fear just magically dissipated. That's not to say it will happen for everyone, and I sincerely hope you don't need a c-section at all, but I was more afraid of the possibility of something maybe happening than I was when I actually knew it was going to happen.

[GoneFishing]

Jan 9, 2014 11:33:58 GMT -5 LMC said:

I'm not pregnant, but is it weird that my "birth plan" is 1) epidural if possible 2) please get my baby out healthy 3) do not circumcise my son ?

Nope.  That's pretty much mine if you add in 4) please please please sedate the shit out of me if getting my baby out healthy involves a C-section.  Aside from that, I figure I'll trust my doctor to ask me when possible and inform me when not.  That's just how we roll.

[kwith]

I haven't seen Knocked Up, and from what I've gathered I should be very thankful for that given its interpretation of birth. In the end, healthy baby = happy kwith for me, but I'd also like to be back on my feet and healthy ASAP too. If those two come in to conflict, then give me healthy baby over quickly healed kwith, but I'd still not prefer that option.

[GoneFishing]

Yeah, H's family is the kind that has everyone and their dog in the room up until the pushing starts. Like, my SIL was visiting with church people covered in sweat with some sort of IV in her vagina and stopping every 6-8minutes to have a contraction, then pick up the conversation. In fact, it's considered rude if you DON'T spend some time in the room with Mommy once she's admitted. The first time I witnessed a birth on that side of the family, I pulled H aside and said "this shit is NOT happening if we have kids."

[kwith]

Jan 9, 2014 12:27:34 GMT -5 LMC said:

Thanks, eas1223 ! Yeah, I likely won't want to be touched. While everyone else is having their wonderful, dreamy childbirth, I'll be one of those screaming things such as "GET THIS THING OUT OF ME" and "FI, WHY WOULD YOU DO THIS TO ME?"

My only labor goal is that I don't want to  be that cliche you see in the movies / tv where the woman breaks down and whines "I can't do this."  F that shit.  I can either do this or get the baby cut out of me. It staying inside is not an option and I don't want to be that whiner.

All other screaming is perfectly acceptable, and since H won't be there I'll happily curse him to pieces and he'll never, ever have to know.  Win-win.

[kwith]

eas1223, since you and I are identical pregnancy twins, I'll probably end up doing the exact same thing.

[GoneFishing]

Jan 10, 2014 17:46:15 GMT -5 efmcc67 said:

Jan 9, 2014 12:27:34 GMT -5 LMC said:

Thanks, eas1223 ! Yeah, I likely won't want to be touched. While everyone else is having their wonderful, dreamy childbirth, I'll be one of those screaming things such as "GET THIS THING OUT OF ME" and "FI, WHY WOULD YOU DO THIS TO ME?"

I am so with you on this! I don't get romanticizing childbirth at all. 

My obgyn cheerfully informed his nurse that he was voting me most likely to throw shit in the delivery room.