# Why Are People Against Elective C-Sections??



## karina5 (Apr 15, 2006)

Okay, I know I am on MDC.







And *I* wouldn't have a C-Section by choice, personally.

But why such a backlash against them? Isn't it in the general realm of "A Woman's Right to Choose" and all that? And shouldn't a person be able to have the birth experience THEY want, just as there are Mama's here who choose to have an unassisted birth.

I am all for a person having a natural and/or unassisted birth, but really, there is risk involved in ANY method of childbirth.

So why are people so against a mother having an elective c-section if she wishes to do so?


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## Ruthla (Jun 2, 2004)

I think that many women choosing elective C/S are *NOT* fully informed of the risks, including the risks to future pregnancies.


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## fek&fuzz (Jun 19, 2005)

It raises health care costs for everybody. Especially if it leads to babies who aren't ready to be born.

(Note - this comment is about the question asked, not about your own personal c-section or premature baby.)


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## carriebft (Mar 10, 2007)

It affects our country's health as a whole, it costs us unnecessary money both through the procedure and the higher negative health outcomes for mother and baby. The increase in popularity of the procedure puts more women at risk to be pushed into Csections when they do not need or possible even when they do not want them. SO you get hospitals with 40-50% Csection rates and higher...it leads to not being able to find hospitals with acceptable rates.

There are also arguments that the woman does get a choice but the child is put at greater risk....which is not an argument I am sure I want to get into since it would probably stray into topics not allowed....

I guess there's a lot of reasons. I also believe the WHO has a large discussion on this, which I will try and locate.


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## karina5 (Apr 15, 2006)

Quote:


Originally Posted by *Ruthla* 
I think that many women choosing elective C/S are *NOT* fully informed of the risks, including the risks to future pregnancies.


But what if someone is informed. And does not want anymore kids? I mean, really, there is some risk involved, but still, the number of deaths is not very high.

I'm honestly not trying to be a pain with this. I'm just genuinely curious why many people are pro "woman's choice" but when it comes to this they sort of backtrack on that thinking.


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## carriebft (Mar 10, 2007)

It's not just death rates...it's increased health problems for the mother, increased NICU time for the baby, increased respitory distress/illness for the baby, etc etcetc...and the procedure is quite costly in and of itself, risks aside.

Then there is the fact that it can hinder breastfeeding intiation/ability to breastfeed, which leads to more health problems...etc...


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## carriebft (Mar 10, 2007)

some examples:

Quote:

Cesarean carries twice the risk of injury and death for both mother and baby. Women with cesarean experience double the rate of hysterectomy, blood transfusion, admission to intensive care, prolonged hospital stay and death, compared to mother who delivered vaginally. Babies born by cesarean were 45 percent more likely to be in the neonatal intensive care unit for 7 days and 41-82 percent more likely to die than babies born vaginally.
Villar, et al., British Medical Journal, 2007;335:1025, 17 November

Quote:

Rehospitalizations in the first 30 days after giving birth were 2.3 times more likely in planned cesarean than with planned vaginal births. The leading causes of rehospitalization after a planned cesarean were wound complications and infection. Hospital costs were 76 percent higher for women with planned cesarean, and hospital stays were 77 percent longer.
Declercq, et al. American Journal of Obstetrics and Gynecology. 2007 Mar; 109(3):669-77


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## bri276 (Mar 24, 2005)

I'm not against elective c-sections in certain cases (previous history of stillbirth, for one). What I'm against is the lack of information given to women about the risks to the baby regarding lung development, and the higher mortality rates for both mother and child. I'm against babies being born prematurely for no reason. I believe most women who make this choice are not fully informed by their OBs, as they should be, because many OBs like, or even prefer, c-sections to vaginal births, which are more risky for _them_ malpractice-wise.

http://news.bbc.co.uk/2/hi/health/7137945.stm


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## Missy (Oct 22, 2002)

The immediate risks to an infant are increased, but, additionally, there are long term implications. The mother is going to be on more medication, which, in turn, can impact bfing. Also, there is also a belief within the medical/scientific field that children born via c/s have an increased risk of allergies. It has something to do with the flora in the birth canal. I have three children. My oldest was born vaginally, no allergies. My second was born via emergency c/s after pushing for more than two hours, so my guess is he was at least somewhat exposed to the flora--no allergies. My youngest was delivered via planned c/s due to complications discovered during the previous emergency c/s. At five years old, he has more than 20 known food allergies. Connection? I don't know.


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## ananas (Jun 6, 2006)

Quote:


Originally Posted by *Ruthla* 
I think that many women choosing elective C/S are *NOT* fully informed of the risks, including the risks to future pregnancies.

Yup, this. They think it's an easy way out, when really, it's much harder on the body and comes with many risks for the mother and baby. There was a study done recently that showed elective c-sections lead to more breathing problems. Elective c-sections seem to be scheduled BEFORE the due date, which can be two weeks off, so it's a lot of babies being born too early.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *fek&fuzz* 
It raises health care costs for everybody. Especially if it leads to babies who aren't ready to be born.

(Note - this comment is about the question asked, not about your own personal c-section or premature baby.)

This.

I have only a hint of a "problem" with it if the woman is paying for it out of pocket.

But if she's using insurance, or government health care then it's not a wise choice. Those don't cover elective procedures as a rule (cosmetic etc) so why would they cover an elective C-section?

-Angela


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## dlm194 (Mar 23, 2005)

Are you asking just about the "too posh to push" c-section or do you include women who choose a repeat c-section or who had a traumatic vaginal birth and request a c-section?

In general "elective" c-sections are normalizing surgical birth. Your body is meant to pass a baby out of your vagina. Why is there even a push for elective c-sections? This blows my mind.

As the demand and push for elective c-sections go up (therefore normalizing it as a method of birth), it makes it more difficult for women to have a normal vaginal birth. And forget VBAC. Since c-sections are so common, women desiring a vaginal birth after a c-section are seen as radical. They are told they are putting themselves and their babies at risk. But major abdominal surgery is okay. Hmmm..... Go figure.

True choice in birth is one thing. Choosing a c-section is becoming much easier than choosing vaginal birth.


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## groovynaturemama (Mar 8, 2007)

i find it strange that any woman would want to have her abdomen cut open through all the muscle layers on a completely voluntary basis providing that she or her baby were not in need of it as a lifesaving measure. i personally would not want to experience a far longer recovery, not be able to hold my baby right after birth (i'm talking seconds of the baby coming out), not be able to carry anything heavier than my baby for 6+ weeks, etc. did i mention how sketched out i'd be about the epidural? i mean, someone hitting into my epidural space is pretty risky- you have to sign a waiver and everything. same with the c-section. i guess i'm against major elective surgery in general, for whid i'd be signing a paper acknowleging possible complications up to and including paralysis or death. that and the fact that it drives up healthcare costs for everyone else (and to think there are already people out there who can't afford insurance- i don't know how they will with the ever increasing c-section rate as it is)


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## Robinna (Aug 11, 2003)

My basic philosophy is that I support whatever choices an informed woman makes for her birthing. That being said, I have a problem with the trend towards spurious or cosmetic surgical births.

For me, it's really a feminist issue. I believe firmly that most women who would choose an elective c/s are NOT completely informed, because I find it impossible to believe that if they WERE completely informed, they would make this choice. It is just too fundamentally illogical to choose surgery if you don't *have* to - it is a very rare person who, in posession of all the facts, would deliberately choose what is so obviously a riskier path. So. I believe that *most* women who want c/s "instead" have been sold a bill of goods through the medicalized birth model that our culture embraces, and each time a woman makes that choice it feeds into our cultural acceptance of medicalized birth as the "norm". And the stronger the medical model of birth becomes entrenched, the harder it becomes for those of us who *do* know, to opt out. So, bottom line, I believe that the trend towards elective c/s sets precedents that limit my choices and the future birthing choices of my daughter, sister, nieces, friends...

Now. If a woman is TRULY informed, and still chooses elective c/s? For sure - her body, her choice. But I think it's a very rare informed woman who would make that choice.


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## LaLaLaLa (Oct 29, 2007)

I had an elective c-section for my second child. I was VERY much informed of the risks and possible complications, and pressured by my Ob/Gyn NOT to have one. After explaining myself and signing a bunch of waivers, I was in business.

In my particular case, things worked out better for everyone involved. My first birth was traumatic. My dd tore through my body to the extent that moments after she was born she was handed to my dh and I was rushed off to have emergency repair surgery under general anesthesia. I didn't hold her. I didn't breastfeed her. Dh gave her a bottle. I don't remember anything from the first day or so, and I was on a great deal of medication (morphine, I think). Our nursing relationship (either as a result of this or a totally separate issue) was never really strong. I couldn't stand without assistance for two weeks. My body wasn't right for months afterward.

Before I became pregnant again, I made certain that my doctors would perform a c-section. If they had said no, I probably would not have had my ds.

Ds's birth: I knew exactly when it would occur, which eliminated any stress of childcare for dd. My parents live a couple of hours away and there was nobody else I felt confident watching dd if I were to go into labor in the middle of the night or something. A childhood friend of mine is a labor and delivery nurse at the hospital, and she specifically planned to be there to work with me. After ds was born, he was brought to me to touch and examine before visiting with dh for a few minutes as I had my tubes tied (since my abdomen was already going to be open and all, it made more sense to us than scheduling a separate surgery) and was sewn up. Ten minutes after ds was born, we were cuddled in bed together, breastfeeding. The next day I was up and showering, a feat it took me two weeks to accomplish after my first birth.

In terms of recovery time, things were better for me. In terms of stress, things were better for all involved. After having dd, dh and my mom really thought I might die, as the blood loss and the doctors' reactions were so dramatic. In terms of medical costs, I would imagine things were similar, as my first birth ended in emergency surgery, as opposed to planned surgery the second time around, plus I avoided an additional surgery by having a tubal ligation at the same time as the c-section.

An elective c-section is by no means right for everyone, and I made the decision the first time around that it was not right for me. But for my second pregnancy.... I wouldn't have had it any other way.


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## DoomaYula (Aug 22, 2006)

Quote:


Originally Posted by *dlm194* 

As the demand and push for elective c-sections go up (therefore normalizing it as a method of birth), it makes it more difficult for women to have a normal vaginal birth. And forget VBAC. Since c-sections are so common, women desiring a vaginal birth after a c-section are seen as radical. They are told they are putting themselves and their babies at risk. But major abdominal surgery is okay. Hmmm..... Go figure.

That. I believe elective c-s make it harder for other women to have vaginal births. As the c-s rate gets higher and higher, soon vaginal birth won't be the norm, and it will be difficult to find a provider willing to "allow" it.

Quote:

believe that *most* women who want c/s "instead" have been sold a bill of goods through the medicalized birth model that our culture embraces
That too, totally. Most women I know who had c-s think it was the greatest thing since the invention of electricity. To hear them, you'd think it was a day at the beach, and that vaginal birth is for women who want to get "stretched out."


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## dinahx (Sep 17, 2005)

Quote:

I think that many women choosing elective C/S are NOT fully informed of the risks, including the risks to future pregnancies.
Great answers everyone! I for one, do not object to any womans 100% fully informed choice, but it is all but impossible to make a fully informed, unbiased choice in a culture that asserts that Surgical/Interventive deliveries are WAY safer than they are and is woefully undereducated about the physiology of natural birth.


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## mwherbs (Oct 24, 2004)

what elective c-sections have shown us is that C-sections are not as life saving as we use to think-- there is a higher infant mortality rate associated with term elective c-sections--
there is also a maternal mortality rate associated with c-section-- I almost think that we need bookies to be advisors someone who can number crunch and give you understandable odds







-- I also think that there is a bias that has to do with personal interest on the physicians part to guide a patient to decide that surgery is best- this puts an OB in the position of doing what is perceived as the most life saving care and protects them from law suits even if what it is,is inferior more dangerous care--


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## karina5 (Apr 15, 2006)

Quote:


Originally Posted by *dlm194* 

Your body is meant to pass a baby out of your vagina.
.


I know what you're saying, but our bodies are meant to do a lot of things that medicine has changed over the last century. Some could argue some of this is good, and some not so much.


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## turtlewomyn (Jun 5, 2005)

1. If other women have the right to choose elective c-sections then I should have the right to choose the type of birth I want. I want an HBAC next time, but because of Florida law and the birthing climate in my area, I will have to travel 3 hours and rent a house in order to do so. If you are going to support a woman's right to choose, we should be supporting EVERY woman's right to choose.

2. I am concerned that women choosing an elective c-section are not informed of all the risks, and that they have doctors pushing them into the decision. I know that I was pushed into an unwanted c-section and I can imagine that there are doctors out there telling women that a c-section is safer than vaginal for them and their baby (which is simply not true).

3. And like others have said that the rising c-section rate will affect us all and the birth choices available to us.


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## dahlsk (May 23, 2007)

As someone who is lucky enough to have health insurance, but is seriously strained by the $1200 a month I will have to pay during my maternity leave to keep my coverage, I think the increased costs of medicalized birthing is very important to remember. Obviously, health care costs are out of control, and this hurts everyone (unless you're the lucky one who can pay cash for a c-s). It's a symptom of our whole health insurance disaster: don't pay for natural processes (HB, prevention, etc.) but cover the really expensive technical procedures needed once things get too far advances for the simpler fix.

I have a friend who was excluded from coverage for her birth because she was 7 days from coverage after a 1 year black out period. Not to mention the fact that the black out period was instituted because she changed the type of coverage she had after years with the same company, not that she was brand new to the company!

She was basically told that if she had the baby at home in the tub and then called 911 for assistance, they would take her to the hospital and cover that as it was "an emergency" but if she planned in advance for a natural hospital, bc or home birth, they would cover nothing.


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## Teenytoona (Jun 13, 2005)

Quote:


Originally Posted by *Robinna* 
My basic philosophy is that I support whatever choices an informed woman makes for her birthing. That being said, I have a problem with the trend towards spurious or cosmetic surgical births.

For me, it's really a feminist issue. I believe firmly that most women who would choose an elective c/s are NOT completely informed, because I find it impossible to believe that if they WERE completely informed, they would make this choice. It is just too fundamentally illogical to choose surgery if you don't *have* to - it is a very rare person who, in posession of all the facts, would deliberately choose what is so obviously a riskier path. So. I believe that *most* women who want c/s "instead" have been sold a bill of goods through the medicalized birth model that our culture embraces, and each time a woman makes that choice it feeds into our cultural acceptance of medicalized birth as the "norm". And the stronger the medical model of birth becomes entrenched, the harder it becomes for those of us who *do* know, to opt out. So, bottom line, I believe that the trend towards elective c/s sets precedents that limit my choices and the future birthing choices of my daughter, sister, nieces, friends...

Now. If a woman is TRULY informed, and still chooses elective c/s? For sure - her body, her choice. But I think it's a very rare informed woman who would make that choice.


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## nausicaamom (Feb 8, 2006)

My biggest beef with the increased cesarean rate is that instead of the uneventful VBAC I should be having, I am having a repeat section because the hoops I would have to jump through to get a VBAC would have put entirely too much strain on myself, the baby and my entire family. I am all too aware of the increased risks that come with the surgery, so while it can be said I am making an informed choice based on my personal circumstances it is by no means a willing choice and I'm sure one that many women having repeat sections find themselves in whether they are aware of it or not.


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## MsBlack (Apr 10, 2007)

I am pro choice, and I very much DO think this is a feminist issue. That said--I have to also say that a very large part of this feminist issue is that women now have been raised in such a highly medicalized environment that many who presumably 'choose' such things as elective csec are NOT making an informed choice--they have no idea of, or belief in, the normalcy and perfection of their own bodies and birthing capacities--and how every bit of the way that birth is designed, is FOR THEIR OWN AND CHILDREN'S HIGHEST WELLBEING. THAT to me is a feminist issue worth fighting for.

Our range of choices have been under a state of seige for quite some time, and simply 'knowing all the risks of csec' is STILL not making an informed choice. The ripoff to women (and our children and partners) being perpetrated through this so-called 'informed consent' is quite insidious, devious and pervasive. You see, the problem is, women today (in general, and present company obviously excluded) is that we are never taught how perfectly suited natural birth is to the short term and long term wellbeing of mother and baby both (and for the family in general).

Knowing 'the risks' of csec is only 1/2--or maybe only 1/4--of the picture. True Informed Consent (under the law) means not only being told the benefits and risks of a particular procedure. It also includes being told the benefits and risks of OTHER OPTIONS, including the option of doing nothing. Women who are informed of the risks of csec (which I believe, as also true with epidural and various other common obstetrical interventions, are presented in a 'harmless' and quite watered-down way), are NOT being told why natural birth is best for all concerned in the vast majority of cases. Most docs do not even know the full range of benefits to natural birth, physically, emotionally, psychologically for mom and baby. The best we get from seemingly 'natural minded' obs is that they are willing to support the mom's wish for a certain 'experience' (so long as all goes well in the doc's mind). They do not acknowledge, and certainly do not promote, the facts which show that natural birth is hands down the very safest, healthiest way for babies to be born/women to give birth, in both the short and long term (for MOST women/babies, with exceptions, obviously).

So, to my way of thinking, this whole 'elective csec' is one of the most horrific of subversions handed to women in this technologically--and still very much patriarchally--oriented era. Separating out those women who do have good reason to choose csec (as with story of a pp), all others who--for no real health reason--seem to 'freely choose' elective csec, are being coerced by a deep and dangerous deception! There is simply no other way to put it.
They are NOT making truly informed choices--and the majority are not even aware of what Informed Consent under the law is and they surely do not know the myriad and deep benefits they are choosing against, by choosing csec.

They are women who have had their femininity stolen from them from the get-go, in the sense that they have been conditioned to believe that having a womanly body is something that can freely be 'bypassed' via patriarchal technologies, INSTEAD of being raised in an atmosphere that celebrates and honors woman's body and reality fully as a sacred and very much necessary element of this dualistic plane we inhabit. They are women who have been taught to believe they can 'bypass' their womanly body via technology, and not pay a price for that, now and on into their own and their children's lives--physically, emotionally, psychologically.

Yes, this is a feminist issue allright! It is very much a feminist issue.


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## Mrs-Mama (Jul 2, 2007)

Quote:


Originally Posted by *dlm194* 
In general "elective" c-sections are normalizing surgical birth. Your body is meant to pass a baby out of your vagina. Why is there even a push for elective c-sections? This blows my mind.

As the demand and push for elective c-sections go up (therefore normalizing it as a method of birth), it makes it more difficult for women to have a normal vaginal birth. And forget VBAC. Since c-sections are so common, women desiring a vaginal birth after a c-section are seen as radical. They are told they are putting themselves and their babies at risk. But major abdominal surgery is okay. Hmmm..... Go figure.










:


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## ~Megan~ (Nov 7, 2002)

I don't think women are really informed by their doctors. All I was told when I had one (b/c of breech positioning) was that a c-section was safer. I was not told of any risks or common complications related to the c-section. I was, in fact, told I could have a vaginal birth next time and then right after it was done the OB told me it would be safer to do a repeat c-section next time.


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## Ruthla (Jun 2, 2004)

Quote:


Originally Posted by *LaLaLaLa* 
An elective c-section is by no means right for everyone, and I made the decision the first time around that it was not right for me. But for my second pregnancy.... I wouldn't have had it any other way.











I think that very few women who choose elective c/s have put as much thought into it as you have. You had specific medical concerns about vaginal birth that applied to your own personal body, not a generic "I don't want my vagina to get stretched out" or "I'm afraid of labor pain."


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## Mrs-Mama (Jul 2, 2007)

Quote:


Originally Posted by *Ruthla* 









I think that very few women who choose elective c/s have put as much thought into it as you have. You had specific medical concerns about vaginal birth that applied to your own personal body, not a generic "I don't want my vagina to get stretched out" or "I'm afraid of labor pain."

I agree with this.

Slightly







: I also think that the term "elective c/s" is misleading in this case. There are truly elective c/s's, medically indicated c/s's, medically required c/s's (transverse breech, etc), and true emergency c/s's. As I will likely have a medically indicated c/s in the future (due to J-incision), it pains me to have that lumped in with "elective" since I would never _elect_ a c/s if it weren't medically indicated (and I had done research to back up that medical indication).


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## Romana (Mar 3, 2006)

I personally am not opposed to elective c/s (not the medical definition - I do mean purely elective, I don't want to birth vaginally non-medically indicated c/s). However, I am opposed to any situation in which a woman is not fully informed of her options and the risks and benefits of different procedures and has the opportunity to make an informed choice.

Part of the problem is that the current social communcations and understanding regarding vaginal birth is that it's scary, unpredictable, dangerous, painful, and otherwise very unpleasant. And its counterpoint is scheduled, elective c/s, which is generally presented and perceived as calm, safe, predictable, and easy (or at least, easier). That's not to say that everyone feels this way or communicates this, but the "big picture" that most first-time moms get is just that. I know I did. If I wasn't such a research junkie and felt compelled to learn everything I could, who knows - I might have been fighting for a non-medically indicated c/s. More and more FTM are.

With that kind of background color, information about natural birth - or even just vaginal birth - is pushing uphill. Under those circumstances, I feel that it should be more difficult to obtain an elective, non-medically indicated c/s than to obtain a NCB in a hospital. Instead, in my experience, the opposite is true.

Women seeking non-medically indicated elective c/s should be required to read and understand information pertaining to their choice. Women seeking NCB should be supported and while education is always important to success in NCB, I would set the bar lower.

There's more to this, though. There may come a time when it really is safer, statistically, to birth surgically than vaginally (at least for the baby - maybe not for mom, or maybe not for some time for mom). At that point, the question becomes deeply complex. Are there still other benefits to vaginal birth? Probably. Are they superior or do they justify the choice for vaginal birth?

One corner I do not want to be backed into as a birth education advocate and NCB supporter is the "Now, scheduled c/s has been proven in studies to be safer for babies than NCB. How can you justify encouraging NCB, or even allowing the option?" This is one reason why I really do support each woman's informed choice regarding the way she wants to birth. If she is ignorant and uninformed, I will not be able to respect her choice to birth surgically. And I will question (inwardly) her chance of success at NCB if she says she's "hoping for NCB" but knows nothing about it. Women have to take an active role in their care and in birthing long before labor starts if they are going to have a chance at birth experiences that are positive for them.

I know that, today, non-medically indicated c/s carries additional risk to both mom and baby, and potential long-term health complications that, IMO at least, outweigh the benefit of, say, avoiding the pain of a natural delivery (not to mention post-op pain with a c/s). However, I still recognize that a rational, informed mother may, for reasons that I may not fully understand, choose a non-medically indicated c/s. I support her right to do that, just as I support the right of women to have unassisted births. I may not understand her reasoning, but I believe patients should have a great deal of autonomy in regards to their care, and that absolutely extends to pregnant and birthing women. Ultimately, the woman should have the right to choose what is right for her and her baby, and she should be supported by HCPs in her decision.

And I think the bigger problem has absolutely nothing to do with non-medically indicated c/s by mother's request and absolutely everything to do with the kind of care provided. How many women are set up for a c/s from the beginning? I'm thinking of my co-worker's wife, who was told at her 8 wk appt that she was probably too small to give birth vaginally (she is completely normal-looking, just 5'2"). How many doctors say things like, "Well, he's estimated at 8.5 lbs already on the ultrasound, and that's an awfully big baby - and you're only 37 weeks. This baby could be 10 lbs by the time you deliver! If you want, we can just schedule a c/s for next week." It goes on and on. THAT is the erosion of patient autonomy. Even if after that you say "Oh and by the way <boilerplate boilerplate>" if you've gained a woman's trust and have already convinced her that she is going to need a c/s, or that it's the best thing to do, what real choice does she have? For the average woman, the average patient, the wiggle room to choose is practically nil at that point.

I think I'm repeating myself so I'll stop. But I don't think we can really blame the huge increase in c/s on women choosing non-medically indicated c/s, as media stories tend to. I think the bulk of that responsibility falls squarely on the shoulders of medical professionals who wield all the power in the doctor-patient relationship.

I would like to see all women better informed and more empowered. It's not an easy thing to do. And it wouldn't eliminate non-medically-indicated c/s, but that's not the point and it's not the goal, either.

Disclaimer: I made some generalizations above WRT how doctors/OBs approach patients. I feel that, as a generalization, it's rather accurate. That is not to say that there aren't great doctors out there, or non-c/s-happy OBs. I just do not think they are a large proportion of the whole. And I very strongly feel that few doctors really do a good job of ensuring patients are informed and aware of their options and risks/benefits of different procedures. A good deal of why that is is simple: they don't have the time.


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## JavaFinch (May 26, 2002)

After paying almost $40,000 to GET pregnant without help from my insurance company, I am already bothered by the fact that others paying the same amount as I can have a child every year for a decade if they want and cost the insurance company $100,000's, but they won't even help an infertile couple have ONE child. So if they're also giving them free C-sections for all those pregnancies without ANY medical reason? No, I'm not cool with that.

I also just don't understand WHY someone would choose it??? I might have to have one due to previa and I will be SO disappointed if that happens. Obviously, my main fear is not having complications or bleeding from previa, but also on my mind is a c-section that I do NOT want! How can someone just choose that? I don't get it.


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## erin_brycesmom (Nov 5, 2005)

Generally speaking, I would say that I am against elective c-sections but I do support women's choice. I advocate against them for many of the reasons mentioned here and more. Ultimately, it should be the mother's choice. There are times when I completely understand why some choose that and there are other times when I don't agree but it doesn't really matter what I think. I think a lot less women would choose elective c-section if they were fully informed about not only c-sections but vaginal birth as well. Honestly, the way some vaginal births go down in the hospital - I don't blame a mother for wanting a c-section instead. Many people don't realize that a vaginal birth doesn't have to be that way. For me, the main issue is awareness not so much the choice. I'm glad it is an option, I just wish it was *way* less used.


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## darsmama (Jul 23, 2004)

Quote:


Originally Posted by *karina5* 
Okay, I know I am on MDC.







And *I* wouldn't have a C-Section by choice, personally.

But why such a backlash against them? Isn't it in the general realm of "A Woman's Right to Choose" and all that? And shouldn't a person be able to have the birth experience THEY want, just as there are Mama's here who choose to have an unassisted birth.

I am all for a person having a natural and/or unassisted birth, but really, there is risk involved in ANY method of childbirth.

So why are people so against a mother having an elective c-section if she wishes to do so?

I am very much in the camp of a woman can and should decide for herself how and why she wants to give birth.
That being said, there are reasons why an Elect. C is a bad idea, just as there are scenerios where a UC or a HB are a bad idea.

Whats that saying - Can't trust me with a choice, how can you trust me with a child?
That.


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## zoeyzoo (Jul 6, 2007)

Quote:


Originally Posted by *thismama* 
I am pro informed birth choices, including elective c sections.









I am too. I just don't think most people fully understand the consequences of that choice. The evidence is so strong on the benefits of NCB but I don't think most women get any clear evidence-based information.


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## Benji'sMom (Sep 14, 2004)

Quote:


Originally Posted by *karina5* 
And shouldn't a person be able to have the birth experience THEY want, just as there are Mama's here who choose to have an unassisted birth.


Yes they should. I agree with what some others have said, it's only the elective c/s that's being allowed, people aren't being allowed to make other choices like VBAC. So there's going to be a backlash against that.

I think if I could go into any hospital and tell any doctor "I want a VBAC" and they'd just say "okay no problem," I wouldn't even care or notice that other women are choosing elective c/s. But if I have to go from hospital to hospital, and from doctor to doctor just to find one that would even *consider* VBAC for any patient, I'm going to get angry that the doctor is pushing surgery on me, and I'm going to backlash against the normalization of surgical birth.

It would be nice if all birth choices were equally respected and seen as equally legit, but it's just not that way.


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## sapphire_chan (May 2, 2005)

Things have pretty well been covered, but I'll restate them anyway. (cause this is better than homework







)

1. How many people who get elective c-sections are actually educated about the risks and such? For instance, how many are done because the woman wants her body to stay the same "down there" and then she's surprised when she gets a tummy pouch because the muscles never recover after the surgery?

2. If the c-section is done under group insurance, everybody in the group gets higher rates. As well as getting to help cover health care costs for the baby if the baby wasn't ready. Fortunately, I don't think any state health care plans cover elective c-sections, so taxes probably aren't an issue. And admittedly they tend not to be covered by insurance at all.

3. Every one done makes doing c-sections for any stupid reason that much more acceptable. And makes people who want natural births have to fight that much more to not get interventions--after all, what's the big deal with an induction? it'll still be a "natural" birth!







:

4. A woman's right to choose for her own body? Well ye-es...but then it'd also be her choice to choose to drink heavily and smoke and live on cheetos. I would not be surprised to find that most women who get elective c-sections take very good care of themselves and their babies during pregnancy, so it's all kind of incongruous to risk everything at the last minute.

5. Not all birth choices are treated equally. Every woman doesn't have a chance to choose the birth she wants. Homebirth, VBAC, etc.


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *karina5* 
I know what you're saying, but our bodies are meant to do a lot of things that medicine has changed over the last century. Some could argue some of this is good, and some not so much.

And which thing that our body was designed to do has medicine changed in a good way over the last century?

I mean, we don't need the appendix's store of digestive bacteria anymore since we're rarely away from other people, but appendectomies were done in the 18th century.


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## thismama (Mar 3, 2004)

Quote:


Originally Posted by *ZoeyZoo* 
I am too. I just don't think most people fully understand the consequences of that choice. The evidence is so strong on the benefits of NCB but I don't think most women get any clear evidence-based information.

I have a good friend who is both a nurse and a medical malpractice lawyer. She is extremely informed, and she chose elective c/s for both her births.


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *thismama* 
I have a good friend who is both a nurse and a medical malpractice lawyer. She is extremely informed, and she chose elective c/s for both her births.

A nurse and a medical malpractice lawyer? A person in her professions would have a ton of work to do just to get over the prejudices of her professions.

Did she educate herself about birth besides observing the same hospital births that give many nurses a distorted view of birth and looking at the medical malpractice laws that lead OBs away from evidence-based practices?

I'm sure she educated herself to her satisfaction and, as long as she doesn't use her positions to influence other women into having elective c-sections, it was her choice to make.


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## Ironica (Sep 11, 2005)

As to the issue of food allergies and c-section, here's an article with some insight on that:

http://www.americanscientist.org/tem...rint=yes#54477

After reading this thread, I think that to a certain extent the outrage against non-medically-indicated c-section is a backlash. I'm right with the folks who wouldn't bat an eye at Super Star getting her baby cut out of her body so she can get the lipo at the same time if it wasn't such a friggin' battle to be allowed to push MY baby out my vagina. When women who have options choose c-section, they ARE making it harder for other women to go with vaginal births.

I'm actually not necessarily on board with the "fully informed" choice either. If someone's paying *entirely* out of pocket, maybe. But I don't personally believe that having children is an automatic right, so I do think that people need to take the good with the bad. It gets hazy when someone's had a traumatic vaginal birth. I think that, in an ideal world, we should be able to count on our birth professionals to examine what went wrong and help us to avoid the same circumstances... but too many doctors view vaginal birth like it's some kind of mysterious voodoo that they can't *possibly* hope to understand, so there's no concept of avoiding the same circumstance next time. The same thing happens in reverse for a primary c-section patient who wants a VBAC; you get some catch-all diagnosis like FTP or even something more precise like secondary uterine inertia (*raises hand*) that doesn't really capture the ENTIRE process that led you to the OR. It's left to the patient to reconstruct what happened and determine if she, herself, feels like SHE has the power to make different decisions and have a better outcome. Unfortunately, whether the initial birth was vaginal (but traumatic) or surgical, the default choice when mom can't process the experience and feel that sense of control is to give birth surgically in the future.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *thismama* 
I have a good friend who is both a nurse and a medical malpractice lawyer. She is extremely informed, and she chose elective c/s for both her births.

I can not come up with a more likely to be biased combination...

-Angela


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## starling&diesel (Nov 24, 2007)

Here in Canada, insurance premiums are not an issue, as all birth options are funded by our universal health care system.

That being said, I'm coming to this as a paramedic and thinking of all the women I've encountered in my job.

Culturally, vag births are definitely the first choice, with reluctant cs being a distant second. Elective CS just are not the done thing here, in my experience anyway. I can honestly say I've NEVER had a patient who birthed via elective CS. Never.

What I notice the most in terms of birth choice oppression here is the medical system constantly telling women that VBAC is impossible.
I take every opportunity to tell grieving women I am transporting pre- or post- reluctant CS that it is possible.

One patient I've seen a lot lately is a now full-term primip complete placenta previa. The first time we raced down to the nearest hospital (3 hours away) was almost three months ago for a dangerous bleed ... she and her partner were so scared, both to lose the baby and because of having to have a CS. I was with the same couple last week, and now their biggest concern is the CS. Everyone is telling her she'll never have a VBAC.

I think the overall issue here is education. Nevermind the doctors. Women need to share their wisdom with each other, free of judgement.


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## erin_brycesmom (Nov 5, 2005)

Quote:


Originally Posted by *starling&diesel* 
Here in Canada, insurance premiums are not an issue, as all birth options are funded by our universal health care system.

Why would that make it not an issue? The money to pay for universal health care doesn't come from trees, it still comes from the citizens. If anything it effects you more because you don't have the option of choosing an insurance carrier who does not cover elective c-sections.


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *alegna* 
I can not come up with a more likely to be biased combination...

-Angela

OB who trained in Brazil (90% c-section rate) who's now a malpractice lawyer in the U.S.?

Sorry, I tend to read "can not come up with" as a challenge to my imagination.


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## applejuice (Oct 8, 2002)

I am against elective caesarean sections because they are never presented to the mother as possibly affecting her future fertility and gynecological health and future.

Doctors present elective caesareans as the modern woman's way of birthing.

After one caesarean section, many women suffer PPD, miscarriages, stillborns, infertility, blocked tubes from infection from the surgery, anemia, PP hemorrhage, inability to breastfeed, uterine rupture, placenta previa, placenta accreta. These occur without the incidence of surgical birth, but surgical birth has increased the incidence of these complications dramatically.

And the baby can be hugely affected by prematurity, RDS, and death. Doctors act as if they can guarantee you a perfect baby if you let them cut you open, but that is not true. Babies are born dead when they are delivered "from above" also. Usually this can be a problem from the previous surgery.

There are no guarantees in this life, never.

Quote:

When women who have options choose c-section, they ARE making it harder for other women to go with vaginal births.
Very true. This is how the march from home births to a virtual 100% hospital birth rate happened. The mothers who had the option, still opted for the hospital, and after decades, birthing in the hospital became the rule.


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## dinahx (Sep 17, 2005)

If insurance automatically covered homebirths with a midwife or even if hospital births with an INDEPENDANT midwife (one who doesn't have her paycheck signed by an OB) were available in all areas and covered by all insurance companies, then there wouldn't be an economic bias toward medicalized birth in general, and c-sections in particular.

But in the USA there is a clear economic bias. :cry

(I personally don't bother with my insurance company. If they want to make a donation, that's nice, but I am NOT going to ask an insurance company how to get my baby out. They are too biased and too lame for me.








)


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## 1006baby (Aug 22, 2006)

One of the problems I have with elective c-sections that I have not seen addressed in this thread yet (although I might have missed it) is the conflict of interest for the physician.

Within the US healthcare system doctors get paid more money for a c/s than for a vaginal birth. Hospitals loose money on vaginal births that last longer than about 20 hours. For Hospitals that are very efficient, c-sections can even be a profit center. (Obviously I work in this area for a living!)

So, how can the people (doctors and hospitals) who are financially incented to encourage c-sections be responsible for ensuring informed consent for an elective c-section? Another question I have is if elective c-sections are so acceptable why is there no official diagnostic option for that choice? When a woman chooses an elective c-section, doctors do not write in the chart c-section due to maternal choice. They lie and say c-section due to "x,y,z" (something ambiguous and hard to disprove) because they want to be certain that they get reimbursed.

If a woman wants to make a choice for an elective c-section, I think she needs to be made to review unbiased information provided by someone other than a physician who is getting more money to perform the c-section or a hospital that can also profit from the surgery.


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## GooeyRN (Apr 24, 2006)

Quote:


Originally Posted by *thismama* 
I am pro informed birth choices, including elective c sections.









me, too. Not what I would choose to do that, but others should be able to do what they want, whether it be homebirth, elective induction, elective c-section, etc. I personally would like to never have a c-section, just b/c I don't want to go through the long recovery. Others would like to avoid a sore vulva.


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## georgia (Jan 12, 2003)

Hi, just a friendly reminder from the User Agreement:

Quote:

Mothering.com is the website of natural family living and advocates natural solutions to parenting challenges. We host discussion of nighttime parenting, loving discipline, natural birth, homebirth, successful breastfeeding, alternative and complementary home remedies, informed consent, and many other topics from a natural point of view. *We are not interested, however, in hosting discussions on the merits of* crying it out, physical punishment, formula feeding, *elective cesarean section*, routine infant medical circumcision, or mandatory vaccinations. We do not tolerate any type of discrimination in the discussions, including but not limited to racism, heterosexism, classism, religious bigotry, or discrimination toward the disabled. We will not host discussions that involve explicit sexual references and are cautious about discussions on volatile topics such as abortion, religion, and race. See statement of purpose below.
Any questions or comments, please PM me, Arywn or courtenay_e. Thanks!


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *sapphire_chan* 
OB who trained in Brazil (90% c-section rate) who's now a malpractice lawyer in the U.S.?

Sorry, I tend to read "can not come up with" as a challenge to my imagination.









Yeah yeah yeah....

There could be worse...









-Angela


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## thismama (Mar 3, 2004)

Quote:


Originally Posted by *alegna* 
I can not come up with a more likely to be biased combination...

-Angela

Everyone is biased. We all have a right to our biases. She is definitely not uninformed.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *thismama* 
Everyone is biased. We all have a right to our biases. She is definitely not uninformed.

Honestly I would deeply doubt if she's truly informed. One does not become informed with the background she has.

Also, admittedly, I have a very difficult time fathoming how a semi-intelligent person could possibly fully informed and choose an elective section (barring another reason- previous trauma etc) It's not a logical choice. The evidence does not indicate that it is a safe or wise choice.

-Angela


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## thismama (Mar 3, 2004)

Quote:


Originally Posted by *alegna* 
Honestly I would deeply doubt if she's truly informed. One does not become informed with the background she has.

She is informed. We have had the discussion. She can talk circles around me with her medical knowledge and stats about various risks, she is not just some ignorant woman under the spell of her OB because she chooses differently than I would. That is my point here.

Quote:

Also, admittedly, I have a very difficult time fathoming how a semi-intelligent person could possibly fully informed and choose an elective section (barring another reason- previous trauma etc) It's not a logical choice. The evidence does not indicate that it is a safe or wise choice.

-Angela
Well, and that would be your bias. It is one that I share (re: risks), but I can assure you my friend is very intelligent and well informed, and yet she makes different choices than you or I would.

Her body, her births. I support her fully. Which is what I am saying in this conversation, ITA that there is a general lack of info about birthing perpetuated by the medical industry, and I feel women should have full access to information when making our choices. But, that doesn't always mean they make the same choices you or I would.

And that is totally cool with me.


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## chiro_kristin (Dec 31, 2004)

"Informed" and "conscientious" are not the same thing. Well maybe conscientious isn't the word I want to use, but I can't think of a better one right now.


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## anne1006 (Jul 1, 2007)

I think that if someone wants and elective procedure, then they should pay for it. If there isn't a medical need for it, then it should be out of pocket and not driving up insurance premiums. My premiums won't pay for my homebirth, and I don't want to pay for someone who is too posh to push. If our medical standards and practices went along more with current research, there would be far fewer interventions and elective procedures, and our insurance would be better off. Though the hospital pocket books probably wouldn't be.....


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## applejuice (Oct 8, 2002)

True, anne1006.


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## thekimballs (Feb 5, 2004)

Quote:


Originally Posted by *alegna* 
Honestly I would deeply doubt if she's truly informed. One does not become informed with the background she has.

Also, admittedly, I have a very difficult time fathoming how a semi-intelligent person could possibly fully informed and choose an elective section (barring another reason- previous trauma etc) It's not a logical choice. The evidence does not indicate that it is a safe or wise choice.

-Angela

Why can't she be informed? Are nurses and lawyers forced to live in a box somewhere and not allowed to read medical literature?

It's ridiculous to say that no semi-intelligent person can choose an elective section (because of the published risks) unless you're also going to say that no semi-intelligent person could ever have a vaginal breech (where the published risks show that it is riskier than a c-section) or a UP/UC (where the published risks show that no prenatal care is associated with a worse outcome).

No woman makes (informed) decisions based solely on statistics, unless she is a Vulcan or a robot. The evidence and statistical predictions are weighed against her desire and need for an experience that empowers her and validates her, and against her emotions and attachment to the vision of the experience.

I have no issue with the idea that for some women a c-section is in fact empowering and validating. I know several who have had two or three sections, the first or second medically necessary and the subsequent "elective." Am I supposed to accuse them of being deluded or lying when they talk about how much more they were empowered by the elective section than by the attempted vaginal birth that went to section in the end?

This assumption that no woman who is truly informed can possibly choose X is very, very dangerous. How would you like it if an MD used that type of logic against you? Or if the courts assumed that type of logic when granting court orders for medical treatment? It's the polar opposite of individual empowerment; it's enslavement to statistical risk.


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## dinahx (Sep 17, 2005)

I *know* I have to pay for my HB OOP, so why shouldn't elective sections be the same???

But I agree that someone could know *all* the facts and still make a different choice. I just learned that with Circ . . . I thought for sure, no one as smart as me AND who had a intact husband would choose to Circ, but then I met *that* mama. With an intact husband and she's a CRNA . . . so she's even seen circs . . . Go figure!


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## starling&diesel (Nov 24, 2007)

Quote:


Originally Posted by *erin_brycesmom* 
Why would that make it not an issue? The money to pay for universal health care doesn't come from trees, it still comes from the citizens. If anything it effects you more because you don't have the option of choosing an insurance carrier who does not cover elective c-sections.

Therefore, everyone has an interest in keeping the costs reasonable.
Perhaps that's why we aren't so keen on them here? And why you have to have a good reason to have one?


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *thismama* 
She is informed. We have had the discussion. She can talk circles around me with her medical knowledge and stats about various risks, she is not just some ignorant woman under the spell of her OB because she chooses differently than I would. That is my point here.

Well, and that would be your bias. It is one that I share (re: risks), but I can assure you my friend is very intelligent and well informed, and yet she makes different choices than you or I would.

Her body, her births. I support her fully. Which is what I am saying in this conversation, ITA that there is a general lack of info about birthing perpetuated by the medical industry, and I feel women should have full access to information when making our choices. But, that doesn't always mean they make the same choices you or I would.

And that is totally cool with me.


I







Thismama! I totally agree with you, people can be informed and choose an elective c-section.


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## SneakyPie (Jan 13, 2002)

Oh for crying in the night. We all know "elective" doesn't mean only "because I don't feel like having a vag. birth." "Elective" also covers every situation in which the mother has any time and warning at all beforehand and makes a DECISION (with her practitioner) that c-birth will be best for her and the baby. The medical profession themselves are the ones who have classified that as "elective," meaning "the opposite of emergency." So ANY non-emergency c-section is "elective" by this definition, and to slam all mothers who have to make that choice as semi-intelligent, not possibly REALLY informed, and undeserving of medical coverage, is just kneejerk and unthinking.


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## Romana (Mar 3, 2006)

Quote:


Originally Posted by *anne1006* 
I think that if someone wants and elective procedure, then they should pay for it. If there isn't a medical need for it, then it should be out of pocket and not driving up insurance premiums. My premiums won't pay for my homebirth, and I don't want to pay for someone who is too posh to push. If our medical standards and practices went along more with current research, there would be far fewer interventions and elective procedures, and our insurance would be better off. Though the hospital pocket books probably wouldn't be.....

No, no, no, no, no! The answer is not to reduce the available choices! The answer is not to make non-medically necessary elective c/s something that is only available for the rich! I absolutely abhor this kind of approach.

What, some jerk male OB a low-income woman on WIC/medicare gets is going to give her a fair shot at getting her "non-medically-necessary elective c/s" covered because she previously had an extremely traumatic vaginal experienece (rape, birth trauma, whatever)? Probably the same crappy OB who caused the trauma in the first place??

The answer is not to reduce choice by financial prohibitions. That can only hurt those unable to afford the procedure and does nothing about the type of non-medically necessary elective c/s that gets media coverage.


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## Romana (Mar 3, 2006)

Quote:


Originally Posted by *SneakyPie* 
Oh for crying in the night. We all know "elective" doesn't mean only "because I don't feel like having a vag. birth." "Elective" also covers every situation in which the mother has any time and warning at all beforehand and makes a DECISION (with her practitioner) that c-birth will be best for her and the baby. The medical profession themselves are the ones who have classified that as "elective," meaning "the opposite of emergency." So ANY non-emergency c-section is "elective" by this definition, and to slam all mothers who have to make that choice as semi-intelligent, not possibly REALLY informed, and undeserving of medical coverage, is just kneejerk and unthinking.

I thought this was clarified earlier in the posts. I for one have specifically been calling the kind of c/s under discussion "non-medically indicated elective c/s" in order to keep that point obvious.


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## holly6737 (Dec 21, 2006)

Quote:


Originally Posted by *thismama* 
I am pro informed birth choices, including elective c sections.









Me too. If a woman is fully aware of the risks and the benefits, and is not swayed by her practitioner one way or the other, I would support that woman's right over her own body and her right to choose an elective c-section.

Her body, Her birth. It cuts both ways.


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## Incubator (May 11, 2006)

Quote:


Originally Posted by *thekimballs* 
It's ridiculous to say that no semi-intelligent person can choose an elective section (because of the published risks) unless you're also going to say that no semi-intelligent person could ever have a vaginal breech (*where the published risks show that it is riskier than a c-section*) or a UP/UC (where the published risks show that no prenatal care is associated with a worse outcome).


Okay okay, wait a minute, here I have problems... Forgive me if I'm wrong but I'm under the impression that a vaginal breech may be riskier for the BABY, but is, in fact, safer for the mother and safer for future babies than a cesarean... And that's not counting how safe the vaginal breech birth might be if the person CATCHING the baby actually has plenty of experience catching them. Were I giving breech birth in a hospital I'd be terrified of the expertise of the CP too, but I'd be insane to deliver a breech vaginally with just ANY care provider... I may as well ask my midwife to do the C-sec, it would probably be just as safe as asking an OB to catch a breech baby.

ETA: I didn't even mention the last part about prenatal care, where the statistics may be skewed by homeless, low income, or drug-addicted mothers who do not seek prenatal care as opposed to generally healthy informed mothers who decline prenatal care...


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## barefootpoetry (Jul 19, 2007)

Quote:


Originally Posted by *sapphire_chan* 
Every one done makes doing c-sections for any stupid reason that much more acceptable. And makes people who want natural births have to fight that much more to not get interventions--after all, what's the big deal with an induction? it'll still be a "natural" birth!







:

Not all birth choices are treated equally. Every woman doesn't have a chance to choose the birth she wants. Homebirth, VBAC, etc.

YES and YES. It really chaps my @ss that I have to search high and low for a HB MW who will do a HBAC and pay her out of my own pocket, but if I wanted a RECS, the docs at the local hossy would be more than happy to do it for me.

The more "unnatural" births there are, the more unheard-of a true natural birth is, and the more difficult it will be to obtain in a hospital setting. That leads to first-time moms like me (er, like I WAS) getting railroaded into yet more C-sections because the staff either doesn't know or won't allow them to labor naturally.

I'm all for freedom of choice, but not when it affects MY choice too.


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## MaterPrimaePuellae (Oct 30, 2007)

Quote:


Originally Posted by *LaLaLaLa* 
I had an elective c-section for my second child. I was VERY much informed of the risks and possible complications, and pressured by my Ob/Gyn NOT to have one. After explaining myself and signing a bunch of waivers, I was in business.

In my particular case, things worked out better for everyone involved. My first birth was traumatic. My dd tore through my body to the extent that moments after she was born she was handed to my dh and I was rushed off to have emergency repair surgery under general anesthesia. I didn't hold her. I didn't breastfeed her. Dh gave her a bottle. I don't remember anything from the first day or so, and I was on a great deal of medication (morphine, I think). Our nursing relationship (either as a result of this or a totally separate issue) was never really strong. I couldn't stand without assistance for two weeks. My body wasn't right for months afterward.

Before I became pregnant again, I made certain that my doctors would perform a c-section. If they had said no, I probably would not have had my ds.

Ds's birth: I knew exactly when it would occur, which eliminated any stress of childcare for dd. My parents live a couple of hours away and there was nobody else I felt confident watching dd if I were to go into labor in the middle of the night or something. A childhood friend of mine is a labor and delivery nurse at the hospital, and she specifically planned to be there to work with me. After ds was born, he was brought to me to touch and examine before visiting with dh for a few minutes as I had my tubes tied (since my abdomen was already going to be open and all, it made more sense to us than scheduling a separate surgery) and was sewn up. Ten minutes after ds was born, we were cuddled in bed together, breastfeeding. The next day I was up and showering, a feat it took me two weeks to accomplish after my first birth.

In terms of recovery time, things were better for me. In terms of stress, things were better for all involved. After having dd, dh and my mom really thought I might die, as the blood loss and the doctors' reactions were so dramatic. In terms of medical costs, I would imagine things were similar, as my first birth ended in emergency surgery, as opposed to planned surgery the second time around, plus I avoided an additional surgery by having a tubal ligation at the same time as the c-section.

An elective c-section is by no means right for everyone, and I made the decision the first time around that it was not right for me. But for my second pregnancy.... I wouldn't have had it any other way.


Wow-- I am so sorry for your first birth experience!! What a nightmare. I don't think I would even categorize your c-section as "elective." I don't know exactly what happened with your first birth, but it seems to me like the c-section was medically indicated.

Bethany


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *SneakyPie* 
So ANY non-emergency c-section is "elective" by this definition, and to slam all mothers who have to make that choice as semi-intelligent, not possibly REALLY informed, and undeserving of medical coverage, is just kneejerk and unthinking.

I don't see anyone here doing that. I see lots and lots of disclaimers to that effect.

-Angela


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## hanno (Oct 4, 2006)

Quote:


Originally Posted by *thekimballs* 

It's ridiculous to say that no semi-intelligent person can choose an elective section (because of the published risks) unless you're also going to say that no semi-intelligent person could ever have a vaginal breech (where the published risks show that it is riskier than a c-section) or *a UP/UC (where the published risks show that no prenatal care is associated with a worse outcome)*.



just want to point out that UP does not mean NO prenatal care


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## thekimballs (Feb 5, 2004)

Quote:


Originally Posted by *Incubator* 
Okay okay, wait a minute, here I have problems... Forgive me if I'm wrong but I'm under the impression that a vaginal breech may be riskier for the BABY, but is, in fact, safer for the mother and safer for future babies than a cesarean...


Quote:


Originally Posted by *hanno* 
just want to point out that UP does not mean NO prenatal care

This is exactly what I am talking about. When you apply aggregated statistical risk to a vaginal breech or to a UP, you totally disregard the fact that there are individual factors involved--that caregivers are very different, that some women may want to assume (or reject) individual risk in favor of baby's risk, that UPs are radically different depending on the woman in question, and a hundred other issues.

We MUST do the same thing for "elective" sections. Making a flat statement like no semi-intelligent woman would ever choose a section or that a woman who chooses a section is ipso facto "not informed" because of exactly those same types of aggregated risk statistics dismisses ALL those individual factors, and also dismisses the preferences and emotional involvement of the mother.


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *thekimballs* 

We MUST do the same thing for "elective" sections. Making a flat statement like no semi-intelligent woman would ever choose a section or that a woman who chooses a section is ipso facto "not informed" because of exactly those same types of aggregated risk statistics dismisses ALL those individual factors, and also dismisses the preferences and emotional involvement of the mother.

Yup! Lots of factors play in. I have a section coming up in March, non emergency & elective. I consider myself VERY educated.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *rmzbm* 
Yup! Lots of factors play in. I have a section coming up in March, non emergency & elective. I consider myself VERY educated.

As has been added by disclaimer, posters here are not talking about medically indicated sections, which yours most certainly is Marie









-Angela


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## CNutty (Apr 18, 2006)

I am not personally agienst fully informed woman having elective c-sections, but 2 questions come to mind...

1. If this woman was trying to avoid labor at all, they potentually could take place WAY to early for the baby, and cause health problems. I guess this could be solved if the woman was willing to go into labor first, and then have the section, but I doubt that is the way it happens.

2. If all woman have this option, then couldnt it become a slippery slope leading to all sorts of people being able to demand whatever kind of elective surgury they wanted? Like say a Doc thought that some other treatment besides surgury was the best option for someone who say had a gullblatter problem, could that person just demand removal and trump the Docs opinion?


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *CNutty* 

2. If all woman have this option, then couldnt it become a slippery slope leading to all sorts of people being able to demand whatever kind of elective surgury they wanted? Like say a Doc thought that some other treatment besides surgury was the best option for someone who say had a gullblatter problem, could that person just demand removal and trump the Docs opinion?

I do actually think all sorts of surgery should be readily available. The patients preference should always win in the end, right or wrong....and they should be willing to take FULL responsability for it. Medical, legal, emotional, etc.


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## CNutty (Apr 18, 2006)

Quote:


Originally Posted by *rmzbm* 
I do actually think all sorts of surgery should be readily available. The patients preference should always win in the end, right or wrong....*and they should be willing to take FULL responsability for it. Medical, legal, emotional, etc*.

I agree with you, but I dont see this happening, I see legal fees and law suits going through the roof...as if they already arent


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *CNutty* 
I agree with you, but I dont see this happening, I see legal fees and law suits going through the roof...as if they already arent









Yes, and it is a huge irritance to me. Very unfortunate. I won't LISTEN to the MD, but I will BLAME them for everything...come on!







:


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## ktbug (Jul 8, 2006)

Multi-quote reply coming up here; what a good thread! First, OT:

Quote:


Originally Posted by *sapphire_chan* 
OB who trained in Brazil (90% c-section rate) who's now a malpractice lawyer in the U.S.?

Holy ... what now? 90%? What the hell is going on in Brazil?
I need to find me some sociological studies about this.

Quote:


Originally Posted by *1006baby* 
How can the people (doctors and hospitals) who are financially incented to encourage c-sections be responsible for ensuring informed consent for an elective c-section?

Such an important point. The money really is the bottom line in a great many cases of dodgy informed consent. But, that isn't going to change until the dominant model of prenatal care changes. And the dominant model of the doctor-patient relationship, and the medicalization of our society, and the blind trust many health care consumers put into their doctors.

Quote:


Originally Posted by *anne1006* 
My premiums won't pay for my homebirth, and I don't want to pay for someone who is too posh to push. If our medical standards and practices went along more with current research, there would be far fewer interventions and elective procedures, and our insurance would be better off. Though the hospital pocket books probably wouldn't be.....

The first sentence ... should be your dddddc.







And I agree with you, I don't want to pay for that either, but that's sadly how the health insurance system (scam?) works.
The second point of your post - if insurance companies based their coverage decisions on hard research and fact ...







... I'm trying to count in my head how many major corporations would have to declare bankruptcy ...
I wish it worked that way, too, but I don't know why the belief so stubbornly persists that insurance companies are in the business of keeping us healthy. They are not. They are in the business of making money, which often correlates to keeping us - wait for it - sick! If they were concerned with our health and well-being, they wouldn't make nearly as much money.

Quote:


Originally Posted by *thekimballs* 
This assumption that no woman who is truly informed can possibly choose X is very, very dangerous. How would you like it if an MD used that type of logic against you? Or if the courts assumed that type of logic when granting court orders for medical treatment? It's the polar opposite of individual empowerment; it's enslavement to statistical risk.

Nicely put, Joanna. I'd like to add that having all the information doesn't really equate to making the best decision based on the available information. And the feeling of empowerment is quite subjective, as you point out. Some women feel very empowered by wearing pants, or driving a car. Some men feel empowered by hurting women. Some people feel empowered by spending money, or by NOT spending money. Here at MDC we tend to focus on the "empowering" aspects of vaginal birth, but not all women who give birth vaginally feel empowered by it.

Quote:


Originally Posted by *Romana9+2* 
The answer is not to reduce the available choices! The answer is not to make non-medically necessary elective c/s something that is only available for the rich! I absolutely abhor this kind of approach.

The answer is not to reduce choice by financial prohibitions. That can only hurt those unable to afford the procedure and does nothing about the type of non-medically necessary elective c/s that gets media coverage.

I agree with this 100%. Either cover it all, or don't cover any of it. Picking and choosing only gives advantage to some at the expense of others; usually to the wealthy at the expense of the not wealthy.

And, finally ...

Quote:


Originally Posted by *holly6737* 
Me too. If a woman is fully aware of the risks and the benefits, and is not swayed by her practitioner one way or the other, I would support that woman's right over her own body and her right to choose an elective c-section.

Her body, Her birth. It cuts both ways.

Yup, yup. Though the salient point is obviously "...is not swayed by her practitioner ...", and you should remember that a lot of times, the swaying is subtle, and not admitted to or acknowledged by the woman.

Haha, "cuts".

Holly, I always find myself agreeing with you in posts outside the vaccinations forum.


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## Ironica (Sep 11, 2005)

Quote:


Originally Posted by *thismama* 
She is informed. We have had the discussion. She can talk circles around me with her medical knowledge and stats about various risks, she is not just some ignorant woman under the spell of her OB because she chooses differently than I would. That is my point here.

She's a medical malpractice lawyer... of COURSE she can talk circles around anyone who isn't with medical knowledge and stats about various risks. That's her job. If she sucked at it, she'd be something else. ;-)

Her job is also one that exposes her repeatedly to all the things that go WRONG. Yes, she can tell you about this risk and that risk and it all adds up to make vaginal birth seem VERY dangerous. But when you take it piece by piece, the various risks are infinitesimal compared to risks we assume every day. And how much does she talk about the risks of surgical birth? One thing she may not have mentioned is that, when someone dies on the operating table or in recovery (which happens more often with c-sections than vaginal births), there's much less likely to be a lawsuit... because the risks of surgery are much better understood and acknowledged. When someone dies after surgery, the doctors can explain it in a way that removes their culpability (often because it truly is a normal risk of surgery... which there are MORE of than normal risks of vaginal birth). So, from her professional perspective, c-section is "safer", because it's less likely to cause a lawsuit. Also, since it's less likely to cause a lawsuit, the arguments about how much more DANGEROUS vaginal delivery is are very well-established. There's tons of case law, statements, and decisions she can read and learn that lesson from. There's a lot less available to argue the other side, since a lawsuit is less likely to happen after a surgical birth.

There may be certain things about HER situation that truly make c-section safer for her, I suppose. But she doesn't have a perspective that allows her to weigh the information in an unbiased manner. My FIL is a personal injury attorney, and I see how that colors his perspective of everyday life. He sees all kinds of ways people could trip or slip or fall as so HUGELY dangerous, while ignoring other very real risks, such as routine kitchen hazards. He's not *wrong* that a cord strung across a pathway could cause someone to trip and fall and hurt themselves, but his perspective of the *relative* danger is skewed by his years of practice arguing that THIS type of hazard is far bigger.


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *rmzbm* 
Yup! Lots of factors play in. I have a section coming up in March, non emergency & elective. I consider myself VERY educated.









I don't consider your planned c-section to be elective. Having a c-section because you've been told by a doctor and a midwife that there will be strong possibility of you dying as a result of vaginal childbirth is not arbitrarily deciding to have a c-section with no thought.


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *ktbug* 
Holy ... what now? 90%? What the hell is going on in Brazil?
I need to find me some sociological studies about this.

Sorry, it's actually just some private clinics in Brazil that have that rate. http://www.time.com/time/magazine/ar...993857,00.html However an OB who trained at one of those clinics would still have a seriously distorted view of birth.


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## groovynaturemama (Mar 8, 2007)

statistically speaking we (the US) could potentially see c-section rates soar to 50% of all births in our lifetime if we continue at the rate we're going. i believe it is 30 something % at this time. despite our ever climbing c/s rate, we still have the 2nd highest infant mortality rate in the developed world...







if nearly 1/3 of our babies are delivered in this manner, then why the high mortality rate? why is our infant death rate higher in this country than in a country where 70% of all births are midwife attended, and the c/s rates are waaaaay lower?

with that known, and being informed about the risks of elective c/s as well as the potential for them to drive up healthcare costs, it almost seems (IMO) irresponsible to have one unless it is medically indicated or an emergency. a c/s really should only be offered if there is a true medical need. this too posh to push stuff is just over my head


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *sapphire_chan* 







I don't consider your planned c-section to be elective. Having a c-section because you've been told by a doctor and a midwife that there will be strong possibility of you dying as a result of vaginal childbirth is not arbitrarily deciding to have a c-section with no thought.

I don't consider it elective either, but that's all the terminology I have to work with, unfortunately. We recently discussed this in another thread. It's basically a medically indicated non emergency section. But I don't *want* it by any means. (But am ok with it.







)


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## applejuice (Oct 8, 2002)

Quote:

Holy ... what now? 90%? What the hell is going on in Brazil?
I need to find me some sociological studies about this.
The Brazilian doctors have told the Brazilian women for decades that a natural vaginal birth will ruin their lovemaking abilities for the rest of their life, so Brazilian women are "demanding" caesareans whenever possible.

There are doctors who say this in the US and people who think this way in this country, so do not laugh. Ignorance is not bliss.


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## Robinna (Aug 11, 2003)

Quote:


Originally Posted by *thekimballs* 
risks) unless you're also going to say that no semi-intelligent person could ever have a vaginal breech (where the published risks show that it is riskier than a c-section)

sorry, OT, but this is my pet subject so couldn't let this pass without correction. Published research does NOT show it's riskier than c/s. The most current large-scale research is the 2 year follow up to the Term Breech Trial, which negated it's own original findings. Criticism of the TBT before the 2 year follow up already pointed out that once you adjusted for the analysis errors in the TBT the 2 groups were equal in outcomes for the babies, and significantly better for the mamas in the vaginal group. And then the TBT's own 2 year follow up showed that at 2 years old, the vaginal group babies were actually in slightly (statistically insignificant difference) better health than the c/s babies.


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## ktbug (Jul 8, 2006)

Quote:


Originally Posted by *applejuice* 
The Brazilian doctors have told the Brazilian women for decades that a natural vaginal birth will ruin their lovemaking abilities for the rest of their life, so Brazilian women are "demanding" caesareans whenever possible.

There are doctors who say this in the US and people who think this way in this country, so do not laugh. Ignorance is not bliss.

Oh, I was NOT laughing. Trust me.

I know women IRL who really think that, and when I try to talk to them about ... well, about birth ... they tell me they don't want to get into it with me. And to be honest, I've never been the proselytizing sort. I'm no good at converting people, which is a lot of the reason why I firmly believe that birth choices are personal and valid across the board, no matter how much research (or lack thereof) went into it. What others choose is not the best choice for me, but it's none of my business if they want to do all the research and still make what I would consider for myself to be a 'bad' decision.

And I definitely make the distinction between medically indicated, medically necessary, and arbitrary patient choice. rzmbm, it's well established that when we're talking about "too posh to push", we're not talking about you.









Be that as it may ... I know many women in real life with whom it is just not up for discussion ... same way it would just not be up for discussion if they tried to tell me to circ, or vax, or ff by choice. They came to their decisions on their own, some after doing lots and lots of research and reading, and they certainly aren't going to change their minds by talking to me.

I'm afraid the mindset/fear you alluded to above, applejuice, is behind a lot of the "too posh to push" decisionmaking process. Between the fear of becoming "loose" and the fear of the pain of childbirth (even with an epi!), yeah, no statistic I can quote about baby safety or mama recovery time or breastfeeding relationship jeopardy is going to hold sway over the spectre of a vagina that is no longer sexually desirable.


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *rmzbm* 
I don't consider it elective either, but that's all the terminology I have to work with, unfortunately. We recently discussed this in another thread. It's basically a medically indicated non emergency section. But I don't *want* it by any means. (But am ok with it.







)

Sorry to continue this off topic side discussion, but I'm wondering, your insurance will cover this right? They aren't trying to claim that just because it's "elective" it's optional?


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## Mindi22 (Jun 28, 2005)

Quote:


Originally Posted by *MsBlack* 
I am pro choice, and I very much DO think this is a feminist issue. That said--I have to also say that a very large part of this feminist issue is that women now have been raised in such a highly medicalized environment that many who presumably 'choose' such things as elective csec are NOT making an informed choice--they have no idea of, or belief in, the normalcy and perfection of their own bodies and birthing capacities--and how every bit of the way that birth is designed, is FOR THEIR OWN AND CHILDREN'S HIGHEST WELLBEING. THAT to me is a feminist issue worth fighting for.

Our range of choices have been under a state of seige for quite some time, and simply 'knowing all the risks of csec' is STILL not making an informed choice. The ripoff to women (and our children and partners) being perpetrated through this so-called 'informed consent' is quite insidious, devious and pervasive. You see, the problem is, women today (in general, and present company obviously excluded) is that we are never taught how perfectly suited natural birth is to the short term and long term wellbeing of mother and baby both (and for the family in general).

Knowing 'the risks' of csec is only 1/2--or maybe only 1/4--of the picture. True Informed Consent (under the law) means not only being told the benefits and risks of a particular procedure. It also includes being told the benefits and risks of OTHER OPTIONS, including the option of doing nothing. Women who are informed of the risks of csec (which I believe, as also true with epidural and various other common obstetrical interventions, are presented in a 'harmless' and quite watered-down way), are NOT being told why natural birth is best for all concerned in the vast majority of cases. Most docs do not even know the full range of benefits to natural birth, physically, emotionally, psychologically for mom and baby. The best we get from seemingly 'natural minded' obs is that they are willing to support the mom's wish for a certain 'experience' (so long as all goes well in the doc's mind). They do not acknowledge, and certainly do not promote, the facts which show that natural birth is hands down the very safest, healthiest way for babies to be born/women to give birth, in both the short and long term (for MOST women/babies, with exceptions, obviously).

So, to my way of thinking, this whole 'elective csec' is one of the most horrific of subversions handed to women in this technologically--and still very much patriarchally--oriented era. Separating out those women who do have good reason to choose csec (as with story of a pp), all others who--for no real health reason--seem to 'freely choose' elective csec, are being coerced by a deep and dangerous deception! There is simply no other way to put it.
They are NOT making truly informed choices--and the majority are not even aware of what Informed Consent under the law is and they surely do not know the myriad and deep benefits they are choosing against, by choosing csec.

They are women who have had their femininity stolen from them from the get-go, in the sense that they have been conditioned to believe that having a womanly body is something that can freely be 'bypassed' via patriarchal technologies, INSTEAD of being raised in an atmosphere that celebrates and honors woman's body and reality fully as a sacred and very much necessary element of this dualistic plane we inhabit. They are women who have been taught to believe they can 'bypass' their womanly body via technology, and not pay a price for that, now and on into their own and their children's lives--physically, emotionally, psychologically.

Yes, this is a feminist issue allright! It is very much a feminist issue.

Where's my standing ovation smiley when I need it? Very well put, MsBlack!

What I'm seeing ignored by the folks that have said a woman's body, a woman's right is the baby. A c-section is NOT gentle on the baby, it is NOT safer for the baby, unless medically indicated (where a vaginal birth could mean baby death, etc), there's nothing about section that is better for baby!

While I personally wonder at the thought process of the woman that says that they can't handle the pain of labor, so they are going to get section.... hmmm... a few hours of pain vs. several weeks of recovery from major abdominal surgery? How is that anywhere near logical???? A woman might decide for whatever reason that a section is better for her. I'm not going to argue with that decision, but I can tell you that the vast majority of MD's sure as heck don't inform women about the risks to the baby of a section.

I'm scheduled to have a section in about 2 weeks for a complete previa that hasn't moved since week 20 of this pregnancy. Am I happy about it? God no! Am I looking forward to it? Nope! Am I worried about baby? Yep! Am I grateful that there are docs that know what they are doing in this situation so that both baby and I can survive? Most assuredly!


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## erin_brycesmom (Nov 5, 2005)

Quote:


Originally Posted by *starling&diesel* 
Therefore, everyone has an interest in keeping the costs reasonable.
Perhaps that's why we aren't so keen on them here? And why you have to have a good reason to have one?

As just shown by the pp, that is not the case (everyone having an interest in keeping costs reasonable) but it should be. She thinks it doesn't matter because she has universal healthcare. That is the prevailing attitude that I see as well and the same with the current government run health care system in America that I am already a part of.


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## erin_brycesmom (Nov 5, 2005)

If I understand correctly the medical term "elective" c-section just means the *time* is elective and has nothing to do with the reasons. The lay person definition for elective c-section is non-medically indicated which is what we are talking about here.

I know some here were on another board when we had a few very informed people at various times (including one lawyer) proclaim the glories of elective c-section. After 300+ page threads, seems like the person changes their mind every time because while they were very informed on the risks of c-sections and typical hospital births, what they weren't truly informed on was *normal birth*.


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## Kidzaplenty (Jun 17, 2006)

Interesting thread. I have nothing new to add, but I am personally against elective c/s. Meaning ones that have no medical indication and are solely for convenience of Dr or Mom. If truly medically indicated, that is a whole other story.


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *sapphire_chan* 
Sorry to continue this off topic side discussion, but I'm wondering, your insurance will cover this right? They aren't trying to claim that just because it's "elective" it's optional?

Yes, my insurance is paying for it...as well they should. If they didn't I'd have to wait for labor, risk my life, fly to the ER and have medical debt out my tushy...not cool! Kind'a why "pay for your own ELECTIVE c/s" freaks me out...who's to make that call. Many here think I shouldn't be having one, as they have as much as said so - good thing they don't work for Cigna, hu?


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## LoveChild421 (Sep 10, 2004)

I'm not against it. I completely understand where women are coming from when they look at their options (generally most woman who haven't done a lot of research look around and see that either a hospital birth with a Dr. or a CNM are their options) and hear stories from female friends about how their vaginas were cut open and the baby pulled out with a vacuum or forceps.
I think women sense that there is something very disempowering about giving birth with your legs held up in stirrups or by nurses and people counting loudly telling you to "PUSH!" when really all you need is gravity to help you out (being on your back is the absolute worst, most ridiculous position to expect a woman to birth a baby in, gravity is working against you and your pelvis isn't able to open up as well either). Women don't want to go through all of that and then end up with a c-section anyway and feel like a failure because "they weren't ABLE to push the baby out in time..." or whatever. The way birth is handled the vast majority of the time here in the US fails women. It isn't something that empowers them.

At least in choosing a C-section you don't have to go through all of that or subject yourself to that system- yes you are going to the hospital to have a large wound cut in your stomach and it isn't natural, but at least you don't have this big birth ordeal to go through.

I see women who choose elective c-section as a lot like us homebirthers and UCers who reject the current state of maternity care. They just either don't see homebirth as an option or decide for whatever reason that it isn't for them.

Quote:


Originally Posted by *karina5* 

I am all for a person having a natural and/or unassisted birth, but really, there is risk involved in ANY method of childbirth.


Statistically you are more likely to die from a C-section (which is major abdominal surgery after all) than vaginal childbirth. This is a consideration and not something that all woman are fully informed of by their OBs.


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## rmzbm (Jul 8, 2005)

You make excellent points, LoveChild!


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## Robinna (Aug 11, 2003)

Quote:


Originally Posted by *LoveChild421* 
Statistically you are more likely to die from a C-section (which is major abdominal surgery after all) than vaginal childbirth.

In fact I believe it's 3X the risk of maternal death. That being said, it's the difference between 1 in 10,000 (I think that's right, but haven't looked it up lately) and 3 in 10,000. But 3X the risk.


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## ktbug (Jul 8, 2006)

Quote:


Originally Posted by *Mindi22* 
What I'm seeing ignored by the folks that have said a woman's body, a woman's right is the baby. A c-section is NOT gentle on the baby, it is NOT safer for the baby, unless medically indicated (where a vaginal birth could mean baby death, etc), there's nothing about section that is better for baby!

The baby's welfare gets ignored in all facets of standard medicalized prenatal care and birth care. U/s can be dangerous for baby, as can something as routine as the glucose test. LOTS of things in vaginal hospital birth are risky for the baby - epidural, forceps, lithotomy position, etc. And formula feeding is obviously an inferior choice for baby's health when made arbitrarily or for cosmetic reasons. Why should this particular aspect of medical childbirth be any different? What you've said about sections could easily be said about ultrasound, epidural, or formula. Pretty much every choice made about health care during pregnancy and childbirth can come down to baby's best interests vs. mom's comfort. And it's extremely common for women to choose their own comfort over their baby's best interests. Why would doctors go out of their way to inform women otherwise, when these choices are making them money hand over gloved fist?


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## saimeiyu (Aug 13, 2007)

I personally don't approve of purely elective c/s... They're usually done too early for the baby to be really healthy, and I can't imagine that the baby really would like to not have a mom because she died during a non-emergency c/s. Not to mention that it can hinder the nursing relationship, etc. I just personally believe the risks to mom and baby aren't justified. I would never choose one myself, however, I know a couple of people who have, and while I disagree with the reasoning that led to the choice, I can understand.

The biggest factor, in my opinion, is fear. The second biggest, is that the doctors don't support what they'd RATHER have.

Here's the story of one woman who I'm trying to help out:
She's active duty military (Which means she doesn't have a *real* choice of where to give birth, because if she opts for a homebirth, not only does she have to pay for it herself, there's a possibility that if something goes wrong, she can get in HUGE trouble.)
For her first child, her water broke before labor began. Being a good girl, and doing like the doctors told her, she went straight to the hospital, where after 6 hours, they decided that since labor hadn't started, they'd just give her pitocin to "help" her. And then when it took "too long" they cranked it up... and then cranked it up, and then cranked it up. She had nonstop contractions, couldn't get a word in edgewise because she couldn't breathe, and still, instead of TURNING it DOWN/OFF, as any sane person SHOULD do, they cranked it up again 'cause she was still only 6 cm... All this took about 22 hours... after that last hour, they said, "Oh, well, you're not progressing, and it's been 23 hours. We have to give you a C/S NOW or your baby will get infected and die because your water has been broken for 24 hours."
She was exhausted, traumatized, and quite ready to be done, since things just "didn't work". So of course she consented to the c/s.

This time around, she has the same doctor, same hospital, same everything. She is morbidly terrified of going back in there to labor vaginally, since the doc told her probably the exact same thing will happen again. After all, her uterus didn't work last time, why would it work this time?
She originally wanted to try for a VBAC, and still kind of does, but she's terrified that they'll decide to give her pit again, and she just doesn't want to deal with all that trauma this time around, esp since it's the same cursed hospital. So she is trying to decide, and probably will decide for a repeat, with her only real problem with a C/S being that they want to do it at 36.5 to 37 weeks, which she's not exactly comfortable with because it's so early.

Do I understand why she'd opt for it? Completely. They don't call that particular hospital Crippler for no reason, you know. She doesn't have any options other than that one for a hospital birth that's actually covered. And they don't exactly listen to you if you're active duty. (as I know from unfortunate experience when they HELD ME DOWN on a bed until I "consented" to a C/S)
Would I do that? He** no. I'd pay for an HBAC myself. But my mom's a midwife, I have a COMPLETELY different view of birth than this poor girl.

Anyhow... That's why I don't exactly condemn elective C/S, but I still don't exactly approve of them either. If a woman really wants to go through that, well, that's her choice, I guess. I just hope the baby doesn't have too much health problems as a result, 'cause I feel bad for the kid.

I don't know, I guess my problem is that sure, it's her body that they're going to gut like a fish, but it isn't ONLY her health that mom is risking. Without a good reason, I just don't get it. Now, granted, I know that in some cases, it's probably necessary/better (the medically indicated c/s, or someone who was abused, for example, if they can't get the proper help to work through that, they could very well end up with a C/S after all kinds of agonizing crap and be even more traumatized, and that's not good for anyone, either.)

Plus, there's all that stupid political crap that the rest of us have to deal with because so many people view C/S and "normal" and "safe" etc. Blech.


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## georgia (Jan 12, 2003)

Quote:


Originally Posted by *karina5* 
So why are people so against a mother having an elective c-section if she wishes to do so?

I think this Mothering article helps sum up a good number of reasons of why.

Personally, it's none of my business if an individual mother does what she feels is best and safest for her and her baby when making an informed decision *not* based on fear-based medicine/scare tactics. It seems so many times, a woman's choices are severely limited by a variety of factors, and that's something I'd like to see change. I guess my main concern is with the technocratic obstetric system that's fueling the discouragement of _normal_ birth in place in many parts of the world.


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## barefootpoetry (Jul 19, 2007)

Quote:


Originally Posted by *LoveChild421* 

I think women sense that there is something very disempowering about giving birth with your legs held up in stirrups or by nurses and people counting loudly telling you to "PUSH!" when really all you need is gravity to help you out (being on your back is the absolute worst, most ridiculous position to expect a woman to birth a baby in, gravity is working against you and your pelvis isn't able to open up as well either). Women don't want to go through all of that and then end up with a c-section anyway and feel like a failure because "they weren't ABLE to push the baby out in time..." or whatever. The way birth is handled the vast majority of the time here in the US fails women. It isn't something that empowers them.

At least in choosing a C-section you don't have to go through all of that or subject yourself to that system- yes you are going to the hospital to have a large wound cut in your stomach and it isn't natural, but at least you don't have this big birth ordeal to go through.



You make a very valid point with this. If my only knowledge of birth was being trapped on my back with my genitals laid out for all to see with strangers yelling at me while I screamed in pain, I would probably jump for the opportunity of having a C-section too. And I'm sure our 1 in 3 rate doesn't help either...I bet a lot of women go, "Well, I might not even GET to give birth, so why go to all the trouble!" I suppose to some, that would make sense. And I can see why. Still doesn't mean I agree with it, though.


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *ktbug* 
The baby's welfare gets ignored in all facets of standard medicalized prenatal care and birth care. U/s can be dangerous for baby, as can something as routine as the glucose test. LOTS of things in vaginal hospital birth are risky for the baby - epidural, forceps, lithotomy position, etc. And formula feeding is obviously an inferior choice for baby's health when made arbitrarily or for cosmetic reasons. Why should this particular aspect of medical childbirth be any different? What you've said about sections could easily be said about ultrasound, epidural, or formula. Pretty much every choice made about health care during pregnancy and childbirth can come down to baby's best interests vs. mom's comfort. And it's extremely common for women to choose their own comfort over their baby's best interests. Why would doctors go out of their way to inform women otherwise, when these choices are making them money hand over gloved fist?


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## thismama (Mar 3, 2004)

Quote:


Originally Posted by *georgia* 

Personally, it's none of my business if an individual mother does what she feels is best and safest for her and her baby when making an informed decision *not* based on fear-based medicine/scare tactics.

Yes.

Quote:

It seems so many times, a woman's choices are severely limited by a variety of factors, and that's something I'd like to see change. I guess my main concern is with the technocratic obstetric system that's fueling the discouragement of _normal_ birth in place in many parts of the world.
And yes. To me it's like the issue of breastfeeding - I think it is wrong to attempt to control, either via laws or shame, what women do with our bodies. If we want to see reduced rates of whatever (c/s, formula) we need to shift the culture so more women have access to the best possible options for ourselves and our babies.


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## the_lissa (Oct 30, 2004)

Quote:


Originally Posted by *thismama* 

And yes. To me it's like the issue of breastfeeding - I think it is wrong to attempt to control, either via laws or shame, what women do with our bodies. If we want to see reduced rates of whatever (c/s, formula) we need to shift the culture so more women have access to the best possible options for ourselves and our babies.

Exactly. Beautiful post.


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## ktbug (Jul 8, 2006)

Quote:


Originally Posted by *thismama* 
To me it's like the issue of breastfeeding - I think it is wrong to attempt to control, either via laws or shame, what women do with our bodies. If we want to see reduced rates of whatever (c/s, formula) we need to shift the culture so more women have access to the best possible options for ourselves and our babies.

Word!


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *thekimballs* 
It's ridiculous to say that no semi-intelligent person can choose an elective section (because of the published risks) unless you're also going to say that no semi-intelligent person could ever have a vaginal breech (where the published risks show that it is riskier than a c-section) or a UP/UC (where the published risks show that no prenatal care is associated with a worse outcome).

hmm...I've never seen a reasonable argument about factors that could affect the stated risks of non-medically indicated (ie. TRULY elective) primary section vs. vaginal birth. OTOH, I've seen the argument that c-section probably is safer for breech, because practitioners are no longer trained to vaginally deliver breech babies (and I know this is true - I've read the OBs on their forum talking about it). I've seen the argument that the studies on "no prenatal care" don't separate someone who is taking care of herself and choosing to UP from a drug addict who doesn't want the doctor to know she's on drugs (as an example of a UP that isn't a philosophically based UP).

I'm not saying there are similar arguments re: studies on the safety of elective primary sections vs. vaginal birth, but I certainly haven't actually seen them.


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## Storm Bride (Mar 2, 2005)

With respect to the OP...honestly, I can't answer that one rationally. I'm totally against elective (in the sense of no medical indication...not in the sense of "non-emergency") primary c-sections...totally. However, it's not a rational thought process. It's totally emotional. Every single woman who is "too posh to push" adds to the "why are you so upset?" attitude that I encounter every single day. Every woman who chooses a section to "save" her vagina/sex life or to "avoid pain" makes it that much harder for someone like me to be taken seriously when I talk about the permanent physical damage to my pelvis (not quite enough to destroy my sex life, thankfully...and the pleasure canal is untouched - lucky me uke), the post-op pain that lasted months in one case and all the rest. Every woman who finds it more "convenient" to schedule a section (and I have to wonder who in their right mind has children at all if convenience is _that_ important to them...haven't met too many babies who schedule their dirty diapers or illnesses) makes it that much harder for me to explain to an OB that I don't _want_ the "convenience" of being laid up for weeks and unable to pick up my older children for even longer.

Rightly or wrongly, I feel that a woman's right to choose an unecessary c-section impinges on my right to choose not to have one. That makes me very angry, and I'm unable to be rational on the subject. Basically...if someone is choosing a c-section for no medical reason, I don't want to hear about it - I just don't. I'm not usually an ostrich, but this subject fills me with such utterly impotent rage that it scares me. I hate it when women hop on the operating table for reasons of convenience or keeping their vagina safe, because I feel they affect my choices in a very negative way.


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## rmzbm (Jul 8, 2005)

I wonder out loud...







...do you really think there are that many women out there who are choosing c-sections simply to maintain the vaginal tone of a teenager? REALLY?!







I must be nieve. That is just SO outside the realm of - I dunno - sanity to me...I still say they should be able to - their body - but wow, how dumb. I am hard pressed to think there are really that many women doing this. But I could be wrong. Maybe that is why I have a hard time with discussions like this. Alot seem to think that the % of moms doing this is pretty large. Why I think of "moms choosing sections" I don't think of those mothers, maybe I should? I dunno.


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## TanyaS (Jun 24, 2003)

Quote:


Originally Posted by *thismama* 
I am pro informed birth choices, including elective c sections.

















:

But I do not believe it should be covered by insurance.


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *TanyaS* 







:

But I do not believe it should be covered by insurance.

But again, who decides? That is a very scary thought to me.


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## Rockies5 (May 17, 2005)

well, _*I'm*_ for unassited births *and* elective cesareans. I'm for women choosing what they want for their births and bodies, period.

IMO you either have freedom and control over your own reproduction, or you don't. It's an area where you simply can't do halfsies.

I wouldn't have a cesarean, but I want that choice available for everyone else. Same with abortion. I don't have to like it, but it's a fact that it's going to happen. Too many times I've heard that same "lack of education and choice" argument used by right to lifers (of which I am one







).

Educated, informed women get to choose. They also are the _*only ones*_ who get to determine if they are enlightened enough to make that choice!

How would you like having to pass a written exam to see if you are capable of making the choice to not vaccinate your child, or decline the GBS or GD tests during pregnancy?

Any of these arguments can be easily urned around and used against natural living.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *rmzbm* 
I wonder out loud...







...do you really think there are that many women out there who are choosing c-sections simply to maintain the vaginal tone of a teenager? REALLY?!







I must be nieve. That is just SO outside the realm of - I dunno - sanity to me...I still say they should be able to - their body - but wow, how dumb. I am hard pressed to think there are really that many women doing this. But I could be wrong. Maybe that is why I have a hard time with discussions like this. Alot seem to think that the % of moms doing this is pretty large. Why I think of "moms choosing sections" I don't think of those mothers, maybe I should? I dunno.

I don't think there are that many. I do think they exist - I've seen them post online, and saw one speak at a hearing on the subject last year (or the year before? I think it was the NIH). I don't think of it as being particularly sane, either.

When I think of "moms choosing sections", those are the moms I think of. There aren't that many of them, but I don't consider medically indicated sections to be elective, even if the mom has to "choose" to have it. When a doctor tells a woman she's going to die, or her baby's going to die, or both, that's not what I call "elective", even though the medical profession does. (Take RCS - I've always wanted to and intended to VBAC - every time. I did let myself be bullied into unwanted sections twice, and I regret that more than I can say. But, I don't think a woman is having an elective section, medical terminology aside, when it's a scheduled repeat. There are good arguments either way, imo. Increased risk of _serious_ birth complications from that first one really is a medical concern.)


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## rmzbm (Jul 8, 2005)

Rockies - you rock!


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## Ironica (Sep 11, 2005)

Quote:


Originally Posted by *rmzbm* 
But again, who decides? That is a very scary thought to me.

Well, under the current model, usually there's some blanket decisions made by the insurance company (we'll cover these procedures for these reasons, but not these for any reason), then the doctor's recommendation determines whether the covered procedure is, in fact, covered. Most HMOs, for example, will cover specialists and lab tests, *if* your PCP referred you and a doctor ordered the test... but *not* just because you walked in and wanted one. (I have this funky weird hybrid insurance with "self-referral," so I CAN just call up an in-network specialist and schedule an appointment, knowing it will be covered, but only pay a co-pay... I like it, but it's always hard to explain to providers when they ask me who my medical group is.)

So, in your case, your doctor says you need a c-section, you get a c-section. Heck, given your medical history, NO insurance company would DARE suggest that it shouldn't be covered. ;-) You worked hard to explore any other option, and couldn't find a single provider who recommended vaginal birth as a safer, or safe, option.

But someone says "Ok, there's absolutely no indication that I can't push this baby out of the hole I came with, but I want a new one anyway." If they can't get a practitioner to diagnose them with something that's a true indication for a planned c-section, then it wouldn't be covered. That's how it works for EVERYTHING ELSE, but doesn't seem to work for this particular procedure, which I think is kinda weird.


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## Ironica (Sep 11, 2005)

Quote:


Originally Posted by *Rockies5* 
How would you like having to pass a written exam to see if you are capable of making the choice to not vaccinate your child, or decline the GBS or GD tests during pregnancy?

Would ya like to SEE the email I wrote to my provider about why I want to decline the GTT? It's basically an essay... (and I'm changing providers, since it doesn't seem to have helped at all).


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *Ironica* 
Would ya like to SEE the email I wrote to my provider about why I want to decline the GTT? It's basically an essay... (and I'm changing providers, since it doesn't seem to have helped at all).

I would.







Only cuz I dealt with this today!


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## Kidzaplenty (Jun 17, 2006)

I don't know, I don't see any difference in an elective c/s not being covered by insurance the same way plastic surgry is not covered. Seems the same to me. Now if they would cover elective plastic surgery just because someone wanted it then elective c/s's should be covered just because someone wanted it.

Just a thought.


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## ryansma (Sep 6, 2006)

Quote:


Originally Posted by *barefootpoetry* 
I'm all for freedom of choice, but not when it affects MY choice too.


Quote:


Originally Posted by *Storm Bride* 

Rightly or wrongly, I feel that a woman's right to choose an unecessary c-section impinges on my right to choose not to have one. That makes me very angry, and I'm unable to be rational on the subject. Basically...if someone is choosing a c-section for no medical reason, I don't want to hear about it - I just don't. I'm not usually an ostrich, but this subject fills me with such utterly impotent rage that it scares me. I hate it when women hop on the operating table for reasons of convenience or keeping their vagina safe, because I feel they affect my choices in a very negative way.


Yeah to both of these. It infuriates me that *I* am the unusual one for wanting an unmedicated, intervention free, natural birth.
The implications of women choosing c/s are far reaching. Like not educating their own children of the very real possibility of natural birth and therefore possibly perpetuating the medicalization of birth.
I have never met anyone IRL who chose a c/s because of a desire to maintain vaginal tone but I have met MANY who's doctors told them their babies were "too big" (not a medical reason for c/s). I would not call these women informed I would call them persuaded and often too trusting of professionals that are not always working in their best interest. And on the topic of the "informed", it is just my humble opinon that a person informed by a medical professional with a medical view of birth is really not that well informed at all. It seems that young women today that know more about their cell phone plans than how their body is made to birth and prepare themselves even less.


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## Rockies5 (May 17, 2005)

Quote:


Originally Posted by *Ironica* 
"Ok, there's absolutely no indication that I can't push this baby out of the hole I came with, but I want a new one anyway." If they can't get a practitioner to diagnose them with something that's a true indication for a planned c-section, then it wouldn't be covered. That's how it works for EVERYTHING ELSE, but doesn't seem to work for this particular procedure, which I think is kinda weird.

nope that isn't how it works. Impotence meds are covered. Gastric bypass, reconstructive breast surgery....

You have to consider the hard to pinpoint reasons some women don't want to give birth vaginally. Like recalled sexual abuse. IMO it's further abuse to make someone do something they don't want to with their "privates"! I think it is a valid reason to some to have a c because they worry about their hoo-ha getting stretched out. It's at least as valid as women who remain childless for fear of loosing their figures. It's valid to them and that's what matters. Same with breastfeeding. I'd love every mother and baby to do it, some moms just can't/won't wrap their heads around allowing a child access to their breasts and we can't force someone to breastfeed....no matter what we perceive as best, healthiest, most cost effective or most normal.


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## ktbug (Jul 8, 2006)

Quote:


Originally Posted by *Kidzaplenty* 
I don't know, I don't see any difference in an elective c/s not being covered by insurance the same way plastic surgry is not covered. Seems the same to me. Now if they would cover elective plastic surgery just because someone wanted it then elective c/s's should be covered just because someone wanted it.

Just a thought.

I think the point is that many insurance companies DO cover elective section (or cleverly written-up medical section, i.e. "doc, my insurance won't cover this section unless you say I need it for medical reasons - make something up! doc - OK, you can't labor, you sprained your ankle...") - - but they don't cover homebirth or midwifery care.


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## Rockies5 (May 17, 2005)

I believe that the freedom to birth however you will are connected. Until we, as women, are seen as capable as making that deision it won't matter if you want an elective c-section or to birth at home. There is resistance to all of them, because we don't have control over how we birth. We are still having to ask permission.

And now there are these huge rifts between women because some think natural birth is crazy, or unassited births are, or elective c-sections are.

Personally the *choice* to take on the risks of a cesarean for any but a life or death emergency is something I can't understand. I feel the same about plastic surgury, and the risks inherent in that choice..but I think both should be a choice, and be covered by insurance.


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## ryansma (Sep 6, 2006)

Quote:


Originally Posted by *ktbug* 
I think the point is that many insurance companies DO cover elective section (or cleverly written-up medical section, i.e. "doc, my insurance won't cover this section unless you say I need it for medical reasons - make something up! doc - OK, you can't labor, you sprained your ankle...") - - but they don't cover homebirth or midwifery care.

I agree. I don't think the c/s rate would be so high if people weren't choosing them when medically unneccesary. And like I said in my post,fear of a "big baby" is NOT a true medical reason for a section. But it is done frequently and I can't say for certain that the dr's document that as their reason but insurance DOES pay.


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## thismama (Mar 3, 2004)

I think elective c/s should be covered and it is not the same as cosmetic surgery. Women have elective c/s for lots of deep reasons... emotional reasons, fear, etc etc. Who am I to judge someone's reasons for such an intimate decision about her body? If you have a baby in your body, it must come out somehow. If something about your life experience leads you to not want it to come out your vagina, I support funding of options to preclude women being forced to go through unwanted vaginal birth.


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## dinahx (Sep 17, 2005)

And just to throw in another twist, when women increase their risks of a secition by choosing elective induction for reasons like "Grandma has a bridge tournament on the 18th" then that also makes it harder to have a vaginal birth, because then the date of birth is seen as 'elective' by the culture at large. :cry

Where I live, doctors are regularly OFFERING to induce women (without being asked) at 39 weeks. :cry


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *rmzbm* 
Yes, my insurance is paying for it...as well they should. If they didn't I'd have to wait for labor, risk my life, fly to the ER and have medical debt out my tushy...not cool! Kind'a why "pay for your own ELECTIVE c/s" freaks me out...who's to make that call. Many here think I shouldn't be having one, as they have as much as said so - good thing they don't work for Cigna, hu?

Easy, they just need to distinguish non emergent medically indicated c-sections from arbitrary ones.

I'm just starting to grasp that "elective c-section" means "c-section decided on in advance" rather than "unnecessary c-section" (e.g. no medical reason including previous birth trauma).


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## bri276 (Mar 24, 2005)

BOTH of my best friends, in their mid twenties, unmarried as of yet, have told me they'd prefer a planned c-section when they have children. And their mothers are both in mainstream medicine- one pediatrician and one labor and delivery nurse (who, surprisingly, spoke up and said no, you don't want a c-section). Now, granted, things may change in time when it becomes reality. But it floored me that this view has become SO pervasive- that c-sections are safe, easier, better, cleaner, etc. One of the reasons was "I don't want to deal with incontinence"- research shows that pregnancy, not labor and delivery, is the cause of that (and it doesn't happen to all of us, anyways, I certainly don't have it and I pushed for over 3 hours). Other reasons were basically all convenience. Despite trying to sound casual about it while imparting some wisdom about risk to the baby and mother, neither seemed to CARE about the risk, viewing it as so minimal as to be ignored.

I think even above and beyond informed consent and self education is personality. Some people really don't think anything bad will ever happen to them or their babies. They don't truly understand how to assess risk (even though I know at least one of them, and probably both, have had to pass college statistics class!) It's a general attitude towards life that includes blindly trusting the doctors, choosing to believe anecdote over evidence (ie, My SIL had a c-section and she said the recovery was SO easy and her baby was fine), and simply not being concerned that there is any REAL risk to yourself or your child. As a parent of a special needs child I've seen that attitude more times than I care to remember- "oh, that would never happen to ME" After all, look at the huge percentage of OB's and OB's partner who choose elective sections!!

Really- there ARE situations where a completely elective c-section truly is appropriate. The mental health of the mother for whatever reason, or a past traumatic birth that may or may not cause complications but the mother doesn't want to risk it, or an unproven, or unlikely but possible suspected risk to the fetus (something odd seen on ultrasound but not confirmed) and probably many more than we could even imagine. I would NEVER want to take away the option completely. What I want is OBs to be held accountable for babies born pre-term or who have respiratory problems due to c-section. The same way they're accountable to any other birth trauma that they could have prevented. As an OB, I would most certainly REFUSE to perform a section on a 36 wk pregnant woman who just wanted to get it over with so she could be a bridesmaid in a wedding (yeah, it does happen). But they don't because they will never be held accountable in court. Court is sadly the only thing that seems to speak to some OBs and force them to consider whether they're responsible for their actions.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *Rockies5* 
You have to consider the hard to pinpoint reasons some women don't want to give birth vaginally. Like recalled sexual abuse. IMO it's further abuse to make someone do something they don't want to with their "privates"! I think it is a valid reason to some to have a c because they worry about their hoo-ha getting stretched out. It's at least as valid as women who remain childless for fear of loosing their figures.

No - it's not. Because if a woman remains childless, she remains childless. There's no pregnancy, and no baby. If a woman gets pregnant and can't have a c-section (for whatever reason - maybe there's a huge state-wide power failure, or the hospitals have all been knocked out by an earthquake - whatever), she _is_ going to have a vagina birth. Once that baby's in there, it's coming out (okay - remember reading one case of a baby that went permanently stayed in its mother's uterus - can't remember the details, but it basically fossilized or something, but that's just beyond freakishly rare - I'm guessing unique). A woman can _plan_ to have a c-section, because of past abuse or because she wants a tight vagina or whatever, but that doesn't mean she's going to _get_ one. What if she's not close to a hospital and goes into labour spontaneously at 37 weeks, with a section scheduled a week later, and delivers before she can get to a hospital?

Labour and vaginal birth are the naturally inevitable consequences of pregnancy, unless there is medical interference, in the form of a c-section, in that progression. If someone is so afraid of labour that they're choosing surgery to avoid it, they should really probably try to get help for that fear before becoming pregnant, if at all possible. Because, modern illusions to the contrary, we canNOT control birth - and we can't eliminate the possibility of having a vaginal birth simply by scheduling a section. Once that woman is pregnant, the possibility of labour and a vaginal birth exists, whether she schedules a section or not. Women _can_ guarantee that they won't ever have a c-section (albeit possibly at the cost of their lives or their babies), by not ever setting foot in a hospital. We canNOT guarantee that we won't have a vaginal birth...that can happen anywhere. I mean - women actually manage to give birth at the hospital, with strangers and bright lights and unfamiliar noises...it can happen _anywhere_ - and it will, if a section can't be or isn't performed.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *thismama* 
I think elective c/s should be covered and it is not the same as cosmetic surgery. Women have elective c/s for lots of deep reasons... emotional reasons, fear, etc etc.

When you get right down to it, I think some women have cosmetic surgery for deep reasons, too.


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *thismama* 
I think elective c/s should be covered and it is not the same as cosmetic surgery. Women have elective c/s for lots of deep reasons... emotional reasons, fear, etc etc. Who am I to judge someone's reasons for such an intimate decision about her body? If you have a baby in your body, it must come out somehow. If something about your life experience leads you to not want it to come out your vagina, I support funding of options to preclude women being forced to go through unwanted vaginal birth.


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## thismama (Mar 3, 2004)

Quote:


Originally Posted by *Storm Bride* 
When you get right down to it, I think some women have cosmetic surgery for deep reasons, too.

Yep. My butch housemate just got a breast reduction. She got it covered coz her boobs are large, ergo 'back pain'







but really big boobs don't fit with her gender identity.

I think she should have been able to get it covered without the back pain bs excuse. I dont think all cosmetic surgery should be covered, but that should.

And I don't think elective c/s is cosmetic surgery.


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## ktbug (Jul 8, 2006)

Quote:


Originally Posted by *thismama* 
Yep. My butch housemate just got a breast reduction. She got it covered coz her boobs are large, ergo 'back pain'







but really big boobs don't fit with her gender identity.

I think she should have been able to get it covered without the back pain bs excuse. I dont think all cosmetic surgery should be covered, but that should.

And I don't think elective c/s is cosmetic surgery.

Sometimes, with some insurance companies, psychological issues are a valid medical "pass" for breast reduction.
I wish I had one of those insurance companies. *covets breast reduction*


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *thismama* 
I think elective c/s should be covered and it is not the same as cosmetic surgery. Women have elective c/s for lots of deep reasons... emotional reasons, fear, etc etc. Who am I to judge someone's reasons for such an intimate decision about her body? If you have a baby in your body, it must come out somehow. If something about your life experience leads you to not want it to come out your vagina, I support funding of options to preclude women being forced to go through unwanted vaginal birth.











Birth is such a personal experience that I can't imagine telling someone that they had to do it a certian way. All moms should be able to have the birth experience that they want, whether it be unassisted or elective c-section.


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *felix23* 









Birth is such a personal experience that I can't imagine telling someone that they had to do it a certian way. All moms should be able to have the birth experience that they want, whether it be unassisted or elected c-section.


Yup. And to me that is the bottom line.


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## thismama (Mar 3, 2004)

Quote:


Originally Posted by *felix23* 









Birth is such a personal experience that I can't imagine telling someone that they had to do it a certian way. All moms should be able to have the birth experience that they want, whether it be unassisted or elective c-section.









ITA. If we want to trend toward better (natural) birth we need to increase education and options. Not police what people can and cannot do.


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## Turquesa (May 30, 2007)

A couple of interesting finds on the issue of Brazilian women and cesareans:

1. http://www.pubmedcentral.nih.gov/art...?artid=1122889

Contrary to anecdotal evidence that portrays Brazil as a place where women demand caesarean section, two recent articles show that *providers, rather than patients, use women's alleged preference as an excuse to follow their inclinations.*

2. http://www.sciencedirect.com/science...4fa7b35abb0139

I also show that *the majority of women surveyed in two cities in Brazil, particularly first-time mothers, do not seek to deliver by cesarean*. Through an analysis of conversations between doctors and women during labor and delivery, and through women's narratives of their delivery experiences, I also show some of the mechanisms that doctors use in order to induce so-called demand for surgical delivery and argue that they are very active participants in the ongoing construction of the culture of cesarean section in Brazil.


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *felix23* 







Birth is such a personal experience that I can't imagine telling someone that they had to do it a certian way. All moms should be able to have the birth experience that they want, whether it be unassisted or elective c-section.

Yes, it is personal. So personal that maybe they should pay for it themselves.

All mothers should be prepared to pay for it themselves. As a homebirth mother by choice, I have done that four times, so a mother having an elective caesarean can pay for it also.

Unnecessary medical procedures such as unnecessary caesareans are making birth and health insurance prohibitively expensive for everyone.


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## thismama (Mar 3, 2004)

I do not think homebirthers should pay for it themselves either. I live in Canada where my midwifery care and my upcoming homebirth are fully covered.

Universal health care... you all should look into that.


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *applejuice* 
Yes, it is personal. So personal that maybe they should pay for it themselves.

All mothers should be prepared to pay for it themselves. As a homebirth mother by choice, I have done that four times, so a mother having an elective caesarean can pay for it also.

Unnecessary medical procedures such as unnecessary caesareans are making birth and health insurance prohibitively expensive for everyone.

No individual is responsible for the whole of birthing women.









I'm glad it's covered.







I shudder to think woman will be forced to stay home because SOMEONE ELSE decided they didn't need something. *I* decide what I need. Same for everyone else.


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## Turquesa (May 30, 2007)

I skimmed through this loooooong thread and, unless I missed it, I didn't see a reference to the groundbreaking obstetric research by Childbirth Connection's survey called _Listening to Mothers._ I refer to it as "groundbreaking" because most of the past research has relied on second-hand reports from physicians instead of the patients who experienced the delivery.

Get this: From http://www.childbirthconnection.org/...e.asp?ck=10372, we find . . .

"Despite some professional and mass media discourse about "maternal request" or "patient demand" cesarean when there is no medical indication, *just one woman (0.08%) among 1314 survey participants who might have initiated a planned primary cesarean without medical reason did so."*

So what's all of the hub-bub about "maternal request" cesareans? Here's how Childbirth Connections explains it:

"These discussions [on "maternal request" cesareans] have been based on the unwarranted assumption that a cesarean with no identified reason on a birth certificate or in hospital discharge records reflects the mother's demand for elective surgical birth. Until the new Listening to Mothers survey results, no data sources have been available to clarify decision-making processes and the understanding of women themselves about these matters.

Moreover, many women trust their caregivers and support the idea of a cesarean if they believe there is medical reason. Women's support for provider-initiated cesareans that they believe will benefit their babies and/or themselves must be distinguished from mother-initiated planned primary cesareans with no medical benefit.

The misleading focus on maternal demand also serves to draw attention away from many legal, clinical, financial and other factors that are contributing to escalating cesarean rates."

Childbirth advocates like Jennifer Block (author of "Pushed") are a little more cynical, citing a need for OB's and similar professionals to rationalize the egregiously high cesarean rate in the U.S.

My own take on it is that in our consumerist culture, we can sell anything so long as we package it as a free choice, be it sugary soda drinks or major abdominal surgery.

So......not to rain on the parade and the point of this thread, but "maternal request" cesareans are almost a non-issue and, for the most part, fodder for a purely hypothetical discussion.


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## applejuice (Oct 8, 2002)

You are completely missing my point.

When half of all of the prenatal tests, procedures and caesarean sections performed are in truth medically unnecessary, the costs of maternity and health care go up, and when these costs are covered by insurance, private, group, government or otherwise, EVERYBODY pays.

This does not even take into account the cost of NICU for those poor babies who end up born too early because the u/s was off.

When I had my babies at home, I paid for it myself. And incredibly, there were still the know-it-all ninnies out there who thought they knew what was best for me and would tell me what to do anyway, even if I paid for it myself out of my pocket.


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## thismama (Mar 3, 2004)

And people pay for roads and education and health issues apparently caused by smoking, the supposed obesity epidemic etc etc on and on. Policing other people's bodies is a slippery slope.


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## applejuice (Oct 8, 2002)

If pregnant women can really push doctors into "elective caesarean sections" for their own reasons, then ask yourself why other pregnant women cannot equally demand and push doctors into attending homebirths?

I really do not see the power that pregnant women have here. It appears to me that women only have a "choice" when they select the only model offered by the medical establishment underwritten by the pharmaceutical houses.

That is where the real power is.


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## thismama (Mar 3, 2004)

Quote:


Originally Posted by *applejuice* 
If pregnant women can really push doctors into "elective caesarean sections" for their own reasons, then ask yourself why other pregnant women cannot equally demand and push doctors into attending homebirths?

Not sure if you read my post above, but the reason is that you all have a crappy health care system. Or lack thereof. Homebirth should be covered.


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## karina5 (Apr 15, 2006)

Quote:


Originally Posted by *Turquesa* 
I skimmed through this loooooong thread and, unless I missed it, I didn't see a reference to the groundbreaking obstetric research by Childbirth Connection's survey called _Listening to Mothers._ I refer to it as "groundbreaking" because most of the past research has relied on second-hand reports from physicians instead of the patients who experienced the delivery.

Get this: From http://www.childbirthconnection.org/...e.asp?ck=10372, we find . . .

"Despite some professional and mass media discourse about "maternal request" or "patient demand" cesarean when there is no medical indication, *just one woman (0.08%) among 1314 survey participants who might have initiated a planned primary cesarean without medical reason did so."*

So what's all of the hub-bub about "maternal request" cesareans? Here's how Childbirth Connections explains it:

"These discussions [on "maternal request" cesareans] have been based on the unwarranted assumption that a cesarean with no identified reason on a birth certificate or in hospital discharge records reflects the mother's demand for elective surgical birth. Until the new Listening to Mothers survey results, no data sources have been available to clarify decision-making processes and the understanding of women themselves about these matters.

Moreover, many women trust their caregivers and support the idea of a cesarean if they believe there is medical reason. Women's support for provider-initiated cesareans that they believe will benefit their babies and/or themselves must be distinguished from mother-initiated planned primary cesareans with no medical benefit.

The misleading focus on maternal demand also serves to draw attention away from many legal, clinical, financial and other factors that are contributing to escalating cesarean rates."

Childbirth advocates like Jennifer Block (author of "Pushed") are a little more cynical, citing a need for OB's and similar professionals to rationalize the egregiously high cesarean rate in the U.S.

My own take on it is that in our consumerist culture, we can sell anything so long as we package it as a free choice, be it sugary soda drinks or major abdominal surgery.

So......not to rain on the parade and the point of this thread, but "maternal request" cesareans are almost a non-issue and, for the most part, fodder for a purely hypothetical discussion.


So the Too Posh to Push thing is kind of an urban legend. That's kind of funny to me.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *applejuice* 
Yes, it is personal. So personal that maybe they should pay for it themselves.

All mothers should be prepared to pay for it themselves. As a homebirth mother by choice, I have done that four times, so a mother having an elective caesarean can pay for it also.

Unnecessary medical procedures such as unnecessary caesareans are making birth and health insurance prohibitively expensive for everyone.


Because only the rich deserve to have the birth experience they want? I think that homebirths should be covered too. Instead of trying to take away women's choices, I think that they should be given more choices. Poor people deserve choices too and I think that they should have the choice to pick what ever birth experience is best for them, from a homebirth to an elective c-section.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *rmzbm* 
No individual is responsible for the whole of birthing women.









I'm glad it's covered.







I shudder to think woman will be forced to stay home because SOMEONE ELSE decided they didn't need something. *I* decide what I need. Same for everyone else.


I just need to follow you and thismama around this thread saying "yeah that".


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *felix23* 
Because only the rich deserve to have the birth experience they want? I think that homebirths should be covered too. Instead of trying to take away women's choices, I think that they should be given more choices. Poor people deserve choices too and I think that they should have the choice to pick what ever birth experience is best for them, from a homebirth to an elective c-section.









Well, let me return the favor...







:


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *felix23* 
Because only the rich deserve to have the birth experience they want? I think that homebirths should be covered too. Instead of trying to take away women's choices, I think that they should be given more choices. Poor people deserve choices too and I think that they should have the choice to pick what ever birth experience is best for them, from a homebirth to an elective c-section.

Homebirths are rarely covered. This limits women's choices.

When my mom had her first homebirth, the neighbors asked if my Father and her were too poor to afford a hospital birth; strange kind of a question, is it not? Health insurance rarely covered a hospital birth in the early 1950s, 1960s and early 1970s. Why? Pregnancy was not considered an accident, it was considered a natural state for a woman to be in. Insurance covered complications and the rare c-secs which were under 10% in those days. Maternity care was quite cheap and women stayed in the hospital for a week after the birth, getting a good rest.

I like choices also.

However, for your insinuation that only the rich have choices because they have the money, that will always be the case because of the world we live in. The rich had homebirths in the 1950s and abortions as well because they could afford it and someone would do the deed for the price they paid, legal nor not. Even if the U.S. institutes a wide-encompassing health care program for everyone in the near future, you can be sure the rich will not stand in line for their care and will get all the elective plastic surgery they desire when they want it.


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## thismama (Mar 3, 2004)

What you are doing though applejuice is crossblaming other women for a problem with the system. Homebirths should be covered. The fact that they are not is a problem of the US health care system and NOT women who have elective c sections. Your whole argument is a red herring.


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## elspethshimon (Nov 23, 2007)

rmzbm and thismama


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## readytobedone (Apr 6, 2007)

Quote:


Originally Posted by *Storm Bride* 
No - it's not. Because if a woman remains childless, she remains childless. There's no pregnancy, and no baby. If a woman gets pregnant and can't have a c-section (for whatever reason - maybe there's a huge state-wide power failure, or the hospitals have all been knocked out by an earthquake - whatever), she _is_ going to have a vagina birth. Once that baby's in there, it's coming out (okay - remember reading one case of a baby that went permanently stayed in its mother's uterus - can't remember the details, but it basically fossilized or something, but that's just beyond freakishly rare - I'm guessing unique). A woman can _plan_ to have a c-section, because of past abuse or because she wants a tight vagina or whatever, but that doesn't mean she's going to _get_ one. What if she's not close to a hospital and goes into labour spontaneously at 37 weeks, with a section scheduled a week later, and delivers before she can get to a hospital?

Labour and vaginal birth are the naturally inevitable consequences of pregnancy, unless there is medical interference, in the form of a c-section, in that progression. If someone is so afraid of labour that they're choosing surgery to avoid it, they should really probably try to get help for that fear before becoming pregnant, if at all possible. Because, modern illusions to the contrary, we canNOT control birth - and we can't eliminate the possibility of having a vaginal birth simply by scheduling a section. Once that woman is pregnant, the possibility of labour and a vaginal birth exists, whether she schedules a section or not. Women _can_ guarantee that they won't ever have a c-section (albeit possibly at the cost of their lives or their babies), by not ever setting foot in a hospital. We canNOT guarantee that we won't have a vaginal birth...that can happen anywhere. I mean - women actually manage to give birth at the hospital, with strangers and bright lights and unfamiliar noises...it can happen _anywhere_ - and it will, if a section can't be or isn't performed.

this is really interesting....


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## thismama (Mar 3, 2004)

But death is the natural consequence of life, and yet we support people trying to stave that off...


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *thismama* 
But death is the natural consequence of life, and yet we support people trying to stave that off...

I wouldn't support somebody trying to make themselves immortal, though.

I'm not saying that a woman who has really deep seated issues about vaginal birth shouldn't have an elective c-section. I think there are times when the emotional/psychological issues are profound enough to practically _be_ a medical indicator. What I'm saying is that if a woman is _that_ afraid of labour, for whatever reason, I really think she'd serve _herself_ better by trying some counselling or something ahead of time...because if she thinks she's got the whole labour/childbirth aspect "beat" or under control by scheduling a section, and then ends up going into premature labour under circumstances where getting to the hospital (or getting that section in the hospital - staff missing, OR occupied, etc.) is impossible, she's going to have a _major_ problem. One of the factors that pops up over and over in childbirth trauma is the unpredictability of it - the loss of control and the feeling of betrayal. People can feel betrayed by circumstances, as well as by people - and I think a woman who thought she could avoid labour and childbirth by scheduling a section is someone who is _extremely_ likely to face major problems with PPD and PTSD.

Scheduling a section in order to avoid labour and vaginal birth (for whatever reason - fear of labour pain, wanting to keep your vagina tight, abuse issues - it doesn't matter) is buying into the medical model - the belief that we can control birth. Most of the time, it's going to work - only a certain percentage of women are going to go into labour prematurely. But, scheduling is not a guarantee that you'll avoid labour and vaginal birth...and it _is_ almost a guarantee that you're not going to be emotionally prepared for it if it happens.

I'll probably be scheduling a section for my next baby (although part of me will be really hoping I have a precipitous labour and push my baby out before it happens), but that doesn't guarantee that me and my baby will be okay. It doesn't even guarantee that I will have a c-section. (Of course, in my case, that's fine with me!) This is _not_ under my control.


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## erin_brycesmom (Nov 5, 2005)

This thread is starting to get bizarre. A few things:

1. Do you guys also think that all abortions should be covered by all health insurance? If you do, this will explain a lot.

2. Saying that homebirth not being covered is a "problem of the US health care system" isn't really accurate either. There are plenty of insurance companies that cover home births in the US.

3. Universal health care in the US will not ensure that homebirth is covered. We can have universal health care here and still not have homebirths covered....the two are very seperate things so I don't understand why it keeps getting mentioned as some kind of a solution the problem we are talking about.


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## thismama (Mar 3, 2004)

1. I personally do, yes.

2. I am coming from a Canadian perspective, where my elective c/s OR my homebirth will both be covered, not dependent on my insurance. So the idea that it is the fault of women who get elective c/s that health insurance does not cover homebirth is pretty obviously a red herring to me. Since women here do get elective c/s, AND homebirth is covered.

3. Right but you should make sure your universal health care, when you get it, covers homebirth. That is what we did here. To do that people need to rally the health care system, not blame other women for differing birth choices and seek to limit women's options further.


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## georgia (Jan 12, 2003)

Please remember that MDC is not going to host abortion debate, so let's please keep this in mind to avoid getting the thread shut down. Thanks!

Any questions, please PM me


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## caedmyn (Jan 13, 2006)

Quote:


Originally Posted by *thismama* 

3. Right but you should make sure your universal health care, when you get it, covers homebirth. That is what we did here. To do that people need to rally the health care system, not blame other women for differing birth choices and seek to limit women's options further.

If universal health care is so great, why do those Canadians who can afford it come to the US for certain types of healthcare to avoid the long wait times in Canada?

If universal healthcare covered homebirth, or naturopaths, or any other alternative medicine, there are going to be a multitude of regulations that cover those things in order for them to be included. How does that increase people's options?


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## the_lissa (Oct 30, 2004)

I have several American friends who have waited longer than me for certain things.

I have personally never waited long for anything except wisdom teeth surgery, which is not covered by our universal health care.

So clearly, universal health does not equal long wait times.

Second, you don't throw the baby out with the bath water. There are groups constantly working on improving health care, including wait times.

Yes regulations can be good or can be a problem, but those can also be changed (and have been.)

If you want an underground midwife who does not follow the regulations you can find one and pay for it yourself, not unlike women in the U.S.

There are a lot more choices here, and they are not as limited by money or insurance companies like in the U.S.


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## the_lissa (Oct 30, 2004)

Quote:


Originally Posted by *thismama* 
1. I personally do, yes.

2. I am coming from a Canadian perspective, where my elective c/s OR my homebirth will both be covered, not dependent on my insurance. So the idea that it is the fault of women who get elective c/s that health insurance does not cover homebirth is pretty obviously a red herring to me. Since women here do get elective c/s, AND homebirth is covered.

3. Right but you should make sure your universal health care, when you get it, covers homebirth. That is what we did here. To do that people need to rally the health care system, not blame other women for differing birth choices and seek to limit women's options further.

ITA.

I think covering abortion is incredibly important.


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## Ironica (Sep 11, 2005)

Quote:


Originally Posted by *Rockies5* 
nope that isn't how it works. Impotence meds are covered. Gastric bypass, reconstructive breast surgery....

Ok, the impotence meds I don't really get, but gastric bypass is only covered when the patient is obese enough that the risk of doing nothing is greater than the risk of surgery... and with _reconstructive_ breast surgery, we're talking about women who have had a prominent part of their anatomy removed for valid health reasons, and insurance companies have to cover the cost of making them look normal again after surgery. I don't see how that's in the same league as non-medically-indicated c-section.

Quote:


Originally Posted by *Rockies5* 
You have to consider the hard to pinpoint reasons some women don't want to give birth vaginally. Like recalled sexual abuse. IMO it's further abuse to make someone do something they don't want to with their "privates"! I think it is a valid reason to some to have a c because they worry about their hoo-ha getting stretched out. It's at least as valid as women who remain childless for fear of loosing their figures. It's valid to them and that's what matters. Same with breastfeeding. I'd love every mother and baby to do it, some moms just can't/won't wrap their heads around allowing a child access to their breasts and we can't force someone to breastfeed....no matter what we perceive as best, healthiest, most cost effective or most normal.

But you can also make the argument that adoption and surrogacy are options available too. I mean, when it comes to sexual abuse trauma, I can see that as a medically-indicated reason (psychiatrists are MDs too), but NO ONE made anyone have sex or get pregnant (unless it's an issue of rape, and that can get back to valid psychological reasons to consider c-section medically-indicated). It's not reasonable to say that, after someone has made decisions that normally lead into birth, we're "forcing" them to do something they don't want to do by not picking up the tab for them when they ask for a c-section. (I happen to feel the same about breastfeeding... I think it's a normal, natural part of the having-children process, and that it should be taken into account when someone's deciding whether or not to have a child.)


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## the_lissa (Oct 30, 2004)

Not to mention, many states have serious restrictions and even outright criminalization of midwifery/home birth? How does that increase people's options?

I will never understand these bizarre things people attribute to universal health care, especially when some of them, such as long wait times or over regulation or restrictions happen in the U.S.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *applejuice* 
Homebirths are rarely covered. This limits women's choices.

When my mom had her first homebirth, the neighbors asked if my Father and her were too poor to afford a hospital birth; strange kind of a question, is it not? Health insurance rarely covered a hospital birth in the early 1950s, 1960s and early 1970s. Why? Pregnancy was not considered an accident, it was considered a natural state for a woman to be in. Insurance covered complications and the rare c-secs which were under 10% in those days. Maternity care was quite cheap and women stayed in the hospital for a week after the birth, getting a good rest.

I like choices also.

However, for your insinuation that only the rich have choices because they have the money, that will always be the case because of the world we live in. The rich had homebirths in the 1950s and abortions as well because they could afford it and someone would do the deed for the price they paid, legal nor not. Even if the U.S. institutes a wide-encompassing health care program for everyone in the near future, you can be sure the rich will not stand in line for their care and will get all the elective plastic surgery they desire when they want it.


I agree with you, not covering homebirths is wrong and does limit a woman's choice and it should be changed. But not covering elective c-sections is equally wrong and also limits choices. IMO they are both valid birth choices and should both be covered.

We must live in very different areas. My grandmother gave birth in the 40's and 50's. She had hospital births, everyone she knew had hospital births. Birth was considered a very medical procedure, and women had very little choices surrounding their birth experience. She said that no one asked her anything, she was just told what they were going to do and when she tried to protest they ignored because she had no rights She was so drugged up that she doesn't even remember anything about the births. Back then the option was homebirth or totally medicated hospital birth. My grandfather insisted that my grandma give birth at a hospital because over half of his sisters had died from birth complications during homebirths. I don't know if my grandparents had insurance, but I can't imagine that they paid the hospital bill out of pocket because they were dirt poor.
Flash forward to the early 70's with my mom. The insurance covered a hospital birth, not a homebirth, and since my parents were also poor they went with the hospital birth.
Hopefully in the near future both hospital and homebirths will be covered.

I realize that life isn't going to always be fair and that the rich are going to have more then the poor. But that isn't going to stop me from promoting the rights of poor women who want to have their births covered, from a homebirth all the way to an elective c-section. If a woman is terrified of hospitals she shouldn't be forced to give birth in one just because she can't afford to pay out of pocket and if a woman for some reason has personal issues with a vaginal birth she shouldn't be forced into that either. I just think that a woman should be able to have the birth she wants, not the birth that someone else decides that she needs.


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## Ironica (Sep 11, 2005)

Quote:


Originally Posted by *thismama* 
And people pay for roads and education and health issues apparently caused by smoking, the supposed obesity epidemic etc etc on and on. Policing other people's bodies is a slippery slope.

Ok... lemme try to parse this out...

I assume roads and education were separate from smoking, right?

First of all, there ARE a lot of folks (in the field of Transportation Planning at least) who see the way our roads are funded as a MAJOR problem with our transportation system. In California, for example, only 70% of our expenditure on the road system is paid for by "user fees," which include gasoline taxes, vehicle registration, and truck licensing fees (among others). There's a push on the policy side to get that to 100%, because there's no reason why people who don't drive cars should subsidize those who do. (A similar issue comes up with zoning regulations that require businesses to provide parking... "The High Cost of Free Parking" is a fascinating book by Donald Shoup on that subject.)

With education, quite simply, the cost of NOT providing it is higher than the cost of providing it. The system evolved over time due to the needs of our society, and now that we're eroding it, we're seeing detrimental effects (poorly-prepared work force, juvenile crime, etc.) But then, we provide certain educational services, and if parents want something different than that, they pay for it themselves.... sort of like paying for certain health care services, and then if people want something different, they pay for it themselves.

A good deal of the (extremely high) taxes on cigarettes go to offset the health costs of smoking. Additionally, personal health insurance will charge you higher premiums if you smoke. There are some jobs you can't *get* if you smoke (firefighter, for example) and there are jobs where you can't smoke at all while you're there (teachers come to mind). There has been a push and shift over the years to put the financial burden of smoking squarely on those who smoke... and I entirely support that.

There's a HUGE difference between "command and control" solutions to societal decision-making issues (policing) and economic solutions. Most of the time, you get the result you're going for much more efficiently if you simply make the undesirable decision more expensive, and the desirable decision cheap or free. What result are we going for in this case? A lower c-section rate, that more accurately reflects the true medical indication for c-sections.

People inevitably turn this into a "rich vs. poor" thing, though, when you propose this issue. The problem with that is, as long as you have rich and poor, the rich *will* have choices that the poor don't. And, saying that this makes elective c-section a province of the rich exposes a huge fallacy: poor people can value things, too. And they can scrimp and save and bargain with their doctors and hospitals and GET the c-section that's so important to them if they need to... just as many moms who are struggling to make ends meet have done for homebirths that aren't covered. What's backwards about our current system is that the most EXPENSIVE options are covered, but the cheaper, safer ones are not necessarily. The notion that people have to carefully consider their decisions and make financial considerations a part of that is not, IMO, a problem... it's part of the solution.


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *applejuice* 
However, for your insinuation that only the rich have choices because they have the money, that will always be the case because of the world we live in. The rich had homebirths in the 1950s and abortions as well because they could afford it and someone would do the deed for the price they paid, legal nor not. Even if the U.S. institutes a wide-encompassing health care program for everyone in the near future, you can be sure the rich will not stand in line for their care and will get all the elective plastic surgery they desire when they want it.

The rich also had twilight births first and now those are covered by insurance companies. The rich had the totally elective c-sections first and now they're covered by insurance companies.

Clearly the solution is for rich women to start having home births--then the insurance companies will cover those.


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## Ironica (Sep 11, 2005)

Quote:


Originally Posted by *felix23* 
if a woman for some reason has personal issues with a vaginal birth she shouldn't be forced into that either.

Who forced her to get pregnant, though? Very, very few pregnancies occur without consent... so I don't understand why policies that make completely elective c-section more expensive are somehow "forcing" someone to do something.


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## thismama (Mar 3, 2004)

But aren't homebirthers typically in the higher income brackets anyway?


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## thismama (Mar 3, 2004)

Quote:


Originally Posted by *Ironica* 
Who forced her to get pregnant, though? Very, very few pregnancies occur without consent... so I don't understand why policies that make completely elective c-section more expensive are somehow "forcing" someone to do something.

Lots of women get pregnant accidentally. And lots of women want babies but don't want to be forced into one type of birth just because other women deem it 'best' for them, no matter how correct we may think we are.


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *thismama* 
But aren't homebirthers typically in the higher income brackets anyway?

Yeah, like college students, and women having their 4th child with one income for the family, and my neighbor growing up who had her second homebirth while living in a house with no electricity or running water.

Yep, higher income brackets.

Seriously though, anecdotes aside, I don't mean rich like upper-middle class, I mean rich like movie star rich. The women who first got twilight sleep in the U.S. were the ones who could sail to Germany and live there until they went into labor and could afford to go to the high class clinics that offered the option. These are the women whose homebirths would cause homebirth to be an standard option.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *Ironica* 
Who forced her to get pregnant, though? Very, very few pregnancies occur without consent... so I don't understand why policies that make completely elective c-section more expensive are somehow "forcing" someone to do something.

Accidents happen. Abstinance is the only form of birth control that is 100% effective.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *thismama* 
Uh, could we then? Because I am well aware of the anecdotes. And women who hospital birth also have similar anecdotes. It is my understanding that homebirthers tend to be in a higher income bracket, statistically speaking, than other women.

I think the more education that gets out, the more homebirth is role modelled (yes partly by movie stars since they are the gods of this culture it would seem), the more women will gravitate toward homebirth. And eventually the powers that be will figure out that homebirth is actually cheaper and a wise thing to fund. I think things are trending that way.

eta - Which is why I think that, apart from the issue of basic human respect, it is a wise strategy to provide education and lobby for options for women who want to birth naturally, and/or at home. Attempted policing of women's behaviour just gets the 'boob nazi' type reputation solidified. Empowerment and options, not removal of women's choices about our bodies, is the solution here IMNSHO.


Natural birth will be better accepted by society if it is not forced, but is instead chosen. Women need to be treated like they are capable of making birth decisions for themselves, not be told that they have to give birth a certian way. More choices not fewer is the answer, IMO.


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## applejuice (Oct 8, 2002)

It is not a good idea to stereo type people into class systems. People are individuals.

My mom had only a high school education and had 8 of 9 babes at home with one income. This was 1953-71. My mom is no Hollywood-type; as a matter of fact my five year experience here leads me to be quite confident that most members here at MDC would readily call her "white trash" since she grew up in a trailer during the Depression and War Era. My family is quite solidly middle class, so saying that only rich, Hollywood type women have had home births in the recent past is just wrong and narrow-minded.

I have met many like-minded people as an adult who were also born at home in the 1940-80s for various reasons, mostly that they were just intellectually curious and "enlightened" enough to try something like that.


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *sapphire_chan* 
Clearly the solution is for rich women to start having home births--then the insurance companies will cover those.

Sapphire, when exactly is this going to happen? I was born at home and I am now 54. My oldest child is 27 and my youngest is now 16.

There is an old thread on this very forum of celebrities who have had their children at home, and believe me, there are several from decades ago.

Dr. Eisenstein has been delivering babies at home as a practice for over 30 years.

Rich women have had babies at home for a while, but it is the power elite, the insurance companies, hospitals, pharmaceutical companies and medical establishment that keeps homebirth a non-choice for pregnant women.

Tell me when this is going to happen so that I can mark my calendar.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *applejuice* 
It is not a good idea to stereo type people into class systems. People are individuals.

My mom had only a high school education and had 8 of 9 babes at home with one income. This was 1953-71. My mom is no Hollywood-type; as a matter of fact my five year experience here leads me to be quite confident that most members here at MDC would readily call her "white trash" since she grew up in a trailer during the Depression and War Era. My family is quite solidly middle class, so saying that only rich, Hollywood type women have had home births in the recent past is just wrong and narrow-minded.

I have met many like-minded people as an adult who were also born at home in the 1940-80s for various reasons, mostly that they were just intellectually curious and "enlightened" enough to try something like that.

Much of my childhood we lived in a small trailer. I don't think that we were "white trash", just poor. My mom was very intellectually curious and enlightened, but she just couldn't afford a homebirth and didn't want an unassisted birth. I think if it were changed so that homebirths were covered, more people would be having them. I have met several people who want one, but can't afford them.


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## applejuice (Oct 8, 2002)

Quote:

We must live in very different areas.
My Father is from Ohio, my mom from Boston. I am in CA.

This thread seems to be discussing the advantages of insuring maternity care.

One's history education should teach how health, life, and dental insurance and retirement plans became part of an employee package. During WWII, with federal wage and price freezes in place, employers needed to have a tool for attracting good employees and keeping them. Since no one could get a raise, insurance for the employee and the employee's family was offered. As time has gone on, these are now a regular part of any good employment, especially in the years when there was bracket creep in the income tax system - in which a person would get a raise only to be paying more taxes instead, negating the raise they just got.

As for other countries having maternity insurance as Canada, their c-sec rates are at the same rate as the U.S.; excessive c-secs are an attitude problem that the medical establishment has in believing in themselves too much and not enough in nature.


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## applejuice (Oct 8, 2002)

Quote:


Originally Posted by *felix23* 
Much of my childhood we lived in a small trailer. I don't think that we were "white trash", just poor. My mom was very intellectually curious and enlightened, but she just couldn't afford a homebirth and didn't want an unassisted birth. I think if it were changed so that homebirths were covered, more people would be having them. I have met several people who want one, but can't afford them.

My parent did 7 of the 9 of the births UC. We did not afford them either. It was a great education for me.

Do not miss my point. Why wait around for someone else to decide to "give" you maternity benefits? Just do it. Have a home birth if that is what you want and your health allows. The system cannot work for everyone, so one must make the system work for them. Period.

History is rarely made by well-behaved women. Go out and make history. No one is going to help you. I have already done my part. It is your turn.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *applejuice* 
My parent did 7 of the 9 of the births UC. We did not afford them either. It was a great education for me.

Do not miss my point. Why wait around for someone else to decide to "give" you maternity benefits? Just do it. Have a home birth if that is what you want and your health allows. The system cannot work for everyone, so one must make the system work for them. Period.

History is rarely made by well-behaved women. Go out and make history. No one is going to help you. I have already done my part. It is your turn.


So your solution is for all poor women to be forced into UC's regardless of whether or not they want them?


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## applejuice (Oct 8, 2002)

Where did anyone say anything about forcing poor women to have UCs?

We are talking about choices. I am saying that if a woman truly wants something as a UC or homebirth, then she should be educated and do it, - not wait for someone else to do it for her, as in government, insurance companies, medical doctors, midwives and hospitals.

When my mom had her babes at home, there were virtually no midwives in CA. At least no CA trained midwives since the state had not given the proscribed exam for any one since the 1930s. It was not until the 1980s when USC opened the first operating midwifery school in decades that CA had certified midwives. But, there have always been granny DEMs.

Life is short. You have to grab the opportunity.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *applejuice* 
Where did anyone say anything about forcing poor women to have UCs?

We are talking about choices. I am saying that if a woman truly wants something as a UC or homebirth, then she should be educated and do it, - not wait for someone else to do it for her, as in government, insurance companies, medical doctors, midwives and hospitals.

When my mom had her babes at home, there were virtually no midwives in CA. At least no CA trained midwives since the state had not given the proscribed exam for any one since the 1930s. It was not until the 1980s when USC opened the first operating midwifery school in decades that CA had certified midwives. But, there have always been granny DEMs.

Life is short. You have to grab the opportunity.

Well, if all women have to pay for their own births out of pocket, then then their are going to be a great deal of poor women who are going to be forced to UC since they can't afford a dr, midwife, or hospital. My mother didn't know anyone who was experienced with a homebirth who was willing to assist for free and she wasn't comfortable with a UC, so she was forced to have a hospital birth. If the insurance companies would have paid, she would have had a homebirth, they didn't, so she couldn't.


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## applejuice (Oct 8, 2002)

We all do what we can.

My mom was just weird.


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## thismama (Mar 3, 2004)

Forced UC due to poverty is a scary, scary concept IMO. Already the US has too high an infant mortality rate. UC is only safe with good nutrition, no prohibitive health complications, and access to medical care quickly if needed. Finances should NEVER force a woman to UC in such a rich country as the US.


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## hanno (Oct 4, 2006)

Quote:


Originally Posted by *applejuice* 
It is not a good idea to stereo type people into class systems. People are individuals.

My mom had only a high school education and had 8 of 9 babes at home with one income. This was 1953-71. My mom is no Hollywood-type; as a matter of fact my five year experience here leads me to be quite confident that most members here at MDC would readily call her "white trash" since she grew up in a trailer during the Depression and War Era. My family is quite solidly middle class, so saying that only rich, Hollywood type women have had home births in the recent past is just wrong and narrow-minded.

I have met many like-minded people as an adult who were also born at home in the 1940-80s for various reasons, mostly that they were just intellectually curious and "enlightened" enough to try something like that.

Applejuice, we're lucky to have you.

I like anecdotes. They are made of individuals and I'm much more interested in individuals than statistics.

I had a homebirth 9 months ago today in a one room basement apartment. My sister in law is about to have one anyday and she works at a daycare. Not so glamourous. My husband works at a factory and hers works at a brewery. We can influence people to consider homebirth as a valid and safe option by making it normal.


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *thismama* 
Forced UC due to poverty is a scary, scary concept IMO. Already the US has too high an infant mortality rate. UC is only safe with good nutrition, no prohibitive health complications, and access to medical care quickly if needed. Finances should NEVER force a woman to UC in such a rich country as the US.


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## Ironica (Sep 11, 2005)

Quote:


Originally Posted by *thismama* 
Lots of women get pregnant accidentally. And lots of women want babies but don't want to be forced into one type of birth just because other women deem it 'best' for them, no matter how correct we may think we are.

I guess some folks are of the opinion that parenthood is an absolute right. I'm not. Of course, there are also ways to have a child, even a child who is genetically yours, without being pregnant. And there are things that people can, if they choose to, do about an accidental pregnancy. I'd never FORCE someone to take such measures, but I won't pretend that they don't exist. Having sex is (normally) a choice. Birth control is a choice. What to do about an unplanned pregnancy is another choice. Frankly, I made all those choices before I ever lost my virginity, because I felt it was that important.

As for "accidents happen," that's very true; HALF the pregnancies in this country are unintended, even though the least effective NFP system has about a 78% effectiveness rate (so clearly, there's something greater at work here). That needs addressing too, but is beyond the scope of this thread.

But it doesn't seem to me that there's likely to be a huge intersection between women who are pregnant unintentionally and women who would demand a c-section for personal convenience, either.

There's also a whole lot of mistaking economic factors for command-and-control factors going on in this thread, as though somehow our economic system deprives people of free will. Clearly, (let's get anecdotal again) with the number of women on here who have done all kinds of amazing stuff to make it possible to afford a homebirth on a very tight budget, if something is very valuable to you, you'll get it. Making something expensive is NOT the same as making it illegal.

I don't think that every woman should have to pay out of pocket for every birth, but I also don't think _I_ should have to pick up the tab for the increased cost of people having vanity c-sections. It's not just the cost of the surgery; it's the increased cost of health care for mom and baby for THE REST OF THEIR LIVES. If we had to pay out-of-pocket for our insurance premiums, it would be over $800/month for our family. We're lucky that my husband's company pays so generously (and they have a sliding scale, so that higher-income employees pay a larger share of their premiums), but millions of folks in this country have NO coverage because it's beyond their means. When coverage includes major abdominal surgery for whatever reason someone can come up with, it's no wonder why it's out of reach.


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## hanno (Oct 4, 2006)

Quote:


Originally Posted by *Ironica* 
I don't think that every woman should have to pay out of pocket for every birth, but I also don't think _I_ should have to pick up the tab for the increased cost of people having *vanity c-sections*. It's not just the cost of the surgery; it's the increased cost of health care for mom and baby for THE REST OF THEIR LIVES. If we had to pay out-of-pocket for our insurance premiums, it would be over $800/month for our family. We're lucky that my husband's company pays so generously (and they have a sliding scale, so that higher-income employees pay a larger share of their premiums), but millions of folks in this country have NO coverage because it's beyond their means. When coverage includes major abdominal surgery for whatever reason someone can come up with, it's no wonder why it's out of reach.

we finally have the term this thread so desperately needed!


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *Ironica* 
I guess some folks are of the opinion that parenthood is an absolute right. I'm not. Of course, there are also ways to have a child, even a child who is genetically yours, without being pregnant. And there are things that people can, if they choose to, do about an accidental pregnancy. I'd never FORCE someone to take such measures, but I won't pretend that they don't exist. Having sex is (normally) a choice. Birth control is a choice. What to do about an unplanned pregnancy is another choice. Frankly, I made all those choices before I ever lost my virginity, because I felt it was that important.

As for "accidents happen," that's very true; HALF the pregnancies in this country are unintended, even though the least effective NFP system has about a 78% effectiveness rate (so clearly, there's something greater at work here). That needs addressing too, but is beyond the scope of this thread.

But it doesn't seem to me that there's likely to be a huge intersection between women who are pregnant unintentionally and women who would demand a c-section for personal convenience, either.

There's also a whole lot of mistaking economic factors for command-and-control factors going on in this thread, as though somehow our economic system deprives people of free will. Clearly, (let's get anecdotal again) with the number of women on here who have done all kinds of amazing stuff to make it possible to afford a homebirth on a very tight budget, if something is very valuable to you, you'll get it. Making something expensive is NOT the same as making it illegal.

I don't think that every woman should have to pay out of pocket for every birth, but I also don't think _I_ should have to pick up the tab for the increased cost of people having vanity c-sections. It's not just the cost of the surgery; it's the increased cost of health care for mom and baby for THE REST OF THEIR LIVES. If we had to pay out-of-pocket for our insurance premiums, it would be over $800/month for our family. We're lucky that my husband's company pays so generously (and they have a sliding scale, so that higher-income employees pay a larger share of their premiums), but millions of folks in this country have NO coverage because it's beyond their means. When coverage includes major abdominal surgery for whatever reason someone can come up with, it's no wonder why it's out of reach.


My mom wanted a homebirth pretty bad, they had NO extra money at all, none, she could find no one who would assist her at home free of charge, so her only options were have an unassisted birth which she wasn't comfortable with, or give birth at a hospital which was covered by their insurance. I don't buy the "if you want something bad enough you can get it" line. Sometimes no matter how much you want it, you can't always find away to get something for no money.


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## georgia (Jan 12, 2003)

I have temporarily removed a number of posts for edits. In the meantime, please remember to avoid taking anything personally.

The B&B forum is filled with emotional discussions that can touch a nerve with you personally if you take them as such, even though they are not about you. Posts are often specific to someone's personal situation and personal opinion. The reality is the discussion is not about you or your family or your birth, so please do not take a post as critical of you personally or an attack of your POV.

If you believe someone has posted inappropriately, please do not respond on the board. Please utilize the Report function (red, black and white triangular button, bottom lower left hand corner of each post) or PM a moderator. The MDC User Agreement requires that we do this rather than potentially derail the thread.

I ask that everyone make an effort to to keep this thread on-topic and avoid making this personal. Any questions or comments, please PM me. Thanks!


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## thismama (Mar 3, 2004)

Quote:


Originally Posted by *Ironica* 
I guess some folks are of the opinion that parenthood is an absolute right. I'm not.

I don't think it is anyone's right to say that someone cannot have children if they do not want to do things the way some group has decided is best or right. I see that argument used entirely too often around here as concerns birth and breastfeeding, that women should be forced to do things a certain way or else prohibited from having children, and I find that argument extremely distasteful and alarming.

Policing other women's bodies is a bad, bad road.


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## georgia (Jan 12, 2003)

I forgot to also ask that we focus on the initial topic and spin any related topics off into their own threads for the sake of organization and moderator sanity







. Thanks!


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## karina5 (Apr 15, 2006)

Quote:


Originally Posted by *hanno* 
we finally have the term this thread so desperately needed!


Which rarely exist, someone posted on that.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *karina5* 
Which rarely exist, someone posted on that.


Yes, most elective c-sections are done for medical reasons.


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## rmzbm (Jul 8, 2005)

Vanity c-sections...I like that term, fitting. Much better than calling them elective. Thanks to whoever said it! (I forgot who.







)


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## rmzbm (Jul 8, 2005)

Quote:


Originally Posted by *thismama* 
I don't think it is anyone's right to say that someone cannot have children if they do not want to do things the way some group has decided is best or right. I see that argument used entirely too often around here as concerns birth and breastfeeding, that women should be forced to do things a certain way or else prohibited from having children, and I find that argument extremely distasteful and alarming.

Policing other women's bodies is a bad, bad road.

For the 632,952,492th time...







:


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *applejuice* 
Sapphire, when exactly is this going to happen? I was born at home and I am now 54. My oldest child is 27 and my youngest is now 16.

There is an old thread on this very forum of celebrities who have had their children at home, and believe me, there are several from decades ago.

Dr. Eisenstein has been delivering babies at home as a practice for over 30 years.

Rich women have had babies at home for a while, but it is the power elite, the insurance companies, hospitals, pharmaceutical companies and medical establishment that keeps homebirth a non-choice for pregnant women.

Tell me when this is going to happen so that I can mark my calendar.

After it becomes the popular "well of course I'll have a homebirth" choice for them and not "oh look how counterculture I'm being!" So, never. Sorry.

It would work if it happened, it's just never going to happen.

I was just postulating based on: rich women started using doctors--doctors became the accepted norm; rich women started getting drugs to knock them out--drugs became the accepted norm...

Now there have been some changes, like allowing the father in the delivery room, that haven't been first part of a huge fad among the elite, so there is hope, I just think it'd be faster if say like Prince Andrew's and Prince William's wives had homebirths and if the daughter of our next President had a homebirth.


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## georgia (Jan 12, 2003)

Off topic posts removed. Thread returned. Please be cautious to remain on topic. Any questions or comments, please PM me. Thanks for your thoughtful participation and cooperation


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## nikag (Sep 19, 2007)

Quote:

I think that, in an ideal world, we should be able to count on our birth professionals to examine what went wrong and help us to avoid the same circumstances... but too many doctors view vaginal birth like it's some kind of mysterious voodoo that they can't *possibly* hope to understand, so there's no concept of avoiding the same circumstance next time.
I think this is somewhat of a consequence of the general view of pregnancy as something sacred, unpredictable, and somehow blessed. It is customary to adopt a hand's off philosophy concerning pregnancy itself and 'let nature take it's course'. And yet, because it is also seen as a highly delicate process, mostly I'm sure because of society's conventional views of the participants involved in the process - women and children - there is an aspect of urgency or hypersensitivity to any possible or perceived complication (real or imagined) - hence the exhaustive testing and screening. Then, when medical professionals do decide to step in (usually at the very slightest hint of a possible complication), they step in strong and feel justified beyond the reality of the situation. Not to mention the fact that the business of pregnancy and birth is highly profitable.

Another factor that contributes is the medical communities general lack of trust in the average person to take personal responsibility and play an active role in maintaining good health. We live in a society of people driven by self-service, impatience, indulgence, and convenience and the for the majority of people, those forces greatly influence their everyday choices from whether or not they practice safe sex, to what they decide to eat for dinner. The medical profession has turned into an institution that most people rely on to CORRECT rather than to PREVENT illness and injury and as time goes on, researchers begin to discover that a great many common ailments could have easily been prevented had the afflicted been informed enough, cared enough, been self-disciplined enough to make better daily choices. It is no surprise that doctors don't trust people to make smart choices about their health and well being. And this is an attitude that unfortunately spills over into all aspects of healthcare - obstetrics and gynecology are no exception.

Docs have become so used to playing 'catch up' that preventative medicine is a foreign concept. They feel like they have to take over for their patients because their patients can't possibly know what is in their own best interests - because in their experience, very few do.

For example, during my pregnancy I submitted to a 1hour glucose screening and ended up with a high result. I refused the 3-hour because I knew my doc couldn't make a definitive diagnosis of gestational diabetes without that test and I wanted to be in control of my own treatment. She freaked out a little. I had to explain to her that even if she'd had a diagnosis right there in her hands, she would STILL have to TRUST ME to monitor my diet and check my glucose levels as those are the first recommendations for treatment. She couldn't realistically come to my house and force feed me low to no carb meals. I had to do it myself. And I'd much rather honor the simple solution than have to pump myself full of synthetic insulin and resign myself to no-stress tests and other mostly asinine interventions. I didn't feel I could trust them not to overreact and take things too far - and I knew that a diagnosis would make them feel obligated to manage my pregnancy in a way I was not comfortable with.

When I was on the phone with an OB clinic nurse discussing the matter (she was actually just trying to literally guilt me into more testing) she kept repeating, "We're just trying to properly care for your baby." About an hour after I hung up the phone (after insisting that if my doc wanted me to do something different, then my doc could call me herself and plead her case), after I hung up the phone it occurred to me in a very epiphany sort of moment that they weren't and have never been responsible for properly caring for my baby. I was and always would be. He resides in MY body. My OB expressed that she didn't like the feeling of being 'out of control' when I told her she was going to have to trust me with my own diet and I realized, she never was in control and really, never would be. I have been carrying this child and will continue to carry this child until he is born. It isn't in their hands. It's in mine. This is something I had always known intuitively and I've always lived my life according to this intuitive understanding, but I'd never before been pushed enough to put into words.

And no one was going to convince me otherwise. I wouldn't be able to live with myself if I gave up responsibility for this little life against my better judgement or gut instinct.


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## annakiss (Apr 4, 2003)

I'm surprised that no one has mentioned at all that truly elective cesarean is unethical for a doctor to perform. This argument shouldn't even be framed as a woman's choice. It goes against the Hippocratic Oath for a doc to do it. You know, "First do no harm," and all that: "To keep the good of the patient as the highest priority."


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## nashvillemidwife (Dec 2, 2007)

But a doctor would have to actually believe they were actually doing harm, and for some reason they don't seem to have heard about the evidence.


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## annakiss (Apr 4, 2003)

Quote:


Originally Posted by *nashvillemidwife* 
But a doctor would have to actually believe they were actually doing harm, and for some reason they don't seem to have heard about the evidence.

But doctors, the media, ACOG - they're all framing it as this mother's choice nonsense, which first of all, it isn't a true choice in almost all circumstances - and we're participating in that argument instead of saying, "hey, you shouldn't even be doing this, it's unethical based on your own research." We're letting these powerhouses frame the argument as our own fault, which it just isn't. It detracts from real issues.


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## wombatclay (Sep 4, 2005)

Quote:

It goes against the Hippocratic Oath for a doc to do it.
Keeping in mind that the oath is voluntary and that many many variations now exist...

Personally I find it difficult to dictate what a person should be "allowed" to do with their own body. However, I also feel like a person needs to be a well informed consumer. If a person has a body modification goal that falls outside the norm, many surgeons will ask that they complete a period of counseling/therapy to make sure they understand the risks, benefits, long term impact, etc of their decision. Since a pregnancy is generally going to take a few months anyway I can't see that a period of counseling would be an undue hardship before an elective c/s.

I'm not advocating a partisan "waiting period" or other partisan "educational" program. Mostly just a period of meeting with a therapist trained in women's health to make sure the woman has a realistic expectation of what her choices will mean for her and her children both immediately and in the long run. I realize the slippery slope this sort of thing is standing on, but it's one possible way of making sure the consumer is informed and prepared for the specific challenges presented by their options without trying to limit those options.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *annakiss* 
I'm surprised that no one has mentioned at all that truly elective cesarean is unethical for a doctor to perform. This argument shouldn't even be framed as a woman's choice. It goes against the Hippocratic Oath for a doc to do it. You know, "First do no harm," and all that: "To keep the good of the patient as the highest priority."


Maybe for some emotional reason it is in the best interest of the patient to have a c-section. Maybe would do more harm emotionally to force a mother into a vaginal birth that she didn't want. I think that a person's emotional well being is just as important as their medical one. I also think that if a really high risk mother that all the research shows would be better off birthing at a hospital, had personal reasons that they want to avoid a hospital birth but instead chose to UC, they should. I personally would not choose that, but I can understand why they are making that choice and will support them. As long as they have done their research and understand the risks, women should be allowed to birth as they wish.


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## annakiss (Apr 4, 2003)

Quote:


Originally Posted by *felix23* 
Maybe for some emotional reason it is in the best interest of the patient to have a c-section. Maybe would do more harm emotionally to force a mother into a vaginal birth that she didn't want. I think that a person's emotional well being is just as important as their medical one. I also think that if a really high risk mother that all the research shows would be better off birthing at a hospital, had personal reasons that they want to avoid a hospital birth but instead chose to UC, they should. I personally would not choose that, but I can understand why they are making that choice and will support them. As long as they have done their research and understand the risks, women should be allowed to birth as they wish.

I would think that extraordinary emotional reasons may become medically-indicated.

I also can see the argument about body modification. There aren't many docs who will cut off my foot even with a pressing emotional reason, however. Plus, c/s involve two lives. While I think that as someone who is pro-choice I believe the mother's health trumps a baby's, does her desire to avoid pushing trump a baby's health?

I don't know the answer to that, to be honest.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *annakiss* 
I would think that extraordinary emotional reasons may become medically-indicated.

I also can see the argument about body modification. There aren't many docs who will cut off my foot even with a pressing emotional reason, however. Plus, c/s involve two lives. While I think that as someone who is pro-choice I believe the mother's health trumps a baby's, does her desire to avoid pushing trump a baby's health?

I don't know the answer to that, to be honest.

For personal reasons that I will not discuss here, I am choosing a repeat c-section. There is nothing medically wrong with me, it is just an emotional thing, that really, no one but me understands. I have spent the last two years going coming to this decision and I am finally content with this choice. Everyone else may think that I'm an idiot for doing this, but I know that I am making the right choice for me. Any birth involves two lives. Do you think that high risk women should be forced into a hospital birth? In a high risk situation does a woman's desire to avoid hospitals trump a baby's health?


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## annakiss (Apr 4, 2003)

Right, but then your c/s is medically indicated, if not medically necessary, per se, so how does that even apply?

As for high risk women being forced into hospital births - no, I don't think they should be forced. But a high risk woman will have trouble finding a care provider outside of the hospital, so it's not exactly a choice because the burden is on her.


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## felix23 (Nov 7, 2006)

Quote:


Originally Posted by *annakiss* 
Right, but then your c/s is medically indicated, if not medically necessary, per se, so how does that even apply?

As for high risk women being forced into hospital births - no, I don't think they should be forced. But a high risk woman will have trouble finding a care provider outside of the hospital, so it's not exactly a choice because the burden is on her.


Most people would say that my c-section is not medically necessary. There is nothing physically that would prevent me from having a vaginal birth. I am choosing a c-section for emotional reasons. I've had people irl tell me that I shouldn't be allowed to choose a c-section for personal reasons, that the only reason a person should have a c-section is for medical reasons.


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## meowee (Jul 8, 2004)

Quote:


Originally Posted by *JavaFinch* 
So if they're also giving them free C-sections for all those pregnancies without ANY medical reason? No, I'm not cool with that.

I consider a woman's mental health to be "a medical reason." If I ever chose a c-section (unlikely, but not unfathomable) it would be due to past birth trauma.

Quote:

I also just don't understand WHY someone would choose it??? I might have to have one due to previa and I will be SO disappointed if that happens. Obviously, my main fear is not having complications or bleeding from previa, but also on my mind is a c-section that I do NOT want! How can someone just choose that? I don't get it.
In my case, I had an extremely traumatic birth experience, so bad that I (briefly) considered an abortion when I found out I was pregnant again. I realized at that point that it was crazy to force myself to go through a natural/ unmedicated birth again if it wasn't my wish or within my safety zone anymore. So I opted for an epi, but I can definitely see how an elective c-section would look appealing to someone who has suffered trauma from a vaginal birth.

I'm under no illusion that c-sections are risk free, but they do offer certainty as to when/ where/ how the baby will be born, which for a woman in a vulnerable psychological state, can be comforting.


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