# What did they do before c-sections?



## seren (Jul 11, 2003)

A friend and I were talking today. She didn't progress with her first child and had a c-section. THe dr told her that her pelvis is too small. And she asked me what would they have done before c-sections. Would she have just died. I don't know the answer to that.

What about breech babies? Why do dr's not want to deliver breech babies? Even my midwife goes to the hospital for a section for breeches. If I were to have another baby I wouldn't want to have a c-section just because the baby is breech.

So what did they used to do? Anyone know?


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## Hayes (Nov 20, 2001)

Breech babies were delivered vaginally. Often, breech wasn't diagnosed until baby's feet or buttocks appeared. Though vaginal breech birth has risks, the risks for cesearean section are much greater.

Before c-sections, there also weren't epidurals or inductions, so many women went into labor when they were ready and were able to be mobile so as to facilitate rather than hinder birth.

That being said, sometimes mothers did die in childbirth. Sometimes mothers still die in childbirth.


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## Kathryn (Oct 19, 2004)

Well, her doctor was most likely lying. CPD is very very very rare. And yes, in those REAL cases, the mother died. Breech babies were born vaginally (like they should be). Babies died, but it had more to do with nutrional problems, bad sanitation, too young of women having babies, and messed up bones (corsetting).


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## velcromom (Sep 23, 2003)

Kmom gives revealing definitions of failure to progress & CPD at her site PlusSizePregnancy:

*Failure to Progress* (FTP) - also known as labor dystocia. This occurs when labor deviates from a normal or average pattern of labor, but is strongly subjective and differs greatly from one provider to the next. Midwives often call this "Failure to Wait" by the physician, since it can result from an impatient doctor or one who does not recognize that labors that deviate from the 'normal' labor are not necessarily pathological. Just what constitutes a normal labor and an abnormal labor that needs intervention is highly controversial and will differ significantly from provider to provider. True FTP can occur, of course, but it is difficult to separate out the cases that are caused by obstetric mismanagement vs. naturally-occuring cases. Common in induced labors.

*Cephalopelvic Disproportion* (CPD)- a baby that is 'too big' for the mother's pelvis. This is a catch-all phrase that doesn't have a lot of meaning; the baby's presentation and position usually has more to do with CPD than the actual size of the baby. An 8 lb. baby that is malpresenting, for example, is likely to get stuck, whereas a 9+ lb. baby that is perfectly positioned and where the mother gets to use optimal delivery positions is likely to come right out. Many women who are given a c-section for CPD and told that their pelvises are 'too small' actually go on to later deliver a baby vaginally that is much bigger. The presentation/lie of the baby, maternal positioning, and forcing labor unnaturally are the keys in many cases. True CPD can occur, but is usually seen in mothers who have had pelvic injury or disease, had rickets, or who were chronically malnourished as children, although it is possible occasionally in normal circumstances too. CPD is most often actually a case of cephalopelvic malpresentation or 'failure to wait' by the physician, but this is often overlooked as a cause.

In the old days there was no "active management of labor" i.e. time limits. There was no one waiting for you to pass the allowed time limit with a scalpel in hand telling you your body couldn't birth.


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## Synchro246 (Aug 8, 2005)

Quote:


Originally Posted by *velcromom*
Kmom gives a definition of failure to progress & CPD at her site PlusSizePregnancy:

*Failure to Progress* (FTP) - also known as labor dystocia. This occurs when labor deviates from a normal or average pattern of labor, but is strongly subjective and differs greatly from one provider to the next. Midwives often call this "Failure to Wait" by the physician, since it can result from an impatient doctor or one who does not recognize that labors that deviate from the 'normal' labor are not necessarily pathological. Just what constitutes a normal labor and an abnormal labor that needs intervention is highly controversial and will differ significantly from provider to provider. True FTP can occur, of course, but it is difficult to separate out the cases that are caused by obstetric mismanagement vs. naturally-occuring cases. Common in induced labors.

*Cephalopelvic Disproportion* (CPD)- a baby that is 'too big' for the mother's pelvis. This is a catch-all phrase that doesn't have a lot of meaning; the baby's presentation and position usually has more to do with CPD than the actual size of the baby. An 8 lb. baby that is malpresenting, for example, is likely to get stuck, whereas a 9+ lb. baby that is perfectly positioned and where the mother gets to use optimal delivery positions is likely to come right out. Many women who are given a c-section for CPD and told that their pelvises are 'too small' actually go on to later deliver a baby vaginally that is much bigger. The presentation/lie of the baby, maternal positioning, and forcing labor unnaturally are the keys in many cases. True CPD can occur, but is usually seen in mothers who have had pelvic injury or disease, had rickets, or who were chronically malnourished as children, although it is possible occasionally in normal circumstances too. CPD is most often actually a case of cephalopelvic malpresentation or 'failure to wait' by the physician, but this is often overlooked as a cause.









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## A&A (Apr 5, 2004)

First of all, getting off of your back and onto a squatting position will open up the pelvic area 42% larger than being on your back. So, "too small" depends on which position you are in.

In the extremely rare case of ACTUALLY being too small, the baby might die (after two or three days of labor) and then could be passed......because dead babies are smaller than live babies.


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## stik (Dec 3, 2003)

Why are dead babies smaller than live ones?

I know that in some cases, doctors used to section fetuses (cut them apart with a scalpel) when labor failed to progress for a very, very long time. This killed the baby, if it hadn't died already, and was very dangerous for the mother. This is one of the reasons that women were extremely unwilling to allow doctors into the delivery room in the 18th century, even though some doctors offered laudanum for pain relief. WOmen associated the presence of a doctor during labor with almost-certain death. Doctors weren't welcome until some time after the invention of forceps (I can't remember the date for that).


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## Quagmire (Sep 27, 2005)

Quote:


Originally Posted by *velcromom*
Midwives often call this "Failure to Wait" by the physician, since it can result from an impatient doctor or one who does not recognize that labors that deviate from the 'normal' labor are not necessarily pathological. Just what constitutes a normal labor and an abnormal labor that needs intervention is highly controversial and will differ significantly from provider to provider. True FTP can occur, of course, but it is difficult to separate out the cases that are caused by obstetric mismanagement vs. naturally-occuring cases. Common in induced labors.

My first instinct was to laugh, but actually this is not funny at all. If anything results in a c-section more often than an impatient OB, I don't know what it is.


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## erin_brycesmom (Nov 5, 2005)

Quote:

THe dr told her that her pelvis is too small. And she asked me what would they have done before c-sections. Would she have just died.
Nope, she wouldn't have died....she probably would have delivered vaginally. Check out the statistics. If you have a birth in a hospital with an OB you are way more likely to have a c-section. And most likely the dr is going to tell you there was a some reason for it afterwards...to cover his own behind. Women who birth at home with a midwife rarely have this problem.

Also for breech, the really really sad thing is that we have grown to rely on technology to solve the problem. Yes many were delivered breech, but there is a greater risk there. Still very possible in many cases though. BUT...there is a really really highly successful way to turn a breech baby that is not advocated enough...WEBSTER through a chiro. My OB was totally ingorant to this techinque when my ds was breech at 37 weeks. SO many people are unaware. Sorry to rant...just taking this opportunity to spread the word as much as I can.


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## mamato3cherubs (Nov 30, 2004)

Well i didnt read every bit of this thread, but no, she most likely wounldnt have died. In almost all cases of that the baby and or mom are having positioning problems. Most cases you can get baby to turn and have a problem free vag delivery. In the extreamly rare case that baby really didnt fit, one or both probably would have died.

breach babies were delivered normally, most situations ended just fine. Of coarse there are sometimes situations that do require a c/s for a healthy outcome, we cant deny that and in those cases death would have been likely, many cases of true placenta previa would be one of those times.

Death rates of both mom and baby were higher before c/s but there are many other factors that most likely played a part in that as well.

I dont know of all the offical numbers and statistics, mostly because you have to be really careful where you get that kind of info and who cam e up with it, but I know in my state from the info I have gathered, about 1 percent of c/s PERFORMED are nessasary. And we have about a 34 percent c/s rate statewide. So that comes to be about 1 in 300 births should end in c/s not 1 in 3!!!!


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## chumani (Apr 12, 2002)

Safety of breech birth has more to do with caregiver competence rather than breech birth being inherently dangerous. I have given birth to a breech baby, I spent 10 weeks preparing for her birth. There are cases where turning the babe is not an option (pm me for long version).

There are no guarantees that your friend would/wouldn't have died in her circumstances. Definitely a certain percentage of births will benefit from cesarean birth, unfortunately birth politics and $$ seem to get in the way of true statistics.

Education and support go a long way toward having a normal labor/birth. Unfortunately we live in a society that depends on experts to tell us what to think and do. Yet when the experts make a mistake our courts fill with lawsuits from the very people that didn't take responsibility in the first place.
I am fortunate that I was raised to question experts and research my decisions. I am prepared to take full responsibility for my decisions.

You may want to gently introduce your friend to books/websites that will educate and inform her for future childbirth choices.

Best wishes,
Sarah


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## littleteapot (Sep 18, 2003)

That "pelvis too small" thing really grates my nerves!
I actually DO have a small pelvis. I have pituitary dwarfism and puberty had to be chemically induced when I was 14 years old when it was discovered that I had stopped all growth and development at around 8 years old. Because of this completely unnaturally puberty, I ended up with weird growth patterns and a lot of hormonal problems. For one, I never developed hips. My pelvis literally didn't change shape. I started my period and my breasts started growing but otherwise I had no puberty-related growth. Not even my facial bones changed shape (normal for puberty) so I tend to have this very child-like look to me and get mistaken for a *very young* teenager.

Can I deliver vaginally?
HELL YES!

And I have.







I will again, too.
Your pelvis opens during delivery, different positions change its size and shape, and there are all sorts of variables.


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## OnTheFence (Feb 15, 2003)

I think its a misnomer to think that all breech babies were born vaginally and alive. Some did die, some died being born vaginally, and some got hung and the mother got her bottom butchered. Its easy in a an era of time where we do have medical intervention to say how wrong it is.

I had a transverse breech baby, I can tell you for certain that I would have never delivered my baby vaginally. What would have happened is my baby would have died probably due to a failing placenta or had my water broke, died from prolapse cord. I would have probably died too, because my uterus is deformed and there is no way a baby was coming out unless it was grossly premature.

I just hope women don't use the past as a judgement on what is happening to women in the future. I don't believe we have real accurate statistics or outcomes for what really did happen. Also, we have less skilled professionals when it comes to delivering breech babies vaginally today.


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## Synchro246 (Aug 8, 2005)

There _is_ more risk in vaginal breech birth- not only with how the legs are positioned (can increase or decrease risk of prolapse cord), but with the positioning of the head too. Thankfully, MOST breech babies are in relativly good positions for vaginal birth. I wouldn't think the ratio of positioning has changed that much over the past 1000 years. Although, I did have a prof. of A&P who insisted that before chairs and things of that kind humans had much better movement and posture, which would have at least a little to do with positioning.
Most breech babies were delivered vaginally right up to the 1970's- this was long after the advent of the Cesarean section.


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## Leilalu (May 29, 2004)

Well, for me, I will never really know if I could've delivered vaginally or not.

dd had not started labor AT ALL, at 44 weeks. Yes, the dates were correct. Nothing done to my body started labor. And I did everything! Many times!

So, who knows what would have happened. Yes, I know the statistics, asnd I know homebirth is the way to go. I guess I am just happy we have medical intevention avilable for the real cases in which it can really be helpful.


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## littleteapot (Sep 18, 2003)

Both my mother and my uncle were vaginal frank breeches. One full term, one preemie. Back then no one considered doing it any other way, nor did they even talk about "how risky" it was and how the baby "could die".

But when I had a frank breech?
"Do you want your baby to die? Do you, do you!? Have a c-section!"


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## littleteapot (Sep 18, 2003)

Quote:


Originally Posted by *Leilalu*
Well, for me, I will never really know if I could've delivered vaginally or not.

dd had not started labor AT ALL, at 44 weeks. Yes, the dates were correct. Nothing done to my body started labor. And I did everything! Many times!

So, who knows what would have happened. Yes, I know the statistics, asnd I know homebirth is the way to go. I guess I am just happy we have medical intevention avilable for the real cases in which it can really be helpful.

A friend of mine just went 45.5 weeks UC. She had absolutely zero labour symptoms at 44 weeks, too. That's just how long her baby needed to be in there.


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## Leilalu (May 29, 2004)

Well, I would've surely died. I was breech and had the cord wraped around my neck at birth, several times. my mom did not die, and I did not die.


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## Synchro246 (Aug 8, 2005)

My mom had me at just past 44 weeks


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## Leilalu (May 29, 2004)

Quote:


Originally Posted by *littleteapot*
A friend of mine just went 45.5 weeks UC. She had absolutely zero labour symptoms at 44 weeks, too. That's just how long her baby needed to be in there.









iI can understand that. but I am talking about my personal situation. I had a choice to make, adn it was a scary one.


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## littleteapot (Sep 18, 2003)

Quote:


Originally Posted by *Leilalu*
Well, I would've surely died. I was breech and had the cord wraped around my neck at birth, several times. my mom did not die, and I did not die.

Cord around the neck does not strangle a baby, it's a very safe place for the cord, and is incredibly common. I had my own cord around my neck twice and my entire body (crotch to shoulder) once. My daughter had hers around her neck, too. In fact almost everyone I know had a cord around the neck... is the only reason for death the breech thing?


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## Leilalu (May 29, 2004)

My mom was in HARD labor at least 2 days. I was NOT coming out. Why so quick to judge? I have done my reasearch, I know all about the statistics, etc etc. No, breech is/was not the only concern


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## littleteapot (Sep 18, 2003)

Quote:


Originally Posted by *Leilalu*
My mom was in HARD labor at least 2 days. I was NOT coming out. Why so quick to judge? I have done my reasearch, I know all about the statistics, etc etc. No, breech is/was not the only concern

I'm not judging, I'm asking... because that's confusing to me. Cord around the neck isn't deadly, so I couldn't figure out why it meant you would have died. Although lots of women mistakenly do believe that it is deadly because they think of fetal necks the same way as adult necks.
(For the record, I'm not speaking out of ignorance or lack of experience either. I was in hard labour for 44 hours as well)


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## Leilalu (May 29, 2004)

Quote:


Originally Posted by *littleteapot*
I'm not judging, I'm asking... because that's confusing to me. Cord around the neck isn't deadly, so I couldn't figure out why it meant you would have died. Although lots of women mistakenly do believe that it is deadly because they think of fetal necks the same way as adult necks.
(For the record, I'm not speaking out of ignorance or lack of experience either. I was in hard labour for 44 hours as well)

Well, I guess I should really say I am not sure. That's just the thing with birth, it is mysterious and wild. One never knows what will happen. But to say that someone cannot die from the cord being wrapped around, well, that is just not for you to say. At the hands of an unskilled country doctor, maybe death was immenant.All throughout history select women have died in childbirth for one reason or another, or their children. Some women are not so lucky.My grandmother died in childbirth with her 15th child, because of a strawberry tumor on her brain. Totally irrelevant to the situation.


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## AnditheBee (Oct 3, 2003)

The thing about a modern c-section is that it's a birth _choice_. What I mean by that is that, a c-section is the choice when the risks of vaginal birth are too great--either from the mom's perspective, or (more often, sadly) from the doctor's. I think this accounts for nearly all the c-sections that occur. Yes--it is possible to birth breech babies vaginally in many cases. But for some women, the risk of things going wrong is too great. It comes down to the balance between the risk of each choice.

I'll elaborate: My grandmother, who was a tiny little woman, under 5 feet and less than 100 pounds when she was first pregnant, labored for three days to get my mother out--finally was able to while straddling her father's lap. Two doctors were called in during the labor--unheard-of in rural Appalachia in 1929--and they estimated my mother to weigh over 11 pounds. They had to resuscitate my mother and my grandmother took weeks to recover and was horribly torn (and their sewing job was so Frankenstein-esque that she never had sex without pain again). Now, when I went into labor, both times I was in good positions and pushed for many hours, and the baby didn't go past my un-flexing pelvic bones. So I wonder: Was my grandmother's problem the same? Would I have had to push for days to get my babies out? Probably. But that was too much of a risk for me. Yes, it might have been possible, but it nearly killed both my grandmother and my mother. It was entirely possible my mother could have been dead at the end of that process. So it's not worth trying and trying and trying for an exceptionally difficult vaginal birth--a c-section is the better risk to me.

Now, as to the OP's question, I agree that "too small" is a ridiculous assessment in most cases. But there are cases where moms would die if not for c-sec, as OnTheFence pointed out. I for one am quite grateful we have the option in these modern times. I just wish it wasn't used quite so frequently and cavalierly by both docs and moms.


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## seren (Jul 11, 2003)

Quote:


Originally Posted by *chumani*

You may want to gently introduce your friend to books/websites that will educate and inform her for future childbirth choices.

Best wishes,
Sarah

I don't really think there is much point in that. I would do that if she hadn't just had her fourth c-section. I think at this point it would be more risky for her to try to have a vaginal delivery.


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## USAmma (Nov 29, 2001)

The last time we went to India I met a man whose wife died in childbirth because the baby got stuck and couldn't come out. They were in a small village and had no access to medical care. They had a midwife but they still couldn't save her or the baby.










Dh's mother and aunt were delivered by csection in India in the 50's. They were breech and would not come out, so they drove them to the hospital and took them out.

Even in my great-grandma's day they had csections. They were done at home in extreme emergencies, without anethesia. They also would, in some cases, cut the baby out piece by piece to save the mother.

In the old days death from childbirth was very high-- I think 1 in 3?


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## sapphire_chan (May 2, 2005)

Or one could always crush the baby's skull.


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## PancakeGoddess (Oct 8, 2004)

...


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## velcromom (Sep 23, 2003)

Quote:


Originally Posted by *USAmma*
In the old days death from childbirth was very high-- I think 1 in 3?

I don't think that _all_ of history has had a maternal death rate that high, would have to research to say for sure, but there have definitely been times when it rose for different reasons. Malnutrition being high on the list, and of course the era when OB management of birth began w/o knowledge of how bacteria caused infection. I think that's the root of our current cultural attitude that birth is hideously, tremendously dangerous and needs to be managed into submission or all women could die... our great grandmothers who saw the effects of that era would surely have been very frightened by them, and probably added their voices to the OB claims that birth is terribly dangerous, and handed down that belief to their daughters.


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## NYCVeg (Jan 31, 2005)

Yes, of course babies and moms died in childbirth before there were c-sections. A transverse baby, for instance, simply cannot be born vaginally. Many of those deaths were due to things like infection, though--antibiotics, much as they're abused now, did a lot to improve fetal and maternal mortality rates.

Citing individual cases of babies who would have/might have died, however, is not compelling evidence to me in the face of c/s rate that's around 30% (and up to 70% in some hospitals/areas). The vast majority of those c-sections are NOT saving women/babies who otherwise would have died. They are, however, making doctors lives more convenient, making lots of money for hospitals, and convincing more and more women that vaginal birth is just too scary/painful/inconvenient for them to go through.

*Most* women will not grow babies too big for their pelvises (providing they're not lying flat on their backs, immobilized); *most* breech babies can be born vaginally without problems (or rather, they could be if birth professionals still learned how to deliver breech babies); twins and even triplets *can* be born vaginally! And a baby whose due date is at an inconvenient time for mom or doctor can almost certainly be born vaginally. Childbirth is not without risk and c-sections save some lives...but c-sections have risks, too, and also cost some lives.


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## crazy_eights (Nov 22, 2001)

While on topic of breech babies, did anyone see the article, I think in the 'green journal' (ACOG's journal) tearing the big breech study apart? Showed all the errors and sloppy data that lead to the conclusion? Pretty bold for a mainstream OB to write such a critique.

I've heard from experienced OB's that the greatest indicator of whether a breech baby should be born vaginally or by c/sec is labor progress. If the mom is progressing nicely, it will be a straightforward delivery. If it is not, better to go to c/sec than to try augmentation of labor or assisted delivery. Sounds sane to me.


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## PancakeGoddess (Oct 8, 2004)

chava, that's very interesting. Makes a lot of sense, particularly for moms who've had more than one baby already. First-timers can be long anyway, yk?


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## huggerwocky (Jun 21, 2004)

Quote:


Originally Posted by *Leilalu*
Well, I would've surely died. I was breech and had the cord wraped around my neck at birth, several times. my mom did not die, and I did not die.

That's not a very serious complication, a cord prolapse would be.


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## Drummer's Wife (Jun 5, 2005)

Great Thread!! I was just thinking about this the other day.... what did they do before c-sections if the baby couldn't/wouldn't come out. I wondered if the mother and/or baby died, or what procedures they did.

Cause I'm struggling with my 3 c-sections 1st and last due to so called FTP. I am postitive that my babies would have came out eventually if there wasn't such pressure to section after so much time had passed.


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## Leilalu (May 29, 2004)

Quote:


Originally Posted by *huggerwocky*
That's not a very serious complication, a cord prolapse would be.

Actually, you weren't there, so who is to say?


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## edamommy (Apr 6, 2004)

If I had not had an emergency csection my baby (and quite possibly me too) would have died. It is a necassary evil. imo.


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## Synchro246 (Aug 8, 2005)

Well, I find it VERY hard to believe that the death rate from human birth would be one in three. The human species as it is today has been around for, what, 1.5 million years. This is LONG before the use of complicated techniques to get babies out. Many women probably did labor for days (and sucessfully birthed), many women and babies probably did die, but I'm willing to bet that many more survived than just 2/3. After all we are a really sucessfull species overall. But what do I know, maybe even more than 1/3 died and the death rate lowered over time because pelvi became better for birth.
I agree that cesareans save lives. I don't think it's that many lives though.


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## MCatLvrMom2A&X (Nov 18, 2004)

There were many techniques some great some not so great to help a baby come that was "stuck" for what ever reason. Most of those ways were lost when dr's took over with the births. Some prolly a very good thing they were lost while others could be used today with great success without cutting a mom open. One way being someone would push down on the baby to make it come out. Sometimes it worked and the baby and mother survived, and then there were the times that either the baby, mother or both didnt make it.







I think mortality for the babies and mothers was pretty high. I (family memebers back in the 40's)know of 2 woman and one baby not making it thru child birth. With one she bleed todeath after the birth but the baby lived(fil) the other her and the baby both were lost (my greatgrandma) due to the same thing blood loss.

I am thankfull there is help for woman out there now thru section and I beleive some are 100% needed but there are many done that should not have been. I do not beleive in section being done just cause the mom wants it unless there is a true medical need for it. If it was dont that way I think the section rate would be very very low. But there is always gonna be dr who will do a section just so they can get that big ol payday







I have been told some sections can cost as much as $20,000 there is a lot of incentive there for some dr to jump the gun.


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## Ruthla (Jun 2, 2004)

Quote:


Originally Posted by *OnTheFence*
I think its a misnomer to think that all breech babies were born vaginally and alive. Some did die, some died being born vaginally, and some got hung and the mother got her bottom butchered. Its easy in a an era of time where we do have medical intervention to say how wrong it is.

Not all vertex babies were born alive either, and not all mothers survived childbirth. C/S can and do save lives in some situations. The problem is that medical interventions are overused today.


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## erin_brycesmom (Nov 5, 2005)

Quote:

Well, I find it VERY hard to believe that the death rate from human birth would be one in three. The human species as it is today has been around for, what, 1.5 million years. This is LONG before the use of complicated techniques to get babies out.
The main cause of death back then was not anything preventable by c-sections. It was a different time. Sure c-sections could hae saved some lives but now they are also taking some lives. My point though is that the death rates can be deceiving. The great decrease in maternal death is not directly related to OB technology.


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## Synchro246 (Aug 8, 2005)

Good point- like nutrition and disease prevention.


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## crazy_eights (Nov 22, 2001)

And antibiotics. At one time 'childbed fever' was a large source of maternal mortality.


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## Quagmire (Sep 27, 2005)

Quote:


Originally Posted by *mom2seven*
And antibiotics. At one time 'childbed fever' was a large source of maternal mortality.

Childbed fever was a hygiene thing. Talk about iatrogenic death... yeesh. Once they caught on to handwashing between patients and it became hospital protocol the instances of childbed fever more or less disappeared.


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## crunchymamatobe (Jul 8, 2004)

Quote:


Originally Posted by *USAmma*
In the old days death from childbirth was very high-- I think 1 in 3?

Haven't y'all read the "Benchmarks in Midwifery" chapter in _Ina May's Guide to Childbirth_? She talks about midwives practicing before the advent of modern technology, before doctors got involved with birth, and finds examples of midwives whose mortality stats were nearly modern. Deaths measured in number of cases per 1000. Even a midwife who delivered a few women and their babies with placenta previa safely. In the 1600s if I am remembering correctly!


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## chumani (Apr 12, 2002)

My great grandmother was a midwife in rural southern Utah for almost 40 years (1920's-1960's). She caught over 500 babies, never lost a mother and only 2 babies stillborn, pretty good stats. She was sent to the East for 6 weeks of training in an eastern hospital and then sent home to catch babies at home in the middle of Utah wilderness. My family has her little black book that she kept track of all her moms and babies in and what she was paid with (if at all).

Vaginal birth after 4 cesareans is not unheard of, I have a friend that had 4 c-sections, 1st for breech, 2nd for twins, last 2 repeat, with her 5th labor went too fast and babe was born footling breech in the ambulance. Baby was beautiful with 9/10 apgars.

The safety of breech birth has more to do with Caregiver Competence than anything else.

Have a great day!
Sarah


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## gentlebirthmothr (Jul 13, 2005)

Quote:


Originally Posted by *NYCVeg*
Yes, of course babies and moms died in childbirth before there were c-sections. A transverse baby, for instance, simply cannot be born vaginally. Many of those deaths were due to things like infection, though--antibiotics, much as they're abused now, did a lot to improve fetal and maternal mortality rates.

Citing individual cases of babies who would have/might have died, however, is not compelling evidence to me in the face of c/s rate that's around 30% (and up to 70% in some hospitals/areas). The vast majority of those c-sections are NOT saving women/babies who otherwise would have died. They are, however, making doctors lives more convenient, making lots of money for hospitals, and convincing more and more women that vaginal birth is just too scary/painful/inconvenient for them to go through.

*Most* women will not grow babies too big for their pelvises (providing they're not lying flat on their backs, immobilized); *most* breech babies can be born vaginally without problems (or rather, they could be if birth professionals still learned how to deliver breech babies); twins and even triplets *can* be born vaginally! And a baby whose due date is at an inconvenient time for mom or doctor can almost certainly be born vaginally. Childbirth is not without risk and c-sections save some lives...but c-sections have risks, too, and also cost some lives.


Quote:


Originally Posted by *erin_brycesmom*
The main cause of death back then was not anything preventable by c-sections. It was a different time. Sure c-sections could hae saved some lives but now they are also taking some lives. My point though is that the death rates can be deceiving. The great decrease in maternal death is not directly related to OB technology.

Amanda and erin_brycesmom,

















:


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## OnTheFence (Feb 15, 2003)

Quote:


Originally Posted by *littleteapot*
I'm not judging, I'm asking... because that's confusing to me. Cord around the neck isn't deadly, so I couldn't figure out why it meant you would have died. Although lots of women mistakenly do believe that it is deadly because they think of fetal necks the same way as adult necks.
(For the record, I'm not speaking out of ignorance or lack of experience either. I was in hard labour for 44 hours as well)

Cord around the neck can be deadly. Many mothers have lost their children to cord injuries. Its not a myth.
Also once you go past 42 weeks the risk of your babyhaving health problems increases as well, as does stillbirth. There is a reason why the cut off is 42 weeks for OBs and most midwives, even lay ones, its not just a number they just pulled out their behinds. I know far too many people who have lost babies after 42 weeks to think its a myth.


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## LadyMarmalade (May 22, 2005)

Quote:


Originally Posted by *Ruthla*
Not all vertex babies were born alive either, and not all mothers survived childbirth. C/S can and do save lives in some situations. The problem is that medical interventions are overused today.

Exactly!

My mother gave birth vaginally to two breech babies - her first and her last. One in the seventies and one in the eighties. No problems whatsoever. She said it was much, much easier than giving first to a vertex. She found out the first time that the baby was breech at 37 weeks, had an xray (eek) and her specialist didn't even mention induction. Her water broke naturally just past 40 weeks - labour was about 8 hours, I think. Baby released mec all over attending doctor due to the pressure of having legs squeezed up next to abdomen. Dad said it was a surreal site - a spray of meconium coming out of mum's vagina.

We also prepared for a breech vaginal but jnr turned just before labour started (I distincly remember the clunk of his head hitting my pelvic bone and the immediate pressure - I went to the toilet to find my mucus plug sitting neatly on my underpants). My doctor was against me having a c-section 'just because' he was breech. But she also refuses to prescribe antibiotics unless you're in serious danger ... and suggests 'alternative' remedies rather than OTC pills (which is why we chose her and love her so much).


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## erin_brycesmom (Nov 5, 2005)

I do have to agree with ONtheFence that cord injuries are real and serious. And that the risks increase after 42 weeks...not that it isn't ok to go past 42 weeks but definitely something to start being concerned about.

Just some more anecdote....My mom, my grandma's, my dh's mom ALL had their first borns breech presenting. All were given TOL and all but my mom delivered vaginally no problems. My mom fully dilated but the baby never decsended through the birth canal. She had a c-section. I have no idea if something else could have been done (that wasn't) to get the baby moving down. I know that her doc wasn't scalpel happy and my mom wanted a vaginal birth.

I don't know if breech is somehow hereditary but both of my babies were breech far along in labor but thankfully I was able to get them to turn before labor started....it probably helped that I was very late with both of them.


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## member234098 (Aug 3, 2002)

Quote:


Originally Posted by *Hayes*
Sometimes mothers still die in childbirth.

Yes.

Nowadays, The doctor simply writes something else on the death certificate as a cause of death; it usually blames the victim.

The bottom line is that the only real improvements in partuition management are antibiotics and blood transfusions.

Any other medical "advance" as universal hospitalization of laboring women, routine intravenous fluids, routine episiotomies, routine amniotomy, routine monitering (internal/external), ultrasound, fetal diagnosis, blood tests, forceps, vacuum extraction, epidurals, routine catheterizations, escalating rise in surgical births, et cetera, are of questionable value.


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## member234098 (Aug 3, 2002)

Quote:


Originally Posted by *chumani*
The safety of breech birth has more to do with Caregiver Competence than anything else.

Outstanding statement!


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## member234098 (Aug 3, 2002)

Quote:


Originally Posted by *mom2seven*
And antibiotics. At one time 'childbed fever' was a large source of maternal mortality.

And childbed fever, puerperal fever, was an iatrogenically caused disease; it was caused by doctors with a g-d complex so strong that they truly believed they did not have to wash their hands. Doctors would walk directly from the morgue, where they worked on dead diseased bodies, to the maternity ward, without any attention to antisepsis.

When this was pointed out to them by one of their own, Dr. Ignaz Schemmelweis, they put him in a mental institution.

Doctors told the women that the disease was all in their head (sound familiar?)

Later, Dr. Lister, in another country, discovered the same thing.


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## member234098 (Aug 3, 2002)

Quote:


Originally Posted by *OnTheFence*
Cord around the neck can be deadly.

It can be deadly if the mother is already fully medicated and the baby is getting lots of the suppressive medication already in its system through the cord.

I have read old medical books in which doctors state that the placenta is a "bloody sieve" which filters out all medications and drugs from the mother. Medical science has learned too well in the last century that this is not true from its own errors as prenatal x-rays, thalidomide, DES, bendectin, rhogam, and limiting maternal weight gain.


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## gentlebirthmothr (Jul 13, 2005)

Miriam,

Thank you for your wonderful replies to thread.


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## Synchro246 (Aug 8, 2005)

Quote:


Originally Posted by *OnTheFence*
Cord around the neck can be deadly. Many mothers have lost their children to cord injuries. Its not a myth.
Also once you go past 42 weeks the risk of your babyhaving health problems increases as well, as does stillbirth. There is a reason why the cut off is 42 weeks for OBs and most midwives, even lay ones, its not just a number they just pulled out their behinds. I know far too many people who have lost babies after 42 weeks to think its a myth.

Cord around the neck is not a cord injury. Prolapse is a better example of cord injury.


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## member234098 (Aug 3, 2002)

Actually, a cord around the neck can PREVENT a very long cord from prolapsing.

Maybe it is a good thing - the umbilical cord around the neck; it must be since it happens so often.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *Synchro246*
Although, I did have a prof. of A&P who insisted that before chairs and things of that kind humans had much better movement and posture, which would have at least a little to do with positioning.

This is something that interests me quite a lot. I've had three c-sections. The first two were both for breech babies. The third was because my OB & FP were hesitant about a VBA2C, and then I went "overdue", so I got sliced up again. DS2 (my third baby) was vertex right up to the end.

I know it's purely anecdotal, but it does interest me that my pregnancy with ds2 was the first one during which I did _not_ sit in a chair at work all day. I was home with dd, and moved around much more during the day.


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## erin_brycesmom (Nov 5, 2005)

Quote:

Maybe it is a good thing - the umbilical cord around the neck
yikes! I don't think it is a good thing in most cases. I know I sure didn't think it was "good" when my baby's first apgar was a 4 because of the cord being wrapped tightly around his neck twice.


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## pumpkinsmama (Aug 20, 2005)

Quote:

Originally Posted by NYCVeg

*Most* women will not grow babies too big for their pelvises (providing they're not lying flat on their backs, immobilized); *most* breech babies can be born vaginally without problems (or rather, they could be if birth professionals still learned how to deliver breech babies); twins and even triplets *can* be born vaginally! And a baby whose due date is at an inconvenient time for mom or doctor can almost certainly be born vaginally. Childbirth is not without risk and c-sections save some lives...but c-sections have risks, too, and also cost some lives.
Slightly Off Topic
I'm not making judgement either way, but wanted to bring up a conversation I saw in a previous thread. There were questions about whether with the amazing frequency of c-sections in the USA, the amount of babies that are "too big" to pass through the pelvis will increase in the next century because the genes will be more likely to be passed on than in previous centuries where mom or baby would just have died. IMO, it seems too small of numbers to begin with to have any impact, but I haven't researched it.


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## crazy_eights (Nov 22, 2001)

The whole 'too big' thing is a myth. Babies were smaller 50 years ago at birth, but mothers often smoked and were told to diet and limit their weight gain to 15 lbs. In the early decades of the 1900's, the average baby was LARGER than they are today. A good example would be my own grandfather, born in 1925 at 13 lbs. No, his mother was not a diabetic.


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## pumpkinsmama (Aug 20, 2005)

See, I never knew that. Thanks! The smoking thing makes a lot of sense, I can picture doctors from that era teaching their replacement that any baby over four pounds was huge. I'm only exaggerating a little, smoker babies can be soooooo tiny!


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## Leilalu (May 29, 2004)

Quote:


Originally Posted by *miriam*
Actually, a cord around the neck can PREVENT a very long cord from prolapsing.

Maybe it is a good thing - the umbilical cord around the neck; it must be since it happens so often.

Ouch. Lets hope you never have to deal with this trauma. I was lucky to be alive, really.

I knew a kid who was not so lucky, growing up. Suppossedly he was partially brain damamged because of the cord around his neck.


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## aweynsayl (Sep 27, 2003)

such touchy issues here. esp for those of us who have "had" to have a c-s. yeah, that's subjective. in my case, i believe that *something* would have gone wrong, and either my baby or I would have been hurt. but i believe that, not because some OB told me that. I believe it because my baby, after 39 weeks of being in the correct position, decided to turn breech. we tried the webster technique, we tried the accupuncture technique, we tried pelvic tilts and all of it... we even got the baby to turn about 3/4 of the way... but as soon as he got there, he turned right back, and after that, didnt budge. he knew something was up, and he knew what to do to protect us. since he was 11 lbs, even my mw all said they wouldnt have tried if he was theirs. who knows for sure, but really? i trust my baby. i really believe that he did what he did for a reason, and i really believe that if we hadnt had the option of a c-s, something very bad could very possibly have happened. i guess my point is simply that yes, c-s are done far too often, but thank goodness they can be done, and can be done well.

it's really challenging to want to be here, having had a c-s, because every time i come here, i read at least one thing that makes me feel like crud for having "had" to have a c-s. if there's any chance that reading MY post makes one woman NOT feel that way, well, then maybe that's why i'm rambeling on... anyhow. hugs to all mommas who have had a c-s-- for any reason.

and, to anyone who feels the need to constantly say in harsh or not harsh terms, that c-s almost never really "have" to be done... just please remember... every time you say that, you might encourage a woman to do things to avoid one... but every time you say that, you most certainly bring tears to the eyes of at least one woman who has "had" to have one.

just some food for thought.
xoxox


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## Leilalu (May 29, 2004)

Quote:


Originally Posted by *moosemommy*
such touchy issues here. esp for those of us who have "had" to have a c-s. yeah, that's subjective. in my case, i believe that *something* would have gone wrong, and either my baby or I would have been hurt. but i believe that, not because some OB told me that. I believe it because my baby, after 39 weeks of being in the correct position, decided to turn breech. we tried the webster technique, we tried the accupuncture technique, we tried pelvic tilts and all of it... we even got the baby to turn about 3/4 of the way... but as soon as he got there, he turned right back, and after that, didnt budge. he knew something was up, and he knew what to do to protect us. since he was 11 lbs, even my mw all said they wouldnt have tried if he was theirs. who knows for sure, but really? i trust my baby. i really believe that he did what he did for a reason, and i really believe that if we hadnt had the option of a c-s, something very bad could very possibly have happened. i guess my point is simply that yes, c-s are done far too often, but thank goodness they can be done, and can be done well.

it's really challenging to want to be here, having had a c-s, because every time i come here, i read at least one thing that makes me feel like crud for having "had" to have a c-s. if there's any chance that reading MY post makes one woman NOT feel that way, well, then maybe that's why i'm rambeling on... anyhow. hugs to all mommas who have had a c-s-- for any reason.

and, to anyone who feels the need to constantly say in harsh or not harsh terms, that c-s almost never really "have" to be done... just please remember... every time you say that, you might encourage a woman to do things to avoid one... but every time you say that, you most certainly bring tears to the eyes of at least one woman who has "had" to have one.

just some food for thought.
xoxox

Well said, and I think maybe we need to remember that we don't have to justify our reasoning..... We know the desicion we had to make.


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## Synchro246 (Aug 8, 2005)

Quote:


Originally Posted by *Leilalu*
I knew a kid who was not so lucky, growing up. Suppossedly he was partially brain damamged because of the cord around his neck.

And supposedly some kids wouldn't have cerebral palsy if a cesarean was done or was done more quickly. Too bad an increased cesarean rate does not correlate with a decrease in cerebral palsy rate.
My guess is that they don't know why the kid you knew was brain damaged, but since humans like to "know" things they clung to the one thing that seemed abnormal.


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## member234098 (Aug 3, 2002)

Quote:


Originally Posted by *Leilalu*
Ouch. Lets hope you never have to deal with this trauma. I was lucky to be alive, really.

I knew a kid who was not so lucky, growing up. Suppossedly he was partially brain damamged because of the cord around his neck.

OUCH! All of my homeborn children did have their respective cords around their respective necks. There are fine, thank you. Mostly because there was no oxygen depriving medication in my blood and therefore none in my baby's system.

The cause of much brain damage in newborns in yester years was because there was a rule in most places that the nurse had to impede the birth of a baby until the doctor arrived. This was accomplished by holding the mother's legs together and/or holding a towel to the perineum.

I attended school with many children who had minimum brain damage from this protocol. This happened alot.

Of course the baby was ready to breathe; just because the doctor was not there, the baby's first breath was delayed and brain damage occurred.

My point is that not all brain damage is from the lack of caesareans or a tightly wrapped cord around the neck; often brain damage is from too much maternal anesthesia or injudicious hospital routines, that is, from iatrogenesis.

Anoter procedure that was done to women with small pelvic outlets was a crippling procedure called a symphisiotomy which broke the pubic arch to allow the baby to be born. Many women never healed properly from this iatrogenic, crippling procedure.


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## odenata (Feb 1, 2005)

Quote:


Originally Posted by *moosemommy*
and, to anyone who feels the need to constantly say in harsh or not harsh terms, that c-s almost never really "have" to be done... just please remember... every time you say that, you might encourage a woman to do things to avoid one... but every time you say that, you most certainly bring tears to the eyes of at least one woman who has "had" to have one.









:

I had an eclamptic seizure during my homebirth. If I hadn't had an emergency surgical birth, my baby and I would be dead.

I think the c-section rate in our country is too high. I'm outraged and upset when I hear of mothers choosing c-sections for convenience and even moreso when I hear of doctors doing it. I'm outraged when I hear of mothers wanting to do VBAC and no one will work with them.

However, a c-section saved my life. C-sections aren't the problem - lazy OBs and overuse is the problem.


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## caned & able (Dec 8, 2005)

Quote:


Originally Posted by *odenata*
C-sections aren't the problem - lazy OBs and overuse is the problem.

Add to that UN-informed consumers, that is mothers who do not do their research.

Women are their own worst enemy.


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## Leilalu (May 29, 2004)

Quote:


Originally Posted by *miriam*
OUCH! All of my homeborn children did have their respective cords around their respective necks. There are fine, thank you. Mostly because there was no oxygen depriving medication in my blood and therefore none in my baby's system.

The cause of much brain damage in newborns in yester years was because there was a rule in most places that the nurse had to impede the birth of a baby until the doctor arrived. This was accomplished by holding the mother's legs together and/or holding a towel to the perineum.

I attended school with many children who had minimum brain damage from this protocol. This happened alot.

Of course the baby was ready to breathe; just because the doctor was not there, the baby's first breath was delayed and brain damage occurred.

My point is that not all brain damage is from the lack of caesareans or a tightly wrapped cord around the neck; often brain damage is from too much maternal anesthesia or injudicious hospital routines, that is, from iatrogenesis.

Anoter procedure that was done to women with small pelvic outlets was a crippling procedure called a symphisiotomy which broke the pubic arch to allow the baby to be born. Many women never healed properly from this iatrogenic, crippling procedure.


I don't see what in my post you are reffering to when you say ouch....

I was making reffernce to my birth, and it was a unique situation.
No one is saying cesareans are nessecary for every cord/neck birth. I am also glad your babies are just fine and no intervention was needed for them.


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## erin_brycesmom (Nov 5, 2005)

Quote:

OUCH! All of my homeborn children did have their respective cords around their respective necks. There are fine, thank you. Mostly because there was no oxygen depriving medication in my blood and therefore none in my baby's system.

The cause of much brain damage in newborns in yester years was because there was a rule in most places that the nurse had to impede the birth of a baby until the doctor arrived. This was accomplished by holding the mother's legs together and/or holding a towel to the perineum.

I attended school with many children who had minimum brain damage from this protocol. This happened alot.

Of course the baby was ready to breathe; just because the doctor was not there, the baby's first breath was delayed and brain damage occurred.

My point is that not all brain damage is from the lack of caesareans or a tightly wrapped cord around the neck; often brain damage is from too much maternal anesthesia or injudicious hospital routines, that is, from iatrogenesis.

Anoter procedure that was done to women with small pelvic outlets was a crippling procedure called a symphisiotomy which broke the pubic arch to allow the baby to be born. Many women never healed properly from this iatrogenic, crippling procedure.
Miriam, I get that you are for non intervention births...I am too, but I don't get what any of this has to do with the serious and real problems that can occur from nuchal cords. Sure most nuchal cords present no problems but there are varying levels. Tight nuchal cords can cause compressions in the cord and prevent oxygen and blood from flowing to the baby which can result in asphyxia and hypovolemic shock. This can happen whether the mama has any drugs or not.

My labor was intervention free, no iv, nothing and nobody would have thought his double nuchal cord was a good thing. I will say that I am really glad that I did not have any fetal monitoring because I am pretty sure that if I did red flags would have gone up and I could just see myself ending up with a c-section and it wouldn't have been necessary.

~Erin


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## member234098 (Aug 3, 2002)

The thread is about what was done before c-secs were so common. I can tell you I do know of many women who had high forceps deliveries and many difficult deliveries accomplished with alot of intervention.

Women did die, babies died from difficult labors and deliveries.

My point is that a difficult delivery is accomplished with a skilled attendant using the necessary tools if necessary. Yet, 95% of the time, nothing really is needed. Forceps, vaccuum extractors, anesthesia are all of the modern medical age since about 1850 when surgical techniques were begun to be perfected. The 1940s saw the advent of antibiotics and blood transfusions which came about the same time as universal hospitalization for childbirth.


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## Leilalu (May 29, 2004)

Quote:


Originally Posted by *miriam*
The thread is about what was done before c-secs were so common. I can tell you I do know of many women who had high forceps deliveries and many difficult deliveries accomplished with alot of intervention.

Women did die, babies died from difficult labors and deliveries.

My point is that a difficult delivery is accomplished with a skilled attendant using the necessary tools if necessary. Yet, 95% of the time, nothing really is needed. Forceps, vaccuum extractors, anesthesia are all of the modern medical age since about 1850 when surgical techniques were begun to be perfected. The 1940s saw the advent of antibiotics and blood transfusions which came about the same time as universal hospitalization for childbirth.

Where are you getitg your statistics? To say that 95 % of women don't need intervention in order to have healthy babies and not die themselves...well, where are you getting this number? Just curious. How does one possibly calcutlate all the births in the world and deicde this number?

I too am all for non-interventive birthing, I just happen to see the other side of things as well, having had two surgical births.


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## member234098 (Aug 3, 2002)

Forget it.


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## Synchro246 (Aug 8, 2005)

The world health organization says that 90% of deliveries can happen normally at home and have good outcomes. I don't know if they mean that the remaining 10% require surgery or just medical care of some kind.


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## member234098 (Aug 3, 2002)

Quote:


Originally Posted by *Synchro246*
The world health organization says that 90% of deliveries can happen normally at home and have good outcomes. I don't know if they mean that the remaining 10% require surgery or just medical care of some kind.

I honestly thought this was very common knowledge.


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## Synchro246 (Aug 8, 2005)

off topic a little, but I once got in an argument, er. . .discussion, on some mainstream boards and when I said that 90% of women can have normal pregnancies/births one woman responded with "That's not true because I have complicated pregnancies"
I was so thrown off by her lack of logic I failed to respond.


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## AnditheBee (Oct 3, 2003)

Quote:


Originally Posted by *Synchro246*
The world health organization says that 90% of deliveries can happen normally at home and have good outcomes. I don't know if they mean that the remaining 10% require surgery or just medical care of some kind.

I'm not sure how they can make that calculation, when so many births in Western countries receive medical intervention whether it is needed or not. We have no way of knowing how many of those births would have required medical help. It sounds likely to be true, on an instinctual level, but I personally doubt the statistical validity of it.


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## eirual (Mar 21, 2006)

When pregnant I read one of Ina May Gaskins' books, don't remember the exact title but it spoke a lot about "The Farm"...There (a place with talented midwives where women would come from nation-wide and around the world to get the natural births they wanted) they had something crazy like a .2% section rate (could have been 2%, but I really think it was .2...)

I highly recomend the read if anyone's interested.


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## erin_brycesmom (Nov 5, 2005)

eirual, keep in mind that the woman who want to give birth at the farm do not have known high risk problems. So that would skew normal c-section rates.


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## Synchro246 (Aug 8, 2005)

It's true that almost none of those women have preeclampsia or gestational diabetes, but that's partly due to the care they receive. They follow a good diet. When's the last time you heard of an OB giving good nutritional advice? I suggest that just by going to an OB a woman is increasing her risk of developing such complications. Getting good care keeps 90% of women in the normal category.

They have breech babies and twins vaginally on the farm.

I think the WHO has access to all kinds of data. They tell how they gather the data. They even look at the rates of certain "causes" for cesarean- like preeclampsia. They use the discrepency to evaluate what an acheivable rate of such diseases could be and they calculate those into their estimation. Some rates of certain abnormalities are fairly consistant the world over- although some must be controled for race for the consistancy to be seen. I think estimating the acheiveable rate of normal pregnancy is quite possible with the right data and the right minds doing the work. It wouldn't be easy, and there would be a good margin of error (esp. since there is no way to implement good sources of food and care everywhere), but it's possible.

Here is a link to some relavant http://www.who.int/reproductive-health/MNBH/index.htm WHO stuff. Browse around- you can read their methodology for yourself. Here is another pertinant link http://www.who.int/reproductive-heal...mortality.html


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## AnditheBee (Oct 3, 2003)

Quote:


Originally Posted by *Synchro246*
I think the WHO has access to all kinds of data. They tell how they gather the data. They even look at the rates of certain "causes" for cesarean- like preeclampsia. They use the discrepency to evaluate what an acheivable rate of such diseases could be and they calculate those into their estimation. Some rates of certain abnormalities are fairly consistant the world over- although some must be controled for race for the consistancy to be seen. I think estimating the acheiveable rate of normal pregnancy is quite possible with the right data and the right minds doing the work. It wouldn't be easy, and there would be a good margin of error (esp. since there is no way to implement good sources of food and care everywhere), but it's possible.

It would probably be far more accurate if doctors were honest about the causes of cesarean. In both my cases, my docs just had to pick something to write down--they had no real diagnosis for why my babies didn't come out. I gather this is quite common. Besides which, diagnoses like CPD and FTP are often just plain bull-hockey. I've got to think that skews the statistics.

As a side note, can you imagine if they were honest about the causes of c-sections? They'd sometimes be writing down things like "golf date" and "doctor incompetence."









Quote:

Here is a link to some relavant http://www.who.int/reproductive-health/MNBH/index.htm WHO stuff. Browse around- you can read their methodology for yourself. Here is another pertinant link http://www.who.int/reproductive-heal...mortality.html
Thanks! I'll check it out.


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## Synchro246 (Aug 8, 2005)

From WHO- underlines are mine
"According to ICD-10, maternal deaths should be divided into two groups:

Direct obstetric deaths are those resulting from obstetric complications of the pregnant state (pregnancy, labour and the puerperium), from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the above.

Indirect obstetric deaths are those resulting from previous existing disease or disease that developed during pregnancy and which was not due to direct obstetric causes, but was aggravated by physiologic effects of pregnancy.

The drawback of this definition is that maternal deaths can escape being so classified because the precise cause of death cannot be given even though the fact of the woman having been pregnant is known. Such under-registration is frequent in both developing and developed countries."

I think it's sad/funny that WHO acknowledges it. Direct obstetric deaths


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## Synchro246 (Aug 8, 2005)

I guess I shouldn't say that WHO acknowledges liar OBs, but they acknowledge the problem
I wonder if the lying is mainly a problem in the US.

I think I'm spelling acknowledge wrong.


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## doula and mom (Nov 28, 2005)

I think one of the biggest issues in the c-section epidemic today (that did not exist way back when) is the approx. 85% of all laboring women who get epidurals/narcotics and therefore are choosing to labor in bed on their backs. It never ceases to amaze me that ANY baby can descend while mom is flat on her back for most of the labor.

NOTE: I am usually a thread-killer.


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## Leilalu (May 29, 2004)

NOTE: I am usually a thread-killer.







[/QUOTE]

not today









I agree, women cant be expected to labor against gravity!


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *erin_brycesmom*
eirual, keep in mind that the woman who want to give birth at the farm do not have known high risk problems. So that would skew normal c-section rates.

Actually, that's not exactly true. Firstly, they give prenatal care to all the women who live at the farm. They also have a lot of Amish women that get care with them, first time moms and for a long time they had a program where they would take in women off the street to have their babies. Anyone who got prenatal care with them is included in their stats whether they are refered to the hospital or MD care.


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## Leilalu (May 29, 2004)

Quote:


Originally Posted by *mom2seven*
Actually, that's not exactly true. Firstly, they give prenatal care to all the women who live at the farm. They also have a lot of Amish women that get care with them, first time moms and for a long time they had a program where they would take in women off the street to have their babies. Anyone who got prenatal care with them is included in their stats whether they are refered to the hospital or MD care.

Yes, but not entirely true. they also except women last minute who have breech babies. I was given the choice with dd of flying out there, but it wasn't feasable.


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## Rico'sAlice (Mar 19, 2006)

Quote:


Originally Posted by *Leilalu*
Yes, but not entirely true. they also except women last minute who have breech babies.

Are you saying they _except_ those women, as in leave them out of the statistics? ('cause that would be false.)

Or do you mean that they _accept_ these women despite/because of knowing baby is breech?

I'm promise I'm not being snarky or part of the grammar police, just trying to understand what you mean. Thanks.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *erin_brycesmom*
eirual, keep in mind that the woman who want to give birth at the farm do not have known high risk problems. So that would skew normal c-section rates.

I'm sure it would skew them to some extent...but not near enough to account for the difference between 0.2% and 30%!

I wish I'd known about and had a way to get to the Farm when I was pregnant with ds1 back in '93...of course, I didn't know he was going to turn breech when I went into labour, so I don't think I'd have gone that route. My doctor (not an OB) certainly didn't have any concerns about my ability to give birth vaginally.


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## Leilalu (May 29, 2004)

Quote:


Originally Posted by *Rico'sAlice*
Are you saying they _except_ those women, as in leave them out of the statistics? ('cause that would be false.)

Or do you mean that they _accept_ these women despite/because of knowing baby is breech?

I'm promise I'm not being snarky or part of the grammar police, just trying to understand what you mean. Thanks.

oops, sorry!







I need a nap!
I meant ACCEPT


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## erin_brycesmom (Nov 5, 2005)

mom2seven - What I mean is who is going to go to the Farm with a *known* serious high risk pregnancy? Sure there are going to also be some people who start at the Farm end up risking out, but there are many women who are already aware from a previous situation that they are high risk and would know they couldn't go to the Farm to start with.

*I'm sure it would skew them to some extent...but not near enough to account for the difference between 0.2% and 30%!*

Storm Bride, I agree fully! I just wanted to point out that the Farm isn't exactly a true representative of all situations that may require c-section. Of course you have a much better chance of not "needing" a c-section when you are at the Farm or even anywhere out of a hospital. The c-sec rates in the US make me sick to my stomach.

I seriously considered trying to go to the Farm when ds#2 was breech at 39 weeks but thankfully diligence with my chiro for Webster paid off and he flipped.


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## caned & able (Dec 8, 2005)

NO one has mentioned the 1978 study done in Northern CA done scientifically matching home for hospital mother and the outcome of the birth.









The Lewis Mehl Study that matched 1046 at home mothers with hospital bound mothers.

This one is done in 1996
http://bmj.bmjjournals.com/archive/7068pr4.htm


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *caned & able*
NO one has mentioned the 1978 study done in Northern CA

You mean the Mehl study? I can't find it linked anywhere, but here is a summary:

Quote:

Mehl, L., Peterson, G., Shaw, N.S., Creavy, D. (1978) "Outcomes of 1146 elective home births: a series of 1146 cases." J Repro Med.
19:281-90
Neonatal Outcomes:

* In the hospital, 3.7 times as many babies required resuscitation.
* Infection rates of newborns were 4 times higher in the hospital.
* There was 2.5 times as many cases of meconium aspiration pneumonia in the hospital group.
* There were 6 cases of neonatal lungwater syndrome in the hospital and none at home.
* There were 30 birth injuries (mostly due to forceps) in the hospital group, and none at home.
* The incidence of respiratory distress among newborns was 17 times greater in the hospital than in the home.
* While neonatal and perinatal death rates were statistically the same for both groups, Apgar scores (a measure of physical well being of the newborn) were significantly worse in the hospital.


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## caned & able (Dec 8, 2005)

Yes.








:


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## maxmama (May 5, 2006)

There was a more recent study (which of course I can't find the citation for -- somewhere in my syllabus from the last conference) that looked at planned home birth in Washington and planned hospital births and found equivalent outcomes, with decreased infant mortality for the home birth group.


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *maxmama*
There was a more recent study (which of course I can't find the citation for -- somewhere in my syllabus from the last conference) that looked at planned home birth in Washington and planned hospital births and found equivalent outcomes, with decreased infant mortality for the home birth group.

I think you mean the CPM study that was written up in the BMJ. However, mortality was the same as similar groups of babies born to low-risk hospital women, but morbidity (injury) was much lower in both mother and baby.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *erin_brycesmom*
I seriously considered trying to go to the Farm when ds#2 was breech at 39 weeks but thankfully diligence with my chiro for Webster paid off and he flipped.

I wish I'd _known_ about the farm...or the Webster technique...when dd was breech at 39 weeks. I don't think my first c-section was necessary, but looking back, I'm still not sure how I could have avoided it...


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## Synchro246 (Aug 8, 2005)

Quote:


Originally Posted by *mom2seven*
I think you mean the CPM study that was written up in the BMJ. However, mortality was the same as similar groups of babies born to low-risk hospital women, but morbidity (injury) was much lower in both mother and baby.

Wooooo Hoooo CPM2000! I heard a group of midwives in a state where midwifery is alegal/illegal went to the legislators saying "the safety of homebirth is established. . . what are you going to do about it" essentially. No more arguing that homebirth is safer(with random people), it just is. I can't believe in a free country that there are states where midwifery is still illegal. There's no excuse now. I might have to go start an activism thread.


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## bravofrenchie (Oct 15, 2004)

After reading this thread, I got out my copy of "Ina May's Guide to Childbirth" and went to the stats page. I don't have it in front of me, so I can't directly quote. But the C-section rate for The Farm, between 1970 & 2000, is only 1.4%.

At the bottom of the page, she writes something like (again, not an exact quote): Our statistics are different from birth centers, because birth centers normally "risk out" twins, breech births, ect. Our statistics reflect every woman who received prenatal care at The Farm, regardless whether they planned a birth at The Farm with a midwife, or with a doctor at the hospital near The Farm.


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## MamaRabbit (May 26, 2005)

What happened before C-sections? Well, how long have C-sections been around? If not a C-section, then what? Now this is a cool paper:

History of the C-section


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## Drummer's Wife (Jun 5, 2005)

Quote:


Originally Posted by *Kannon99*
What happened before C-sections? Well, how long have C-sections been around? If not a C-section, then what? Now this is a cool paper:

History of the C-section

Kannon, thank you so much for that link. i found it all so interesting, especially the part about a possible section in the yr 1500 where the mother survived and went on to birth 5 more babies vaginally. Even if it's not completely accurate it does give hope to vbac'ers today.


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## MamaRabbit (May 26, 2005)

It is cool. The instruments they used to use are scary looking! And even more scary... some of them are still used


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## Drummer's Wife (Jun 5, 2005)

I agree, scary! Especially the ones used for craniotomy. Just reading about it made me feel ill. I understand that it was often safer than sectioning but sheesh.

Forceps freak me out as it is, I couldn't imagine how they used them way back then.


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