Thoughts on Elective C-section?

[mamadiva]

Was'nt sure where to put this so decided as it was news related it should go here.

After reading that Colleen Rooney has decided to have an elective C-section as she does'nt want the birth to conflict with Wayne's footie I just started to think more about whether it's really right or not.

I am all for women having choice and all but surely it should be down to her not wanting to go through natural labour than worrying about it clashing with work, is it really right that people can make these kinds of decisions without medcal guidance?

I do think that sections should only be used in emergencies or cases where people are genuinely terrified of child birth etc, but for convenience I think it's wrong.

I had an Emergency CS with my son and whilst it was'nt an horrible experience I would have rather done it naturally I know not everyone has had the same experience.

I just fail to see how people can choose surgery which has quite a slow recovery process for mother and baby (as far as I know) just for the sake of convenience.

So much for Colleen being a 'real woman', a real woman would choose what's right for herself and her abby whether it be natural or CS she has chosen for the sake of a football match.

So do you think it's right that this should be allowed?

Libra - that was my point too.

An El. CS means (IMO - maybe I'm wrong) no labour... you can't decide - mid labour - to have an El CS... that's an EM CS, surely?

Sorry, I must be reading it wrong, I still cant see anything about that - where is it?

tiggerlovestobounce what I meant is that if you put side by side the figures for pure ELCS and pure VB then yes pure VB probably wins because in most cases it's the really low risk ones end up as VB, you need to somehow factor the VB that end up as EMCS to have a true picture of what is safer.

OK, I see what you mean now. This one is probably better from that point of view?

The percentage of United States births delivered by cesarean section continues to increase, even for women considered to be at low risk for the procedure. The purpose of this study was to use an "intention-to-treat" methodology, as recommended by a National Institutes of Health conference, to examine neonatal mortality risk by method of delivery for low-risk women. METHODS: Low-risk births were singleton, term (37-41 weeks' gestation), vertex births, with no reported medical risk factors or placenta previa and with no prior cesarean section. All U.S. live births and infant deaths for the 1999 to 2002 birth cohorts (8,026,415 births and 17,412 infant deaths) were examined. Using the intention-to-treat methodology, a "planned vaginal delivery" category was formed by combining vaginal births and cesareans with labor complications or procedures since the original intention in both cases was presumably a vaginal delivery. This group was compared with cesareans with no labor complications or procedures, which is the closest approximation to a "planned cesarean delivery" category possible, given data limitations. Multivariable logistic regression was used to model neonatal mortality as a function of delivery method, adjusting for sociodemographic and medical risk factors. RESULTS: The unadjusted neonatal mortality rate for cesarean deliveries with no labor complications or procedures was 2.4 times that for planned vaginal deliveries. In the most conservative model, the adjusted odds ratio for neonatal mortality was 1.69 (95% CI 1.35-2.11) for cesareans with no labor complications or procedures, compared with planned vaginal deliveries. CONCLUSIONS: The finding that cesarean deliveries with no labor complications or procedures remained at a 69 percent higher risk of neonatal mortality than planned vaginal deliveries is important, given the rapid increase in the number of primary cesarean deliveries without a reported medical indication.

link

Are there any statistics even gathered on the damage to fanjos after vaginal births? So many women are left unable to enjoy penetrative sex and are very likely to suffer incontinence in later life. Why do you think the tena lady stuff sells so well? Emergency CS also has much greater risks.

Given that is the case, I would think it should be up to the mother to decide if she wants an elective CS under her own particular circumstances, with an understanding of the risks involved in that choice.

tigger - That study looks at c-sections from a decade ago, and does not differentiate between CS done at 37 weeks and CS done at 40 weeks.

In the study you posted previously on the other Colleen thread, we saw that any increase in newborn mortality in CS done at 39 weeks is "not statistically significant".

So, basically, don't have a CS done before 39 weeks and your baby will be in no extra risk for having exited your body through your tummy rather than your fanjo.

I had my middle one at 38 weeks he was huge and likea big rolling pig (yes he could roll from side to side)
hth

but her bloke has a bizarre job. Guess it's kind of like teaching - teachers do get long hols but they cannot TAKE TIME OFF DURING TERM-TIME. Sorry for caps..........

Footie is like that, much as she would have liked to have had her due date in the summer break, conception is unpredictable!

Just because she has a planned delivery date does nnot mean that she regards children as a 'commodity' as one poster put it.

It's the Rooney's life, none of our business.

Having had an Em CS, I don't know why anyone would choose that over a VB, but this is a girl with tons of money so I doubt the NHS will be doing hers.

I mentioned this to DH the other day actually, and he said "rooney has to play, it could be a deciding game on whether we play in the world cup". He then looked at me like I was an idiot. .

at your DH, HarryB (like the name!!! )

Cote - the study looking at respiratory problems only looked at respiratory problems, so I dont think you can extrapolate the results of it in that way.
Im certainly not attempting to present a comprehensive review of the evidence around this subject, theres quite a lot of work on this topic.

Without reading all the papers, in reality it is pretty damn safe for both mother any baby whether birth is CS or vaginal in this country.

And probably even safer if you're being danced attendace on by the finest and most expensive medical team in the country, which I imagine is what Colleen has booked.

Assuming that the date she wants for her section is reasonable, if that also coincides with when her DH isn't on the pitch then that makes sense - I mean it would be pretty nuts to choose a day when he wasn't going to be able to be there surely.

The thing that bothers me with the sleb CS tihng is that I have heard that they often have them really quite early, to avoid getting too massive, so they are able to get back into shape quicker. If the babies are being taken out before they are good n ready, for no medical reason, then that is out of order.

tigger - Now that we understood CS does not cause respiratory problems when performed at 39 weeks or later, what other potentially lethal problems does CS cause?

I asked this question before and don't think I got an answer.

I wonder if she'll get a tummy tuck at the same time.

Course she will smallorange.

And new breasts and collagen filler and will wake up from her anaesthetic to the friendly faces of her personal trainer, chef, motivational buddy and team of nannies and wetnurses...

Mind you she also has to look at wayne

I actually explained in the other post on this subject Cote...

You are at an increased risk of

Placenta Preavia
Placenta Accreta
In subsequent pregnancies

These are LIFE THREATENING complications in pregnancy.

Cazzaben - I was talking about lethal complications for baby.

If you followed the conversation at all, tigger posted a research (before she fully read it, probably) which basically said CS at 39 weeks doesn't increase risk of respiratory problems. Now she posts another research (from over a decade ago) that says babies born with CS have higher morbidity than VB.

My question was: Which other lethal complications does CS lead to for the baby?

Personally, I'm guessing that the increase in morbidity in this second study is because it has made no distinction between elCS at 37 weeks (which can cause respiratory problems) and elCS at 40 weeks (which doesn't).

Kirkeby Hansen and Jain note that during labor, a woman secretes powerful stress hormones. This triggers stress-hormone secretion in her fetus. The hormones have two effects on the fetal lungs. They speed the absorption of liquid. And they increase secretion of surfactants, natural substances that help clear liquid from the lungs.

"Once a woman is in labor, all this gets started," Kirkeby Hansen says. "In women who do not have labor, this process is not believed to start."

Jain says labor is the most reliable sign that a baby is ready to be born.

"When mother nature calls on spontaneous labor to start, it mostly is accurate in terms of the biologic clock and a good likelihood the baby is mature," he says. "But when we do it by elective C-section, we trust mothers' last-period dates or ultrasounds performed early in pregnancy, and those calculations are not always accurate."

SOURCES: Kirkeby Hansen, A. BMJ, online first edition, Dec. 12, 2007. Anne Hansen, Perinatal Epidemiology Research Unit, Aarhus University Hospital, Denmark. Lucky Jain, MD, professor of pediatrics, Emory University School of Medicine, Atlanta

So its only natural labour that prevents problems in the lungs and respiratory problems in a newborn...

Whether or not you have it at 40 weeks or 37 weeks. Although it is 4 times more likely that a newborn will have respiratory problems at 37 weeks gestation. There is still an increased risk if you dont go into labour at all.

Sorry I will re-phrase that (just in case)

'So its only natural labour that prevents problems in the lungs and respiratory problems in a newborn... most of the time....

Cazzabean do the same risks apply to induction then? As "mother nature has not called on spontaneous labour to start"?

Cazzaben - Read the first research tigger posted, where it clearly says that CS at 39 weeks does not increase risk of respiratory failure.

I said this before, latest in the post you replied to. You are clutching at straws now.

If you can't come up with any problem other than respiratory, I guess we will have to conclude that the argument that CS increases fetal morbidity at or after 39 weeks is a myth.

Besides, are you really arguing CS doesn't cause mother to secrete stress hormones? Really???

Very few posters on mumsnet are prepared to accept that a woman could possibly have made a fully informed decision to have an elective section for no medical reason.

Really, if someone is fully aware of the risks and benefits of their birth choice and has evvaluated them in relation to their specific circumstances then I think that they should be supported in their choice and I'd want better sources than an article in the Sun before I assumed that Coleen hadn't made a decision in such a manner.

"In women who do not have labor, this process is not believed to start."

Well it either does, or it doesn't. So which is it? What are the actual facts?