My Ob/Gyn admitted is is indeed true that most female Ob/Gyns opt for elective c setcion!

[cherrysodalover]

So having had a c section first time round(baby over 10 pounds- small pelvic opening) I assumed I would automatically get a c section.
Now I can have one if I want but am also being offered normal delivery as an option-we can scan to see how big baby is in the days pre due date- this can be 1 pound out though.
So I asked my female Ob/Gyn whether it is true that most Ob/Gyn's choose elective c sections and she admitted yes as do most urologists.
I asked her why she thought they did this knowing the slow recovery time and she said it is as they see what happens when things go wrong and so weigh up the disadvantages of a planned c section against this possible outcome which of course is far worse than the week of healing after major surgery- she also mentioned your pelvic muscles are less likely to be badly damaged by a c section.

I have to say it kind of shocked me- the women involved in helping people post birth who have problems choose surgery over natural.

It made me think maybe the midwives don't see this which is why so many are so anti c section- they may see women with pereneums damaged but they do not deal with them going back sometimes for many years trying to get the issues caused by this resolved?

And mmm yes it is making me sway towards having a second c section.
Anyway it really is food for thought isn't it?

Can I just add that I have loads of friends who have had natural deliveries with no problems from it at all, for all of you about to give birth naturally but if the female medical experts who deliver the babies are opting for c sections and they must surely see a lot of healthy deliveries it is a bit revealing somehow, like they are happy for us to take the risk of ripping our perineums whilst they opt for the managed cut involved in a c section!

no, obs/gyn's don't "see a lot of healthy deliveries"...they only get involved when there are complications, so have an unbalanced view of what goes on.

Mw's accompany cs's to theatre, aswell as discussing birth histories with women (and experiencing every other variety of birth) so i would consider their experience more rounded.

in countries where ob/gyns do the actual delivery in all cases (not just the complicated ones) they make the same decision though. both female ob/ gyns and the wives of male ob/gyns have c-sections in large part to prevent undercarriage issues.

i see it less as evidence towards better outcome for the mother than as evidence of their belief system though - that science can improve upon nature. presumably why they chose medicine and surgery as a career rather than horticulture.

fwiw, i had elective cs with dd1, then vbac 1 and 2. dd2 is brain damaged and has cp as a result of birth hypoxia with vbac 2. i should have had a c section.

good luck with whatever you decide. x

I think, as a group, the control of CS would appeal to them anyway - nature of the beast. They are probably also less likely to hold romantic ideas about birth that lead many women to feel dissapointed when they have a CS. They also witness the downside of natural birth when bits get damaged.

I wonder if most male Obs recommend CS for thier wives?

Interesting points.
Moonface as I am in the States, the Ob/Gyn attends and births all babies here- midwife is in supporting role.So midwife takes you through all the labour and the doc is called into deliver or perform surgery (if needed).I had an amazing experience here in the states with baby 1 in spite of it being a long labour ending in emergency c section.The one to one care was brilliant- can't compare to the UK as I have not given birth there.

To be honest I was a bit disappointed she suggested I could try for a vaginal which is why I asked her the question- I worked with kids with cerebral palsy as a teenager- amazing kids but with real challenges in their bodies that need not have been that way- certainly the boy I cared for- the cause was birth related so maybe this is why I have never had a romantic view of vaginal delivery and was more than happy with my emergency c section.I also know someone who lost her baby during a home delivery( and two friends who had amazing experiences so I know that can be great when it turns out how we all wish) .

If I had not had a giant baby first time round I would be more happy to at least try for a vaginal delivery- of course surgery should be avoided if possible.
At the same time one in four mothers used to die in childbirth and the infant mortality rate was higher so I know people go on about- it's what your body is designed for but let's be honest - a significant proportion of women's bodies clearly are not so well designed for it if this was the statistic of the past and today c sections save many lives.

My male Ob/Gyn let me labour for 30 hours before he very gently suggested his advice was to have a c section as no progress was being made- it turned out it would have been impossible for me to give birth to my over 10 pounder.
He told me later when I asked what would happen in the past with big babies-his grandmother lost two babies as they were too big to come out naturally and it was pre c section era.She survived but how sad.
But contrary to what the UK midwives said to me when I moved to the States half way through the pregnancy no pressure was put on me to have a c section at all- in the end it was suggested but after 3 hours of serious pushing.
I'm annoyed now by those British midwives who scaremongered so much about how appalling the US system is and did I know the mortality rate there?
I wonder if I would have been given a c section in the same circumstances in the UK or whether they would have encouraged me to carry on after 3 hours of pushing and no progress.

Doesn't surprise me, we have a family friend who is a mechanic if you ask him which car you should buy and which has less breakdowns etc he says none theyre all rubbish!

They see the extreme and know what the worst case is, plus it might also be partly career led, think I read on her that's quite an unusual area for a woman, maybe don't want to end up in from of a co-worker?

I think may all be down to targets. Hospital trusts are, in general, working at a rate of 1 in 4 deliveries being c sections but they are being pressured into significantly reducing this regardless of what is actually medically best for mothers. I was told independently that a c section was the best and safest option for me and baby due to a med issue. However my original NhS provider would not even discuss this me. I have since changed to another provider and it's being done. Maybe they are nearer their target!
The other thing to bear in mind in whether these ob/ gyn have private medical care or NhS!!

Well in the states it is all private so no concerns on targets.
I suspect that of the Nhs, which is why I hope I get to deliver this one here as in we stay as long as spring.

Hmmmm, i would be questioning the income of the hospital for a cs compared to vaginal. And with few exceptions womens bodies really ARE capable of natural delivery or else the species would die out. I have read a number of reports that suggest that cs rates have risen dramatically both to control birth and as a result of doctors not studying natural and healthy births but only seeing 'worst case scenario' and putting those observations onto all women.
Of course there is a role for this life saving surgery in plenty of cases but at the end of the day it IS major surgery that can have serious risks and complications.

a lot of historical high mortality rates was down to simple things like infection caused by not washing hands. As stuffthenonsense says the majority of women are capable of giving birth naturally.

From what i know of birth in the states (i'm an expert based on OBEM ) i think you could argue that intervention is so routine obs prob almost never see a natural delivery. Routine epidurals etc and a 30% cs rate (compared to ina may gaskin's rate of 2% working in the same population)

Tbh cherry imo the states should be ashamed of it's maternity care. Maybe if they kept records of maternal mortality there would be improvement.
No, you would not have been expected to push for more than 3hrs in nhs care.

It's very sad that your friend lost a baby. Many babies die in hospitals, and some of those will do so because of over medicalisation. Intervention can be life saving, but it can also create problems where none existed, which can lead to lives lost.

I went to see my colorectal surgeon earlier this year but he wasn't in and I got his young, childless, female registrar. I wanted to discuss a vaginal birth following repair surgery.

She told me my consultant had said he supported it but she just wondered why I would even want a VB when no one would disagree with a CS following my surgery.

She said she didn't know a single colorectal surgeon who wouldnt have an elective CS.

To be fair though, if she saw women like me day in, day out I can understand why.

I am a rare case but she didn't see it like that/ think the risk was worth it.

I know where I'd rather have my baby.

Besides, it is hardly surprising that a surgeon/consultant would choose surgery is it!

I was about to say are you American and then I saw your next post!

One of my friends is a consultant ob/gyn and she has had vaginal births. One of my ob/gyn colleagues is pregnant and planning a vaginal delivery.

I dont think this is the case in the UK. I know lots of people working as doctors in O+G who have had babies, and dont know of a single one who has had a non-medically indicated CS (though I expect that they could have had one if they had wanted). Thats not to say it never happens, but I dont think that most female O+G go for non-medically indicated CS.

Interesting. The surgeon who performed my second c-section told me something similar. She said she had had three elective sections and was pregnant and had already booked in her fourth. She said (her exact words) 'you lose all romantic notions about birth in this job').

What about midwives, though? They see births of all kinds - probably a far more varied array than Ob/Gyns. I wonder what the rate is with them? Anecdotally, the two midwives I know have both opted for home births.

I think women should be allowed to choose what they feel is best for them with their individual circumstances. Having said that, C sections should always be carefully weighed up - I have a friend who is having trouble conceiving because of scar tissue from 2 previous c sections. If a normal delivery was going to be difficult for me, I would definitely want a c section though.

"i see it less as evidence towards better outcome for the mother than as evidence of their belief system though - that science can improve upon nature. presumably why they chose medicine and surgery as a career rather than horticulture."

Indeed! Very good point!

cherry, just to clarify, that's not a midwife, it's a labour and delivery nurse. If you have a nurse-midwife in the US she conducts your delivery too :)

On the topic at hand, I do know of midwives who have chosen elective section. And midwives are certainly very aware of the longterm risks of vaginal delivery, but they also see many more normal births than an OB.

I suspect it is mainly a product of different belief systems, though.

It's kind of what we knew all along in our hearts put down in writing really

Moonfaced.to say the states should be ashamed of their maternity care is exactly the attitude I dealt with from midwives in theuk before I went to the states and had a superb birth experience.the fact you have to have health insurance can indeed be criticized but I have received outstanding care every time I have been in hospital here.
The thing is when I survey the ten friends who have given birth in the uk under Nhs care, all except one had poor experiences.some are so affected they have decided not to have a second child.
Now I realize this is anecdotal but it is from reported experience of friends giving birth in London.
The thing is giving birth is risky and some women will have problems from vaginal birth that a c section would have prevented.
My theory is that on those occasions when a c section is the best option, in the uk,it is less likely to be offered because of cost factors and that is wrong.okay soin the states it is probably offered too quickly but I think that is preferable when you consider the effects upon baby and mother when things go wrong.
I cannot say enough good about the us system and the choices you are given here.

In the US system a lot of choices are taken away, too. The insistence that one dilates at 1cm/hour, and the fact that you have to wait to push until the doctor is ready! To be fair, it does depend a lot on what state you're in, and what hospital.

Of course, if you lack health insurance, you don't really have many choices at all, a problem no one's going to run into in the UK.

quite zim.

Cherry in particular i am thinking of the fact that no records of maternal mortality are kept in the states. Are womens lives worth so little that their deaths are not worth of note?

Shamefull.

There is no cost bennefit to the nhs of withholding a necessary section. They carry the financial burden of any further care and treatment required so it is in their interest to seek the best outcome. The cost of a cs pales in comparison to life long care for an oxygen deprived baby.

And the nhs isn't perfect but it has no profit margin to maintain.

I think part of the issue is that all drs are very at ease in the hospital environment, understand the system and will be familiar enough with their colleagues to know who they want to do the sugery. It is a very different experience for the average NHS user.

I detest hospitals (having gone to them mostly to watch rellies die or be diagnosed with horrible things like cancer). They make me a bit panicky. I've had too lots of surgery and my first words on coming round both times were "can I go home yet". All I wanted to do was get out of the place. If I had a section, it would be pot luck who did it and whether they did a good job. In the shoes of a dr, I might well chose a section too, but as a mere patient I would much prefer a delivery with as little intervention and time in hospital as possible.

two not too