Death twice as likely by caesarean

Been following with interest and I agree with Maz! Kelly is there any research about rupture and births close together?? Mine will be 16 months apart so although it hasn't deterred my determination for a vbac I just wonder if the risk is higher when they are so close together? Also isn't the risk of u/rupture the same percentage as the risk for cord prolapse in any vaginal birth?

ETA- Also, what are the signs that a rupture has occured? Would you know while in pain of labour that there was something else wrong????

I have had 4 c/s - 2 emergancy c/s and 2 planned. with my 2nd pg I wanted a VBAC but as I went into early labour (it was stopped) at 34 weeks - I had to have a planned c/s due to my scar being torn internally from contractions. I had a nice black bruise across my scar for well over a year due to this.
I get really peaved at this mummies who are to posh to push as it gives us mummies who really cant do the ah la natural birth (and we really want to) and have to have a c/s a bad rep.

YEs, its great to know the facts but I get so sick and tired of hearing all the negetives about a c/s and statistics along with it. We dont hear the bad things about natural child birth.

I think people need to tread carefully on this subject as yes, It is very hurtfull to continually hear that c/s's are terrible and without realising it, people can often make us feel like second class citizens

Apologise to anyone I may peeve off about my post - and for not keeping my mouth in my draw PMSL

You could never compare it to cord prolapse because you could have a midwife or Ob rupture the membranes on a high baby and get a prolapse which was completely unavoidable in the first place. I think Obs like the scar to be healed for 12 months but prefer 24 but I am not sure with the scientific answer sorry.

A good Ob would recommend you not have an epidural if you have a VBAC as you will be quicker to spot a rupture in the RARE event it will happen. An epi will cover the pain. But my teacher who has been doing support for almost 30 years has only seen one rupture ever and they actually were able to repair it and she saved her uterus. Thats one birth in 30 years of practice. Also you have to remember that rupture rates are increased by inductions, so they wont induce you, or if they do they are VERY silly. And I mean pharmaceutical inductions. You can still rupture with no prior c/s but if you are induced - so why aren't people afraid of inductions? You can even lose your uterus from haemorrage. It DOES happen. But people are more comfortable being induced than a VBAC. Don't get it.

Maz - natural childbirth rarely does go wrong - its a process as natural as digestion. Sometimes we get digestive disorders but heck the world has a functioning digestive system that serves us well! But vaginal birth can go wrong where inductions have been involved, forceps etc. Natural (i.e. vaginal + NO drugs or pharmaceuticals) is the way of minimal complications. Its just a fact that there are more complications with surgical birth and again, its not something we should hide from the public - they would be outraged if no-one said anything. For some women it's needed and in those cases then the benefits definitely outweigh the risks.

It's just a sad fact that many women are having unneccesarians and the wool is being pulled over their eyes. Its all in the care of the woman and how she is treated - and what support is available to her. As someone said to me today after asking what I do, 'I had continuity of care from my ob! I was induced twice at 9 days past my due date so my Ob just did a ceaser, so I already had continuity of care.' Of course we can all guess what happened with the second birth.

I'm glad she's happy with that though, I wouldn't be. We take too much as gospel.

Then you've got the other end of the scale where doctors insist on "natural" births only. It's so ridiculous. I don't think anybody gets pregnant just to give birth, but to have a happy and healthy baby. As long as mum and baby are safe that should be the most important thing.

Natural birth doctor accused of caesarean baby death blunder
By JAMES MILLS and MARTYN HALLE - More by this author ? Last updated at 08:13am on 19th September 2007

A leading obstetrician who is a strong advocate of natural births is accused of causing the death of a baby by failing to perform a caesarean section soon enough.

Dr Susan Bewley, who has spoken out against the rise in "unnecessary" caesareans, allegedly delayed carrying out the emergency procedure until it was too late to save the child.

The 49-year-old consultant is due to face a disciplinary hearing at the General Medical Council and could be struck off.

But colleagues claim the tragedy was not her fault as she had not been given a proper briefing about expected complications before she delivered the baby.

One colleague said: "She was not given the woman's notes and was unaware that the baby was at risk.

"She didn't deliberately decide to hold back on the caesarean. When she realised the baby was in difficulty she acted quickly but it was too late.

"Susan is very distressed by what happened but the view is that she would have acted differently if she had been briefed about scans that showed the baby was at risk and needed to be delivered sooner rather than later.

"She is a controversial figure and she seems to have been made the scapegoat for what has gone wrong."

The tragedy happened at Guy's and St Thomas' Hospital in London in December 2004 but Dr Bewley has been allowed to continue in her job.

The mother who lost her baby had caesareans to deliver her first two children but Dr Bewley apparently felt she was capable of a normal delivery for her third.

As complications developed during labour, she performed an emergency caesarean. But the infant died soon after the birth.

After an investigation by the Healthcare Commission, Dr Bewley and a junior doctor were reported to the GMC and a midwife was reported to the Midwifery Council.

Dr Bewley, who has worked at Guy's since 1994 and is a former head of the obstetrics and gynaecology department, is the only one to face disciplinary charges as a result of the complaint and will face a hearing on Monday.

The panel will decide whether Dr Bewley's 'examination, assessment and treatment' of the mother was 'of a standard expected of a reasonably competent obstetrician'.

Caesareans carry an increased risk of death for mother and child and Dr Bewley has been at the forefront of calls for more natural births.

In Britain almost a quarter of all babies are now born by caesarean. Its popularity has been fuelled by celebrities and those 'too posh to push'.

Last year Dr Bewley and two colleagues warned in the British Medical Journal that women were being given needless caesareans because of the decisions made by inexperienced young doctors and a shortage of skilled obstetricians.

Dr Bewley, a former co-chairman of the Gay and Lesbian Association of Doctors and Dentists, lives with her female partner in South London and has a nine-year-old son, to whom she gave birth naturally at home.

A spokesman for Guy's and St Thomas' said: "Apart from the current case under consideration by the GMC, there have been no other concerns raised about Dr Bewley's clinical capability, her commitment to her patients or her judgment.

"She is highly regarded by clinical staff who work with her and has not been the subject of any disciplinary action or any investigation into personal or professional misconduct.

"It would be inappropriate for us to comment further at this time."

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One colleague said: "She was not given the woman's notes and was unaware that the baby was at risk.

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This pretty much sums it up - number one, the hospital staff would be held accountable for not informing the ob of the risk and history, and secondly, why on earth didn't she read the history/chart when advising on what to do. I doubt this type of thing is common practise and is a case where there are other circumstances that need to be looked at, not just at the fact that the ob is pro-natural birth.

Kelly -thanks for that info. Ok so on my list so far I have, a doula (still to convince DH but Im very close ;) ) we will not have an epidural(that scares me a little because I wonder if I will be able to cope :( ) no induction (which I think won't be offered anyway)
Ok so far so good - now to work on my fear factor in dealing with pain! Sorry to get so OT too ladies.

Speaking of digestion, here's a great article :D

Birth as a Bowel Movement

ps. it's okay, throw tomatoes, I can take it! I have seen enough behind the scenes of birth to know that some things happen far more than once ;)

LOL I dont think we have too many of those sorts of Obs here in Australia! Did you know we have a higher c/s than the US?! It doesn't stipulate what the complications were, and it may not even be related to VBAC - who knows. But I do know plenty more unneeded c/s are done compared to ones that were needed.

Tan you can have an epi still if you want but its a good incentive based on a wee 0.7% risk!

Kelly

I think you need to write a book with all your knowledge woman - I would have benefitted from it for sure!

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This pretty much sums it up - number one, the hospital staff would be held accountable for not informing the ob of the risk and history, and secondly, why on earth didn't she read the history/chart when advising on what to do. I doubt this type of thing is common practise and is a case where there are other circumstances that need to be looked at, not just at the fact that the ob is pro-natural birth.

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I know what your saying, but I guess what I'm trying to say is as long as baby and mum are not at risk, a person should not be made to feel like they are putting their child at some sort of immense danger or risk by choosing to have a c-section if that means it is in the best interest of the child. I don't know? I think in the country we live in and in this modern age, women put a lot of pressure on each other and themselves and for what ? Education entails knowing all the facts - meaning we shouldn't just get the worst possible stories about c-sections and then based on this , poo-poo this kind of birth. There are just as many "natural birth" disaster stories that you could google but they never seem to get a mention ?
A healthy baby and a healthy mum are more important than silly statistics that don't have anything to do with the individual circumstances of any particular individual at any given moment.

Going for a VBAC here. My last birth was a long labour, she was almost out, we changed positions even attempted a ventouse extraction, but she had to be born by c-section. I do not feel bad or attacked by articles which highlight the risks of c-section births, the information needs to be known and I am pretty sure that the journalist is not thinking of deliberately hurting my feelings when they wrote it. I am thankful the information is getting out there. No one should be denied knowlege to save the feelings of someone else.

Too many ob's run on auto pilot, the ob at my last appt even said that too me. We need to speak up to tell them what we want and to no be afraid of reminding them, for most it will not hurt their feelings (her words). My last birth I did have the auto pilot ob who threw my notes in the corner and went on her merry way of assaulting and belittling me. It was her way only. Having experienced that is it has made me very aware of educating oneself and speaking up not matter how hard it is.

As for the uterine rupture, I heavily discussed this at my last appt. The ob has witnessed one in her time (she looks to be late 30's) and they managed to save the uterus due to monitoring (the bubs hb dropped dramatically). So she admits she is cautious with VBAC and insists on monitoring. She will allow an epidural (I do hope to avoid one though) as there is monitoring in place. I am willing to risk the small chance of uterine rupture for a VBAC as I really believe in the benefits of a natural birth. We are not planning on a large family, so this will most likely be the last time my uterus gets to do its job. If it ruptures I will deal with the possible consequences. There are risks with everything, it is up to us to weigh up the odds for our situation.

PB, there is the point

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as long as baby and mum are not at risk

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by doing unneccesary c sections you can very well be putting your child at risk. I'm not saying that every time a woman has a c section something negative is going to happen, just the same as every time a woman births vaginally it isn't going to go perfectly. But the truth of it all is that there are far fewer complications with "natural" births, meaning no interferance, drugs etc, than there are with c section births.

Of course if there are medical conditions that really do mean it's safer for mum or bub, and I'm not talking about something an OB might suggest off handidly, but true physicological reasons then no one would truelly expect you to choose otherwise.

I noticed in that article too that it never did say just what the complications were.

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PB, there is the point by doing unneccesary c sections you can very well be putting your child at risk.

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I don't advocate "unnecessary" c-sections, but if mum and bub's are at risk and it means going the c-section route then it should be done, therefore necessary to save the lives of the mother and child.

It certainly doesn't make any sense to have an "unnecessary" c-section ?

Good for you Astrid for making a fantastic and wonderful decission for yourself and your baby. I hope your both your sakes that you get exactly the birth you deserve and crave. Im sure there are many c/s mum's out there that are cheering you on.
Have you got a doula for this birth so you get what you want and can chat to the ob..as I know Kelly is a wonderful Doula (have heard many wonderful things) and she acts for the mum to be...so when ob's run on auto pilot and when you cant 'think' due to being in the pains of labour, the doula can be your voice
Now have to ask also - as you are not aloud to be induced...whats your birth plan then if you do not go into natural labour?

i've read this thread with interest. i am a child born via a completely un-necessary c/s - my mum told the dr her EDD based on LMP was one date, he said it was three days earlier. she had her membranes ruptured on the dr's date. on HER date she still hadn't commenced any sort of labour, so the DR went to my DAD to sign the c/s consent forms for the next morning - this wasn't a necessary procedure and it's something that should never have happened. my mum was never able to BF due to issues with milk coming in and coping with c/s scar complications.

i wanted to just draw attention to the one thing that stood out in the article Trish initially posted -

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The study, which involved more than 8 million births in the US over four years, is the first of its kind to focus on full-term babies born to women with no medical reason for choosing a caesarean over a vaginal delivery, an increasingly common phenomenon in Australia.

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i don't consider any of the posts here to be from people that don't have a genuine medical reason. psychological reasons are still medical!! i think what is trying to be said here is the individuals who are told by their ob's (or family - i'm not even utd and my sil is telling me i shoudl have a c/s cos she had issues giving birth and ended up with two emergency c.s) that they should have a c/s. what are the reasons? is it for convenience? i think that's the bit that needs to be pointed out - the article is referring to c/s with NO MEDICAL REASON

FWIW - i think anything that doubles the chances of problems to your child unnecessarily are extremely important to know. a lot of individuals that visit BB (or similar sites) are looking for information and aren't sure where to start. Personally, i havent gone looking for child mortality stats on c/s vs vaginal birth - but i'm a hell of a lot more informed from reading these kind of threads. educating yourself is so important - and it's got to start somewhere!!!

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Now have to ask also - as you are not aloud to be induced...whats your birth plan then if you do not go into natural labour?

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Oh Maz - thank you thank you thank you - I've been thinking this for ages and keep forgetting to write it down and remember to ask someone what to do..... I really need to start a list of questions to ask my doula and care givers I think.

Astrid - fingers crossed for us both that we won't need to cross this bridge when going for our VBAC's but better to be prepared than not.

That's exactly right, Well said Briggsy's girl !

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I know what your saying, but I guess what I'm trying to say is as long as baby and mum are not at risk, a person should not be made to feel like they are putting their child at some sort of immense danger or risk by choosing to have a c-section if that means it is in the best interest of the child. I

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Not being argumentative but the point is, that provided that mum and bub are not in any risk and there are no pre-existing conditions to indicate otherwise, the risk of elective c/s to the baby and mother are much higher than if the mother has a vaginal birth. As you said, all women have a choice and need to be informed of exactly what the risks are, if they decide to go down this path, and articles like the one that Trish has posted does this. I had a c/s after 36 hours of a failed induction and my issue is with my induction occuring when it did (far too early) leading to a cascade of intervention that led to what essentially ended up being a c/s that may not have occured had we waited a few more days. I want to go into this labour fully informed, empowered and ready to know that EVERYTHING I have done and read leads to an outcome where I can say, righteo we did our best, and if that leads to a c/s (It had better not ;) ) then so be it. OT sorry, but just wanted to point this out!

ETA - Well said BG, the other reasons for c/s too after you have had one is being "high risk" in the eyes of some ob's because of a previous c/s. My c/s was not for any other reason than "failure to progress" so there is no reason that this birth will end up the same way. At the hospital I was originally booked into I was classed as high risk and was told by the booking midwife that I would be asked to book into an elective c/s at every apoointment by the ob's.... but supported by the midwives for a vbac.... so I've switched hospitals to where I'm not classed as high risk and where I feel I can give it a good shot.

Thank you BG :hug:

Tanya, Astrid and BG, I hope that by reading threads and information like this that it does not serve to scare you, rather to inform you of what can happen. Of what you can achieve and what the options are. It doesn't always have to be so cut and dry.

Goodluck Tan and Astrid, I hope you both have beautiful births.

And BG, well, we all know that you will demand that beautiful birth hun, just as soon as you get that gorgeous baby growing :D