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Thread: Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On Y

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    Default Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On Y

    http://www.friscowomenshealth.com/?o...5&lang=en&p=89


    Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On You



    Posted on November 14, 2012 by Jonathan Weinstein


    I have been a practicing OB/GYN for fourteen years. I live in Frisco, Texas, one of the fastest growing cities in the United States, and I truly enjoy living and working here. It is a great place for my family and, for the first time, my office is attached to the actual hospital I practice in. This is the third and final place I will practice medicine. I trained with some of the most respected academic OB/GYN?s in the country. These physicians have contributed to books on Obstetrics, created practice guidelines for the American Congress of Obstetricians and Gynecologists (ACOG), and taught me to practice medicine based on scientific evidence.

    I follow a few simple rules: do no harm, give your patients options, and provide information so they can make informed decisions. So, last night I was sitting in my office looking at the fourth Cesarean Section (C/S) operative report of the day for yet another patient who wants to have a vaginal delivery following a previous C/S. I am frustrated and feel like I am fighting a losing battle.

    When did Cesarean Sections (C/S) and elective inductions at 39 weeks become the standard of care? That is not what I was taught, and that is not in any textbook or ACOG practice bulletins. So why in Dallas, Texas do people have to drive more than an hour to find a doctor who actually has no desire to do an unnecessary C/S? It has become obvious that I cannot attend every vaginal birth a patient wants to have after their traumatizing C/S experience. If close to 50% of the patients are getting a C/S each day and there are hundreds of practicing OB/GYN?s in the Dallas Metroplex, the math is not difficult. I know at least one physician who only does C/S?s, and vaginal delivery is not even an option. If one of his patients delivers vaginally it is only because the baby came faster than he could get to the hospital.

    This is the only place I have lived where C/S and elective inductions are king. So, women of the world, I am giving you the knowledge to stand up for yourself before you get that first C/S!



    Top Ten Signs Your Doctor Is Planning To Perform an Unnecessary Cesarean Section on You

    1. Arrives to L&D immediately after office hours and says, ?I just don?t think this baby is going to fit.?

    2. Third Trimester, Routine Office Visit, ?I think this is going to be a big baby. You should just have a C/S? ? Did you know? ACOG has very specific guidelines for when it is appropriate to offer a patient an elective C/S for MACROSOMIA (fancy word for large baby). ?Prophylactic (elective) cesarean delivery may be considered for suspected fetal macrosomia with estimated fetal weights greater than 5,000 gms (11 pounds) in women without diabetes and greater than 4,500 gms (9.9 pounds) in women with diabetes.

    3. ?We should induce at 39 weeks because your baby is getting too big? ? Did you know that, according to ACOG:

    ?Induction of labor at least doubles the risk of cesarean delivery without reducing shoulder dystocia (rare situation where baby?s shoulder can get stuck at delivery) or newborn morbidity(complications). Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.?

    4. Performs routine ultrasounds at end of pregnancy to see how big your baby is. Did you know that ultrasounds at the end of the pregnancy can be 1-2 pounds off? Ask some VBAC patients who were talked into a C/S for this, then had a vaginal delivery of a bigger baby the next time.

    5. ?You have a positive herpes titer (or history of herpes); the baby will get it if you deliver vaginally.? Try some Valtrex for the last month of the pregnancy that is pretty much standard of care now. It prevents outbreaks and allows for a normal vaginal delivery.

    6. ?Your baby is breech. You need to have a C/S? Ever heard of or performed an External Cephalic Version (process by which a breech baby is turned to the proper position)? It really does work.

    7. ?You have pushed for 2 hours? (with an epidural that prevents you from feeling anything so you are probably not pushing effectively; this is evident on exam because the baby?s head is still perfectly round, but you do not need to know that) ?It?s just not going to come out?

    8. ?I scheduled you for an induction at 39 weeks. It is just soooo? much more convenient for you!? (and so much higher risk of ending in a C/S, especially if you are not dilated when you start the induction). At least 80% of my VBAC patients were induced the previous pregnancy. For whose convenience was the induction?

    9. First Visit (7 weeks), ?Congratulations you are having twins. I will go ahead and schedule your C/S at 38 weeks, but don?t worry if you go in to labor early I will cut you right away!? Translation, ?I am scared out of my mind for you to deliver your babies vaginally because I am not trained on what to do when the second baby is coming, plus it pays more to cut you open. Oh yeah, I don?t have that great a rapport with you because I only spend 2 minutes (fundal height, heart beat and ?I?ll see you next time?) with you each visit, so I am afraid I will be sued for trying to do the right thing.?

    10. First Pelvic Exam in Office (7 weeks), ?Hmm, your pelvis is pretty narrow?.

    Bonus Tip:

    11. 38-week visit, ?Your blood pressure is a little high today. You are probably developing preeclampsia or toxemia. That can cause you to have a SEIZURE! The treatment is to deliver the baby. You need a Cesarean Section, as this is the quickest way to resolve it. Let?s get you up to L&D NOW!? Translation ? Preeclampsia or Pregnancy Induced High Blood Pressure is a pain in the butt. If I induce you, it could take 24 hours or more and then I would have to manage your blood pressure, and put you on Magnesium. This is way too inconvenient. Do not worry you can try to have the baby vaginally next time. Yeah right!



    Well, I hope you future moms find use for these tidbits of info. If anyone wants to add anything, please feel free. Your experience may help other women in the future. Remember, there are only a few emergent reasons for a C/S such as fetal distress, unexplained heavy vaginal bleeding, etc. It is okay to ask your doctor questions. We are not supposed to bite.



    Jonathan Weinstein, MD, FACOG

    Obstetrician/Gynecologist



  2. #2

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    Awesome!!

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    Default Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On Y

    Ahhhh they all wanna cut me open!!!!

    Naa I'm lucky I have a great ob both my friends went to a "natural" pro vaginal birth ob and both ended up with those 10 things

    Love mine she looks at baby yep everything looks good see you next time Even when I started getting complications she was happy to see if baby would come before 41 weeks first

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    wow, 41 weeks. how generous when normal gestation is up to 42 weeks.

    when the c section rate is close to 30%, there is a lot of unneccessary cutting going on.

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    Default Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On Y

    I had problems with my placenta so it would have been dangerous to go much longer instead of just cutting me open she waited to see if I would go into labour on my own

    I would be interested to see how much the cs rates go up from those figures in the weeks leading up to Christmas I found even when I was booked into an induction it was busy because everyone wanted their baby the week before Christmas and not on Christmas

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    They missed the top reason! How do you know your Ob wants you to have a section? You have an Obstetrician. There you go.

    Giving me the knowledge to stand up for myself? Don't make me laugh. I had the knowledge and I tried. Hard to stand up for yourself when you're pinned down and your husband agrees to anything They say.

    (Not that I'm jaded here.)

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    Quote Originally Posted by The Flying Butter View Post
    They missed the top reason! How do you know your Ob wants you to have a section? You have an Obstetrician. There you go.
    Hehehe

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    [QUOTE=The Flying Butter;3234603]They missed the top reason! How do you know your Ob wants you to have a section? You have an Obstetrician. There you go.

    QUOTE]

    I know you've had a bad experience, but not all obs are like that! I've had ob care for two of my four babies and both obs were far more in favour of natural unassisted birth then any of the midwives I've ever had. If not for the persistance and determination of my first ob, I would have ended my first labour with a 'real' emergency c-section (ie, not even time to go from the delivery suite to the theatre type emergency c-section). I know there are plenty of bad ones out there, but I don't think they should all be tarred with the same brush.

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    Wow - love how they can bamboozle you with big words and frighten you into submission....

    My OB was great.

    I was told that he had a very high CS rate and that he would try to talk me into one.

    I freaked out at first only to find that on my first visit that he had no intention of a CS. He asked me how my first pregnancy was and if I delivered vaginally (it was 15 years before). I gave him a quick rundown on what my labour was like and he said, oh well, we'll just go with that then shall we?

    CS was never mentioned....not once!

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    Quote Originally Posted by misty View Post
    I know you've had a bad experience, but not all obs are like that! I've had ob care for two of my four babies and both obs were far more in favour of natural unassisted birth then any of the midwives I've ever had. If not for the persistance and determination of my first ob, I would have ended my first labour with a 'real' emergency c-section (ie, not even time to go from the delivery suite to the theatre type emergency c-section). I know there are plenty of bad ones out there, but I don't think they should all be tarred with the same brush.
    I will point out that I did say I know that I'm jaded, although for some reason you chose not to quote that part. And I have met some nice Obs and nice midwives - but none, as yet, I would trust anywhere near me as I laboured. But that's my experience talking, I am pleased others do not have this experience.

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    Yeah, TBH my OB first baby wasn't like that either.

    Now I'm in the public system they are all trying to gear me up to have another C/S on their terms, going on about the induction. Lucky I had the risks of both explained already to someone rational in my previous pregnancy. I'll never agree to induction with the risk of E C/S being so high but that is my personal choice. They are trying the baby too big thing too, becuase I stack on heaps of fluid weight, so the fat police are out in force to making wild claims about my babies size and the risks.

    I just found it odd they went "oh if this happens we will be doing this" I thought to myself really? This is the kind of "care" you give people?

  12. #12
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    Default Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On Y

    I am so tired of obstetrician bashing.

    That's all.

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    Default Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On Y

    I think its an informative article. There are things you have to watch out for doulas too and I am happy to list them. Doesnt mean I am bashing them though. Wherever you get carers there will be types to look out for - better to know what those things are.
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    In 2015 I went Around The World + Kids!
    Forever grateful to my incredible Mod Team

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    Quote Originally Posted by Rach83 View Post
    I am so tired of obstetrician bashing.

    That's all.
    I am more concerned about the women who are undergoing unneccessary surgery and having their rights denied.

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    Stand up for yourself then. I do. Sometimes this stuff can create paranoia about OB's when I have found its the hospital and the registers to be most of the problem in my case.

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    Default Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On Y

    You'd be surprised how many people believe these things though. If an Ob puts an induction on the table without disclosing risks (mine didnt, made it sound like I was booking in to get my hair done) then people wont see any problem with it and think its just kicking of labour as it would be without one... People DONT know this stuff - we're not born knowing it - I had no idea myself until a friend lent me a copy of 'Misconceptions' by Naomi Wolf. Then, you have those who are afraid to stand up for thenselves or cant... Especially if the Ob plays the dead baby card which I have seen a few times, and heard of even more. What do you do then? Luckily my clients hired a doula, so they had a chance. All had very healthy babies, no dramas - one in less than 4 hours.
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    In 2015 I went Around The World + Kids!
    Forever grateful to my incredible Mod Team

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    Default Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On Y

    Quote Originally Posted by Lolpigs View Post
    Stand up for yourself then. I do. Sometimes this stuff can create paranoia about OB's when I have found its the hospital and the registers to be most of the problem in my case.
    that's quite insensitive to women who have experienced trauma at the hands of care providers who lied to them or did things to them without their consent.

    I don't know about you but when I was in labour, I was in no state of mind to be fighting battles with people who wanted to be doing things to me that I wasn't ok with. Sadly our maternity system doesn't really allow for continuity of care so you can have stuff written down in a birth plan or you can have stuff written in your notes but if you show up to hospital in labour, it's luck of the draw as to whether the person 'caring' for you will respect your wishes.

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    Default Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On Y

    I was induced at 42 weeks with my first, ended in Emerg C/S. it was still a good birth. With my second I had done all my research and I found an ob in my area that was very VBAC friendly. He was fantastic. I made a birth plan. In the middle of full on hard core labour I fought with both my MW's and the on call ob and I didn't back down till I got what I wanted - so yes you can stand up for yourself in the middle of labour! But it's the power of knowledge that gets you over the line. I had obs tell me bub was to big at 36 weeks and just book in for a repeat CS. But I was determined and did everything in my power and got mt VBAC with my 9p 2oz little boy.

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