Interesting...

I had told my ob that i would rather do a c section because i was so scared of delivering one vag and than needing an emergency c section for the second baby. My ob was all for the vag delivery, said he had lots of experience with breech extractions and that he would hate to have me go thru major sergery and have to go home and try to recover with Two babies just because i was scared of what could happen.
I had a wonderful birth experience delivered both babies vag. 9 minutes appart, abigail was 5 lbs 10 oz and mason was 5lbs 5oz. No NICU for either of them.

 

My dr (who is well known for delivering twins) said unless they were both head down, he wanted to do a c section. He said you never know what could happen to baby b after baby a comes out.

I trusted his experience and knowledge so I ended up having a csection. Since I dont know what a vaginal birth recovery is like i have nothing to compare it to but all I can say is it was not a bad recovery. I definately needed my pain killers on the scheduled time but as long as I took them, I was fine.

 

My Baby A was head down, Baby B was breech. My OB had no problems whatsoever delivering them vaginally ... And I'm a small person (5'2", 100lbs). It's definitely better for babies to be born vaginally if they can be .... the stress of going through the birth canal helps to remove the amniotic fluid from the lungs, and fewer vaginally birthed babies end up on vents. After all, vaginal delivery is what was intended by nature.

 

"If you want scientific proof, my best recommendation would be for you to become an RN and do labor & delivery for a living."

Um....no.

Brook, as a medical professional, I would expect you to know the difference between scientific proof and anecdotal evidence. You are using a common debate fallacy by introducing your own personal experience as proof. To what, I'm not sure. That SOMETIMES c-sections are the safest way for twins to be born? I agree with that. What I don't agree with are the medical professionals who tell women it's safer--across the board. It's a lie. There is no proof. Yet right here on this board we have many, many women who are being told this. And even if their gut is telling them otherwise, they will follow their doc's advice. Why? Because he/she is the expert, of course. I guess it begs the question: Do you have to be a medical professional to read the literature and have a good understanding of risks and benefits of any given procedure or intervention--including cesarean surgery? I think not. This is where you and I disagree and will never come to terms. The way I look at is that the burdon of proof is always on the expert making the assertations. PROOF. Not OPINION. There *is* a difference.

Yes, deciding between vaginal birth and a c-section is a personal choice. However, when I hear women saying that they're not sure what to do and their doctor is basically dictating how things will proceed, I don't see how it hurts anyone that I suggest doing some further research on the topic before taking the doc's word as gospel--regardless of how well-regarded he/she is. Doctors are people and they make mistakes and have their agendas just like everyone else on the planet. That's NOT doctor bashing in the least. It's called informed choice. Why does this bother you so?

FYI: I'll admit that sometimes I get a bit snarky. But I really don't appreciate being called a "birth Nazi". I find it completely offensive and unnecessary.

 

QUOTE(mom23cuties @ Apr 26 2007, 02:55 PM) [snapback]234917[/snapback]
Vaginal birth has it's own set of risks also, but I don't believe women's bodies were designed/evolved to routinely malfunction. Babies are *supposed* to go through the birth canal. I, for one, don't feel the need to question that assumption unless something is obviously askew.


QUOTE(mom23cuties @ Apr 26 2007, 07:21 PM) [snapback]235211[/snapback]
Did he mention that having a c-section puts future pregnancies at risk? It's not some benign procedure. It's major. And it's quite painful. Plus, I've already mentioned the issues with the babies' breathing.

So what is the reason women are soooo loyal to their doctors? Is it shyness? A need for approval? A sense of safety? Cultural conditioning? Seriously. What is it that would drive a woman to be medically induced or undergo major abdominal surgery just to make sure *her* doctor is present?


QUOTE(mom23cuties @ Apr 30 2007, 09:15 AM) [snapback]238331[/snapback]
You are entitled to your opinion. And so is your well-regarded OB. I prefer evidence when making my healthcare decisions.


QUOTE
Brook, as a medical professional, I would expect you to know the difference between scientific proof and anecdotal evidence. You are using a common debate fallacy by introducing your own personal experience as proof. To what, I'm not sure. That SOMETIMES c-sections are the safest way for twins to be born? I agree with that. What I don't agree with are the medical professionals who tell women it's safer--across the board. It's a lie. There is no proof. Yet right here on this board we have many, many women who are being told this. And even if their gut is telling them otherwise, they will follow their doc's advice. Why? Because he/she is the expert, of course. I guess it begs the question: Do you have to be a medical professional to read the literature and have a good understanding of risks and benefits of any given procedure or intervention--including cesarean surgery? I think not. This is where you and I disagree and will never come to terms. The way I look at is that the burdon of proof is always on the expert making the assertations. PROOF. Not OPINION. There *is* a difference.

Yes, deciding between vaginal birth and a c-section is a personal choice. However, when I hear women saying that they're not sure what to do and their doctor is basically dictating how things will proceed, I don't see how it hurts anyone that I suggest doing some further research on the topic before taking the doc's word as gospel--regardless of how well-regarded he/she is. Doctors are people and they make mistakes and have their agendas just like everyone else on the planet. That's NOT doctor bashing in the least. It's called informed choice. Why does this bother you so?

FYI: I'll admit that sometimes I get a bit snarky. But I really don't appreciate being called a "birth Nazi". I find it completely offensive and unnecessary.


As a non-medical professional, I guess I shouldn't assume that you know the amount of training and education that goes into my profession. I am well aware that anecdotal evidence is not scientific proof. But I consider my 2,000+ hours of professional training, the countless hours I've spent learning just because of my own curiousity or because I have a patient who is dealing with a specific issue and I feel obliged to make sure they are well educated about ALL options, and the 10 years I've been reading The Journal of Maternal-Fetal and Neonatal Medicine would make me at least a little qualified. Part of our difference of opinion comes from the fact that you have studied healthy pregnancies with a focus on vaginal delivery. I have studied typical and atypical pregnancies with a focus on the safest thing for both mother and child. My specialty is high risk pregnancies while yours is low risk. My personal experience could be of the norm or not -- but what I have learned through researching those issues (what do you think, they bring in a new situation and we just "decide" we know what it is?) through studying medical journals and sites, is that there are times that vaginal delivery is NOT as safe as it is made out to be. It may turn out to be okay 95% of the time, but when you weigh the odds that 5 out of 100 children will have significant issues due to certain things AND you understand in full detail just what those issues are, you would think very differently. Add to that the fact that I have lived TWO high risk pregnancies, one which touched on the majority of common bigger issues (never got GD or PIH). I am not "making opinions," I am basing my information on solid fact -- something that is often lost when there is a sway one way or another. I am not for or against either c-section or delivery so I believe my views are probably a bit more unprejudiced.

I am all for researching and gathering information in order to make an informed decision: It is my job to assure people have been provided with ALL of their options, as well as resources for them to make a decision. I don't, however, feel that making someone feel that their body is failing them or that they are failing their babies if they don't go through the birth canal is okay. And I have a HUGE issue with the whole bonding thing -- 4 of my 5 children were in the NICU, one for 7 days, one for several hours, one for 71 days and one for 66 days. And guess what? We're perfectly well bonded, just as bonded as the son who never left my side and that came home with me when he was 11 hours old. To me, that is a scare tactic and is NEVER appropriate. I have seen a few (less than a handful) of women who were not bonded with their babies, and based on their lifestyle, I would bet that would have happened had they been in the NICU or not. Hard to bond when you're baby is withdrawing from heroin and you're looking for your next fix.

I am typically a proponent of vaginal birth if there is no underlying medical issues. But since you don't know the medical issues at hand, making a statement such as "I don't believe women's bodies were designed/evolved to routinely malfunction. Babies are *supposed* to go through the birth canal. I, for one, don't feel the need to question that assumption unless something is obviously askew." This implies that unless there is a specific problem with the pregnancy that it is wrong to not deliver vaginally. That is not always the case. There are plenty of problems that a woman can have that put her at higher risk which I would bet you have never even heard of. Your statement makes it seem as if a woman is failing her baby if she doesn't have a vaginal birth. That's my opinion and I know others felt the same way because they contacted me.

"Did he mention that having a c-section puts future pregnancies at risk? It's not some benign procedure. It's major. And it's quite painful. Plus, I've already mentioned the issues with the babies' breathing" You and I had an argument not too long ago about having a VBAC while pregnant with twins -- I was TOTALLY against, you were for. So I am curious as to why the change of heart? If it was safe to deliver twins after a VBAC, then just what risks are you talking about? The risk of infection, the risk of implantation issues, acretia, what? And who told you that a c-section is "quite painful"? I have had 2 vaginal deliveries, 2 c-sections. My first vag was WAY more painful than my c-sections, but my 2nd delivery was much less. There are a lot of women who do great after a c-section just like there are a lot of women who require significant pain control after a vaginal. I conceived twins just 7 weeks after delivering via c-section and my c-section was NOT an issue during my pregnancy whatsoever!! Is that true for everyone? No. But the risks for a c-section are much smaller than you lead people to believe, at least in the way that I am interpreting your words. Of that, there is scientific proof, NOT opinion.

If you are talking about being snarky in reference to rude comments such as, "You are entitled to your opinion. And so is your well-regarded OB. I prefer evidence when making my healthcare decisions", then I have no understanding for why the term "birth nazi" would bother you. I don't see it as any more snarky, unnecessary or offensive than your comments.

 

The thing to remember is that you will never be able to scientifically prove that c/s are more healthy for babies... You can't prove that a baby who died or was injured as a result of waiting too long or a long vaginal delivery would have lived if a c/s were done. You can guess about it...but you can't prove it. It's like trying to prove that bedrest really works... it makes sense...but did you know that there is absolutely no scientific proof that it actually is helpful!! Now most of us have plenty of anectdotal evidence that it works...and it makes logical sense that if a woman is contracting or has a shortening cervix that she ought to lie down... But there is no way to prove that a woman who gave birth prematurely wouldn't have given birth so early had she been on bedrest. You can't reproduce the exact same woman with the exact same pregnancy and try it with bedrest.

An interesting note here...in education circles anyway, anectdotal evidence is very valid... It's not just the scientific, empirical evidence that is considered useful. And I think plenty of us that have been on bedrest are glad that our doctors went with "common sense" instead of just the empirical scientific evidence. For the same reason there are plenty of women out there that SHOULD have c/s. And plenty of women who will be fine with vaginal deliveries. I think almost any health care professional who has seen a number of deliveries would tell you that if there is any extra risk a c/s is well worth it to "guarantee" as close as possible a healthy baby. Here's some more anectdotal evidence... my aunt is an anesthesiologist...she's seen lots and lots of crash c/s...and she's seen what happens to a baby who has been in an extra long labor or for whom extra risk has been taken...as opposed to simply doing the c/s first.. My aunt just about flipped when she found out that I was even considering vaginal delivery for my twins. And when my baby A went transverse, for the peace of the family, I was relieved... I simply had the c/s. For my own sake I was disappointed. I think die-hard proponents of vaginal delivery, do need to remember that many, many women who have c/s are genuinely disappointed in that fact. Perhaps if we all remember this we will be more supportive of them in their decisions or in their doctor's decisions. Instead of bashing each other over having a c/s why don't we try to be supportive..."yeah I know it stinks and in an ideal world you would have a perfect vaginal delivery...but you did what you and your doctors felt was best for your babies..." And leave it at that. How you give birth is not so important in the long run. I personally think that women should stop judging so hard on this aspect and just be more supportive... of course I feel the same way about breastfeeding...lots of women don't do it for a variety of reasons... and most of those women are disappointed over not having the ideal breast feeding experience..and it doesn't help to have other women point at you and act like it's your fault or continually harp on the benefits of breastfeeding...that only makes it worse.

We all know vaginal delivery has it's benefits. But certainly c/s can have benefits too...as in the case where a baby simply will not come out vaginally...or in the case where both twins are transverse or breech. I have no doubt that if I had lived a hundred or more years ago in an area where no doctor could be found to do a very nasty version of a c/s that I would have died and my babies too. So I'm extrememly greatful to not only have the c/s possibility, but to have it available in a relatively comfortable manner. We are extremely blessed to have such flexible, professional medical care. Even 55 years ago, they didn't have this flexibility...even for vaginal deliveries...if you gave birth in a hospital you were mostly knocked out by drugs and instead of pushing your baby out they pulled him out with forceps... Hows that one for vaginal proponents??... Times have changed and we're very blessed to have a variety of relatively safe birthing options. Thank GOD for c/s... and thank God for doctors who know when to make the call that a c/s needs to be done. Let's not second guess any woman or their doctors on what choice they make!!

 

"We all know vaginal delivery has it's benefits. But certainly c/s can have benefits too..."

Ok. This has gotten really out of hand.

I would never argue that c-sections don't have benefits. My point was that doctors should NEVER tell a woman "you must have a c-section" across the board. Surely, anecdotal evidence plays a valuable role, but it shouldn't mean that it trumps all else. There IS empirical evidence (that in uncomplicated twin pregnancies with a vertex Baby A) that there are no medical benefits to c-section. There is also research that debunks the "old school" thinking that ALL twins need to be induced or sectioned by 36 or 37 weeks. There is EVEN some research showing that a breech Baby A can be safely delivered vaginally--especially if mom has already given birth vaginally. How many women know this? How many doctors tell their clients this?

If a woman's particular doctor doesn't have experience with vaginal birth and that's what she's hoping for, then it's in her best interest to shop around for someone else who is qualified to help her have the safest vaginal birth possible.

So, to reiterate my original thought:

Personal opinions are personal opinions. Everyone has those. But when I'm making decisions about the health and welfare of my unborn babies and myself, I would hope for a bit more from a medical professional. Isn't that what informed consent is all about? How can you inform women about the risks and benefits if all you have to base that on are your own biased experiences? You can't, because the doctor down the road may have a whole different set of experiences that are also shaped by his environment, his colleagues, his client base, his insurance, his history of litigation, his fears, and his personal values. That's why we NEED to consider the science behind the recommendations.