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    Choosing a Cesarean Section
    Sarah McMoyler, RN posted:

    Historically, cesarean sections (C/S) have been done for specific medical indications to ensure the health of the mom and baby. Currently, the definition of an elective C/S is upon request when there is no medical need. Open and honest conversation with your OB/Midwife is really important as you start to think about the route your baby may be born; they are more than equipped to assist you in decision-making.

    Choosing to have a C/S may include:
    · Convenience factor
    · Fear of labor and delivery
    · Impression that it is safer for the baby
    · Dissatisfied with previous birth experience

    Medical Indications for a C/S can include:
    · Labor is not progressing
    · Pelvic disproportion
    · Placenta problems
    · Vaginal herpes outbreak
    · Previous C/S
    · Breech
    · Fetal heart rate concerns
    · Multiples

    Keep in mind that a cesarean is considered to be major abdominal surgery — great to avoid it when you can. On the other hand, if a C/S is how to accomplish a healthy mom/healthy baby — then I say let's go for it.

    For further information:

    Sarah McMoyler RN
    tlkittycat1968 responded:
    I had two C/S due to prior abdominal surgery. I had large uterine fibroids and had an abdominal myomectomy to have them removed. Due to their size and number, my doctor recommended I not go into labor and have a C/S instead. I still had the rush to the hospital at 1a for DS because my water started leaking two days prior to my scheduled C/S. Recovery from that one was a breeze and I was driving two weeks after he was born. DD was born when scheduled but that recovery took longer. I had some pain and wasn't driving until at least a month after she was born. I had to go to the ER for heavy bleeding (soaking a night plus pad in 45 minutes) 3 weeks after she was born.

    I would have liked to go through labor with both my kids but it wasn't meant to be. I do not recommend a C/S at all unless it's for medical reasons. IMO, convenience isn't a good enought reason.
    phoenix31674 responded:
    I had to do a c-section with DD because of fetal distress. Turned out the cord was around her neck. Recovery was not that bad for me. Thankfully i had the opportunity to vbac with DS and the recovery was much better. Was birth painful? You bet, but the recovery was quicker. after having done both, I can't understand why someone would want to do a c-section voluntarily.
    jmarsh81 responded:
    I am going on my 3rd c-section monday morning. My 1st son was born naturally. With the 2nd I was in labor 36 hrs, and he stuck his arm out 1st, so emergency c-section. With the 3rd, I was going for a VBAC, but had a placental abruption, so another emergency c-section. Now with this LO my dr won't even give me a choice after 2 sections. I would love to have her natural. Of course the recovery is usually easier than with a c-section. But I would love to just have that experience again. Some people prefer c-sections, but I feel like if it is not medically necessary, they shouldn't be elective. It is a major surgery, and not something I look forward to, but I would not put my LO in danger just to get my wishes.
    Me, Jessi 29, DH, Mike 39, DSS, Michael 1991, DS1, Brandon 2000, DS2, Jeremy 2006, DS3, Tyler 2007, DD1, Katie Chyanne EDD 11/07/2010
    Taurino; replied to jmarsh81's response:
    I love that we are able to choose. We are women in a man run world and there is little we get to choose about. It's been proven that women that a pap smear is not needed every year, yet that is the requirement in order for us to get birth control. What kind of medical visit is a man required to do before getting condoms? The choice of how to give birth- even if it is out of convenience-is something we should protect as a woman's right to choose what happen to her body. I personally know someone who's baby died during vaginal birth. She swears she will not be having a vaginal delivery for her next one-and luckily she has that choice.
    Sarah McMoyler, RN replied to tlkittycat1968's response:
    I agree with you completely- if it is medically indicated, the decision has been made for you. Major surgery for conveneince does not make senses- to me. Thanks for sharing your experiences, as well as the heads up about bleeding : soaking a pad once you are home is TOO much bleeding. It must always be followed up with your OB/Midwife.

    Sarah McMoyler RN
    Sarah McMoyler, RN replied to phoenix31674's response:
    Thanks for your account of having had both a C/S and then VBAC (vaginal birth after cesarean). Important to point out that fetal distress warrants the fastest route of delivery- sometimes by C/S. Although, a cord around the neck can sometimes still be a vaginal delivery. Definitely a case by case decision. This is an example of how electronic fetal heart rate monitoring has revolutionized the outcome in labor and delivery!

    Sarah McMoyler RN
    Sarah McMoyler, RN replied to jmarsh81's response:
    According to your post, as of today, you are the mom of four-congratulations! I hope that the cesarean birth went smoothly and that you have lot's of support at home!

    Sarah McMoyler RN
    Sarah McMoyler, RN replied to Taurino;'s response:
    WOW! Some strong points there - with food for thought. I am so sorry to hear about your friends loss; it certainly warrants strong consideration for a cesarean birth - both medically and emotionally.

    Sarah McMoyler RN
    Starla_94 replied to Sarah McMoyler, RN's response:
    I like that people do have a Choice as well.. Some people prefer a csection for whatever their reasons are and thats a personal decision..

    What so scary is now the Doc's seem to PREFER C-sections as they are "Scheduled" they know when they have to be there and when they are devlivering a baby so they can schedule around it..

    This is why i think its important like we talked about in another post for Parents to be Educated and Understand ALL their options in various events.. I know my hospital with my first walked me through everything this is what we will do in this case, this is what we do in that case.. etc.. the various birthing tools available. (forcepts, etc) they gave us the warnings and why docs prefer or not prefer certain methods..

    this was given by a nurse but a nurse that was deemed more for Training, the birthing classes and hospital tour etc...

    i found this very informative and helpful cause ther were things i didn't know about. like the Montor for the HB they can actually put on the babies head in utero instead of the belly wrap thing that never stays in place.. LOLOL (And this was 7 years ago) i can only imagine whats out there now :)

    So i just encourage people to REALLY weight their options.. Get the facts, do the research, write down the pros and cons about both.. Consider C/S is a major surgery and don't let the doc sway you to a C/S more because he/she just wants to keep their Scheduled T Time that week.. If you still chose to go with a C/S then you can say you made an educated and well thought out decision, after all it is ultimatly your decision in many events (minus the emergency cases)
    Christina - 1 D/S Oct-2003, M/C April 2010,M/C June 2010 ~oOo~ currently TTC ~oOo~ BFP 8/15/2010 Come on Sticky Baby!!! ~oOo~
    Sarah McMoyler, RN replied to Starla_94's response:
    Thanks for the really thought filled reply! You are voicing EXACTLY what I teach in McMoyler Method classes in San Francisco (also seen in the the childbirth DVD This is in part because I am an L&D nurse and teach expectant couples the must know not the nice to know. Glad to hear that your memory is positive as far as knowing what to expect.

    Sarah McMoyler RN
    furgisrl responded:
    Just curious what you opinion is on having a vaginal birth for your second child when you had to have a C Section for your first. I have a little boy and when he was born he was breech so i had to have a c section. my husband and i are trying to get pregnant again and i was just curious what opinions/facts are about having a vaginal birth after c section?
    jmarsh81 replied to furgisrl's response:
    I think if you could have a VBAC with your next child it would be wonderful. I had plans for a VBAC with my after my 1st c-section, but we had a placental abruption, due to a minor car accident and had no choice but to get the baby out. I would have loved to deliver my most recent LO vaginally, but my dr wouldn't support it because of 2 prior c-sections. Good luck to you with getting pregnant, and with a vaginal birth.
    Me, Jessi 29, DH, Mike 39, DSS, Michael 1991, DS1, Brandon 2000, DS2, Jeremy 2006, DS3, Tyler 2007, DD1, Katie Chyanne EDD 11/07/2010
    Sarah McMoyler, RN replied to furgisrl's response:
    Dear furgisrl,

    The decision to attempt a vaginal birth after cesarean (VBAC) is very individual and made on a case by case basis. Discuss this with your OB to hear their current stance. It was more common ten tears ago. The risks associated include potential uterine rupture (the incision to the uterine muscle, weakens the muscle).

    Good luck with your next pregnancy and delivery!

    Sarah McMoyler RN
    Sarah McMoyler, RN replied to jmarsh81's response:
    Dear jmarsh,

    This is a great example of how modern medicine has increased the outcome of healthy mom's and babies. With an abruption, there is bleeding and swift action must be taken to deliver the baby. While disappointing to not achieve your goal of a vaginal birth, the abruption, combined with 2 prior cesareans necessitated this surgical delivery.

    Sarah McmOyler RN

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