My mind still hasn't changed on this topic - I still want an elective c-section. I am hoping that this is an option and that my decision will be respected. My Dr. will be giving me a referral to an OBGYN at my next prenatal appointment (at 33 weeks). I hope that the OBGYN will be receptive, as frankly trying to find one who is when I'll be less than 7 weeks from my due date seems to be a daunting challenge. I want to avoid a vaginal birth as fiercely as many women want to avoid a c-section. The ironic thing is, that women who want vaginal births even in light of circumstances that are likely to merit elective c-sections (VBAC, breech) are likely to be more supported than the woman who wants a c-section in the absence of any medical reason.
So what do I perceive to be the advantages of an elective c-section:
1. Avoidance of pelvic floor damage and tearing.
2. Avoidance of going through an extensive labour and needing a c-section anyway.
3. Ability to mentally and physically prepare for the delivery.
4. Minimization of very adverse birth outcomes for my child.
5. Ability to organize support resources for my recovery.
6. Control over the experience.
7. Minimization of the risk of sexual dysfunction.
My understanding is that overall the risks (to the mom) of the two birth methods are relatively comparable, particularly in light of the fact that many planned vaginal births do not result in unassisted vaginal deliveries.
Mrs W, You might be interested in a Canadian study (http://www.ncbi.nlm.nih.gov/pubmed/19941705) of almost 40,000 term deliveries, 1994-2002, comparing outcomes of planned cesarean delivery for breech presentation with spontaneous labour with anticipated vaginal delivery (i.e. planned vaginal delivery) at term in pregnancies with a cephalic-presenting singleton. Life-threatening maternal morbidity was similar in each group. Life-threatening neonatal morbidity was decreased in the cesarean group. It concluded that ‘elective pre-labour Caesarean section...at full term decreased the risk of life-threatening neonatal morbidity compared with spontaneous labour with anticipated vaginal delivery.' (Dahlgren et al, 2009)
ReplyDeleteThis is one of many studies I cite when illustrating that a planned cesarean delivery at 39+ gestational weeks is the safest delivery method for a baby.
Also, I might be able to help you (regarding the situation you wrote about on my blog) if you'd like to email me at info@electivecesarean.com
Thank you Caesarean debate - the article you mention is definitely one of the ones I plan on bringing with me when I'm referred to the OBGYN at my next prenatal!
ReplyDeleteI will email you though...
We live in Canada. Very different healthcare system from the States. In the US if you can afford it, you can get the "best of the best". They do not actually do many studies to look at if the "best of the best" is worth it. Canada does.
ReplyDeleteWith universal health care the pot only goes so deep. I agree that women should have control over their birth choices, however if the choice does not fall into normal medical recommendations the woman should need to pay for the cost of the procedure herself. Just like in the US.