cesarean - Elena LaVictoire on Diigo

10 Jun 09

03 Jun 09

My Domestic Church: Christina Aguilera Still in Pain After Childbirth

www.mydomesticchurch.com/...ilera-still-in-pain-after.html - Preview

26 Apr 09

Mommy, What Did You Do in the Industrial Revolution? - Semaine Mondiale pour l'Accouchement Respecté

Excellent article on the state of birth in this country. I had a couple of thoughts while reading it.

A couple of years ago I had a discussion with a woman who had pretty much opted for a Cesarean at her first prenatal visit! She didn't with to be challenged on it either. I never considered the perspective that "high risk" in this country has come to mean "special." And that's how ACOG has come to make it so acceptable.

I also wonder why the feminists and "green" people haven't picked on this. Industrialized birth today takes power away from women. This is just as bad ad the old day when women were tied down during labor, like my mother was, back in the 50s and 60s. Yet other than Ricky Lake, I'm not hearing a peep from them.

As far s the green movement, I guess it's okay to keep the earth clean and pure but to savage women's body with invasive medical procedures seems to be okay.

www.smar.info/article-30653416.html - Preview

birth childbirth cesarean AGH

The cesarean rate in the US has been rising for decades, and in 2006 hit an all-time high of 31% (Hamilton, 2007.) This record is likely to stand for only a brief time, that is, until figures are
released for 2007. Can it really be that one-third of women are unable to birth without high-level technological support? And is there an endpoint in sight? “In the next decade or so the
industrial revolution in obstetrics could make Cesarean delivery consistently safer than the birth process that evolution gave us.” (Gawande, 2006, 8) Against such an argument, who could hope to
stand?
Although he lauds the
success—often unheralded-- of obstetrics in saving mothers’ and infants’ lives, I hear within the paean a threnody for the vanishing art. Skilled obstetricians like those legends of the past,
whose names lived on in the maneuvers they devised to usher babies into the world, are vanishing from current practice: goodbye, Lovset; hit the road, Rubin; Mauriceau, it’s been swell, but we’re
through.
8 more annotations...
- If cesarean is a response to any
  perceived risk, why would women at statistically lower risk of a poor outcome have higher cesarean delivery rates? New Jersey has the highest cesarean rate among states, (Denk 2006) but no lower
  levels of maternal or perinatal mortality. (MacDorman 2007, CDC 1999) What it does have, however, is the highest median household income. (Census Bureau 2007)
- Does this paradox reflect a differential understanding of risk? I have seen, over years of practice in maternal-fetal medicine, an odd and somewhat unsettling pride among women who announce that
  they have a “high-risk pregnancy.”
- In some cases it is difficult to persuade a low-risk woman to continue her care with a general OBGYN practice instead. “But I’m high-risk,” she says.
  Does she really mean, “I’m high-status,” or “My baby is high-value,” specifically, more precious than someone else’s? Is it a statement of importance? Does it mean that she is special? Or is it a
  Disneyfication of a primal human endeavor, longing for the synthetic and dramatized experience in preference to the authentic? These questions are raised, but cannot possibly be answered, in this
  commentary.
- Women who want to be high-risk (read: special) in their designation are nonetheless hugely risk-averse when it comes to the real thing. Obstetricians have tapped into that fear in daily practice.
  Vaginal birth after cesarean (VBAC), for example, is associated with a very low although measurable risk of uterine rupture. Presented with the figures and asked to sign a consent for VBAC which
  spells out that risk, most women now decline: the VBAC rate in 2005 was under 8%. (Martin, 2006) Whether this is driven by reluctance of doctors to offer or women to undergo VBAC is impossible to
  ascertain, but it is clear that fear is contagious.
- For developing or low-income countries, where
  access to safe maternity care is an issue, a rise in national CS rates from 0% to 8-10% is accompanied by a drop in stillbirths, neonatal deaths, and maternal deaths. (Goldenberg 2007, McClure
  2007.) But across the developed world, or across medium- and high-income countries, there is no additional benefit of further increase in cesarean rate (Althabe 2006.):
- Nonetheless, seduced by the promise of pain-free, risk-free childbirth, women and their doctors are driving the cesarean rate ever higher. Rates approaching—or exceeding-- fifty percent are now
  seen in some hospitals (New Jersey Star-Ledger.) This is the normalization of deviance. This is the new normal.
- Let us enumerate what a full spectrum of childbirth choices entails. Women can give birth at home unaided; at home with family or with trained assistance; in a birth center, either freestanding
  or hospital-based; in the hospital delivery room with trained assistance; or in the operating room where they are acted upon. But of all these choices, extending across the entire range of
  reliance upon the medical profession (from none to total), exercising the options at the end of the spectrum where the physician has the least sway will get women the least support. The American
  College of Obstetricians and Gynecologists calumniates not only women who want a home birth but anyone who advocates leaving that option open. (American College of Obstetricians and
  Gynecologists, 2008.) Once in the hospital, women who might like to exercise their right to self-determination by choosing vaginal birth after cesarean, or vaginal breech delivery, will have a
  hard time of it. (Leeman and Plante, 2006) Is it not the opposite of autonomy to support only those choices which increase the woman’s reliance upon the physician?
- Industrial obstetrics strips the locus of power definitively away from women.

21 Jan 09

injennuous: The Myth of CPD

When I hear about a new mom going to her OB/GYN for a first prenatal appointment and being told that she "probably" is going to need a C-section because she couldn't possibly have a baby naturally, I cringe. I cringe because it happened to me and I went on to have several babies larger than my first one. Here are some other moms who have done the same!

injennuous.blogspot.com/...myth-of-cpd.html - Preview

AGH agracioushome Cesarean birth

01 Oct 08

Sunday Housecall w/ Dr. Rosenfeld - FOXNews.com

http://www.foxnews.com/video2/video08.html?maven_referralObject=3075279&maven_referralPlaylistId=&sRevUrl=http://www.foxnews.com/health/drrosenfeld/index.html

C-section babies more at risk for diabetes

www.foxnews.com/...index.html - Preview

cesarean childbirth birth

09 May 08

CfM ~ Supporting The Midwives Model of Care

CFMs rebuttal to ACOG's anti-homebirth press release.

cfmidwifery.org/...Item.aspx - Preview

midwifery homebirth birth childbirth cesarean

27 Mar 08

eMedicine - Eclampsia : Article by Stephanie R Fugate, DO

www.emedicine.com/...topic633.htm - Preview

PBA cesarean

26 Mar 08

Preeclampsia and Eclampsia Revisited

www.medscape.com/...462328_4 - Preview

PBA cesarean eclampsia

Delivery is generally recommended for women with severe preeclampsia, even if the fetus is at less than 38 weeks' gestation (Table 3). When severe preeclampsia is diagnosed in a pregnant woman at preterm gestation (usually <32 wk), however, an initial observation period and conservative expectant management in a tertiary care center may be attempted cautiously (Table 3).^[65,66] When eclampsia develops, expedient delivery is mandated, regardless of gestational age.
Once it is determined that delivery is required, labor induction should be performed without delay. The goals during the intrapartum period are to prevent seizures, stabilize blood pressure, and promote delivery. During labor and delivery, women with preeclampsia-eclampsia receive IV magnesium sulfate for seizure prophylaxis, usually as a loading dose of 4 to 6 g magnesium sulfate × ⁷H₂O infused for 20 minutes followed by a continuous IV infusion at 2 g/h. Because magnesium is excreted in the urine, blood levels also depend on urine output. Serum blood levels should be monitored. The therapeutic range for magnesium sulfate is generally considered to be 4 to 8 mg/dl. In a patient with elevated creatinine or oliguria, the patient's magnesium level should be followed carefully and the magnesium sulfate infusion adjusted accordingly.
Continuous electronic fetal heart rate and uterine activity monitoring should be instituted in all cases. Vaginal delivery is safer than cesarean section in women with preeclampsia-eclampsia and usually should be attempted unless there are other obstetric indications for cesarean delivery. Certain women at preterm gestation with severe preeclampsia or eclampsia in whom the cervix is unfavorable for vaginal delivery may benefit from cesarean section without attempting labor induction.

Eclampsia: Induced or Cesarean Delivery Information on Healthline

Another article on treatment of choice in eclampsia before 30 weeks- Csection.

www.healthline.com/...uction-cesarean-eclampsia.html - Preview

cesarean eclampsia

Preeclampsia -- familydoctor.org

Article specifically stating Cesection treatment of choice if mother or baby in danger

familydoctor.org/...064.html - Preview

Cesarean PBA abortion

A cesarean section (an operation to deliver the baby) is more likely if your health or your baby's health is in danger.

27 Feb 08

Midwives, home birth proven safe - contrary to ACOG's false assertion | BlogHer

www.blogher.com/contrary-acogs-false-assertion - Preview

ACOG Cesarean VVG birth childbirth homebirth

26 Feb 08

Birth, The American Way | Newsweek Culture | Newsweek.com

But the image that viewers may find most shocking is that of a baby being cut out of a woman's abdomen via Caesarean. This, according to Lake, the executive producer of the film, and Abby Epstein, the film's director, is the right reactio

www.newsweek.com/96400 - Preview

ACOG VVG birth cesarean childbirth

But the image that viewers may find most shocking is that of a baby being cut out of a woman's abdomen via Caesarean. This, according to Lake, the executive producer of the film, and Abby Epstein, the film's director, is the right reactio
should not be a first choice for healthy mothers.
6 more annotations...
- perinatal specialist Dr. Jose Villar found the risk of death for mothers who had Caesareans, while slight (.01 percent of the women who delivered vaginally died vs. .04 percent who had elective C-sections), was triple that of those who delivered vaginally.
- The risk of death for infants delivered via C-section—who are more likely to have a low birth weight—was double that of vaginal births, and C-section babies were more likely to have respiratory problems. According to a study published in the journal Birth, labor clears liquid from the infant's lungs, preparing the baby to breathe outside the womb. Caesareans impede this process. Yet the rate of Caesareans is spiking: in 2006, C-sections accounted for 31.1 percent of births nationwide, a 50 percent increase over the past 10 years. Natural birth—without drugs or interventions—whether at home or in a hospital, remains a rarity (despite the fact that home births don't have an appreciably higher risk rate than hospital births).
- But defining medical necessity is complicated
- Natural-birth advocates say that hospitals, driven by profits and worried about malpractice, are too quick to intervene.
- One of the knowledge gaps is a clear understanding of the indications for C-sections," she says.
- If nothing else, "The Business of Being Born," with its indelible image of a naked, exhilarated Ricki Lake cooing "Hi there!" to her seconds-old son in her bathtub, will give them another view.

Beyond the Multiplex: "The Business of Being Born" | Salon Arts & Entertainment

In the case of Abby Epstein's documentary"The Business of Being Born"(which Rebecca Traistercoveredlast year at the Tribeca Film Festival), Netflix is arguably the film's principal exhibitor. After screening in a few major cities this month, Epstein's b

www.salon.com/...business - Preview

ACOG VVG birth cesarean childbirth

In the case of Abby Epstein's documentary "The Business of Being Born" (which Rebecca Traister covered last year at the Tribeca Film Festival), Netflix is arguably the film's principal exhibitor. After screening in a few major cities this month, Epstein's button-pusher on the natural-childbirth and midwifery movements will be made available by Netflix "to women everywhere" in February, as the film's press kit puts it.
It only makes sense to reach an audience that largely consists of pregnant women (or would-be pregnant ones) in their living rooms.

25 Feb 08

The True Face of Birth: 10 responses to ACOG's statement on home birth

For the first time, ACOG has suddenly started supporting freestanding birth centers, a drastic shift from its long-standing opposition to out-of-hospital births. The research on birth centers has not changed—in fact, the outcomes from theNational Birt

rixarixa.blogspot.com/...o-acogs-statement-on-home.html - Preview

ACOG VVG birth cesarean childbirth

For the first time, ACOG has suddenly started supporting freestanding birth centers, a drastic shift from its long-standing opposition to out-of-hospital births. The research on birth centers has not changed—in fact, the outcomes from the National Birth Center Study are similar
I would argue that it is hardly fashionable or trendy in that sense. Women choosing home birth face significant social stigma. It is not an easy or socially acceptable path. Instead, it is a choice that some women will always make out of deeply held philosophical or religious beliefs. This statement also implies that women choose home birth for frivolous reasons without serious thought or carefully weighing the risks and benefits of various options.
9 more annotations...
- On the other hand, one recent trend in childbirth—elective cesareans with no medical indication—is supported by ACOG as ethically justifiable “if the physician believes that cesarean delivery promotes the overall health and welfare of the woman and her fetus more than does vaginal birth.”
- ACOG yet again pays lip service to “a woman’s right to make informed decisions regarding her delivery and to have a choice in choosing her health care provider” while working to undermine women’s ability to make those very decisions.
- Dr. Marsden Wagner has noted that ACOG “has no data to support it [the 1999 VBAC recommendations], no studies showing improvements in maternal mortality or perinatal mortality related to the characteristics of institutions or availability of physicians.”
- This shows ACOG’s distrust in a woman’s ability to make her own decisions.
- 5) ACOG claims to be concerned about the rising cesarean rate and states that it “remains committed to reducing it.” However, several of ACOG’s actions actively promote higher cesarean rates, including its support of patient choice cesareans as ethically justifiable and its 1999 VBAC recommendation.
- ) When all else fails, blame the woman
- Yet with no new research on birth centers in the past year and a half, ACOG has recently reversed its stance. ACOG also ignores the CPM 2000 study about midwife-attended home birth, a large, prospective study of all CPM-attended births in the year 2000.
- In states where midwifery is illegal, many midwives are forced to abandon their clients if they transfer to a hospital out of fear of being arrested. Midwives in many states cannot openly refer clients or consult with backup physicians. Surely these situations do nothing to improve safety for the birthing woman.
- The main goal should be a healthy and safe outcome for both mother and baby. Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby.” This statement as insulting as it is misinformed, and it shows ACOG’s inability to recognize that women choosing home birth do it to safeguard their baby’s well-being. Accusing women of being “bad mothers” is both unprofessional and paternalistic.

Belly Tales » ACOG’s Statement on Homebirths

Many other websites have covered this topic in exhaustive detail, so I’ll refer you to them in just a moment, but first a few comments of my own. As Rixa rightly pointed out on her blogThe True Face of Birth, ACOG’s sudden acceptance of out-of-hospi

www.bellytales.com/...acogs-statement-on-homebirths - Preview

ACOG Cesarean VVG birth childbirth homebirth

Many other websites have covered this topic in exhaustive detail, so I’ll refer you to them in just a moment, but first a few comments of my own. As Rixa rightly pointed out on her blog The True Face of Birth, ACOG’s sudden acceptance of out-of-hospital birth facilities (i.e. freestanding birth centers) flies directly in the face of their earlier November, 2006 Statement on the subject, where they were adamant that the hospital “is the safest setting for labor, delivery, and the immediate postpartum period,” and that “ACOG strongly opposes out-of-hospital births.” I wonder what caused the sudden change of heart?
There has got to be so much back-room wheeling and dealing and politics involved in all of this that one can only wonder at the motives. But crucially, why must support of freestanding birth centers be at the expense of homebirth?
5 more annotations...
- As Rixa conjectured, maybe all of this is indeed in response to Ricki Lake and Abby Epstein’s documentary The Business of Being Born, which has done a terrific job of raising awareness regarding homebirth. The real question we need to continue to ask ourselves is this: Why is it that America, with all of it’s insistence on hospital birth and safety, still has one of the highest rates of neonatal and maternal mortality among developed countries? That question lies at the heart of The Business of Being Born, and clearly, the American way of doing birth, for all its emphasis on hospitals and safety, has not adequately addressed this.
- The Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) support home birth for women with uncomplicated pregnancies. There is no reason why home birth should not be offered to women at low risk of complications and it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman’s likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby.^1–
- And don’t forget the economics at work here.
- what’s good for the mother is ALSO GOOD FOR THE BABY. The two are not diametrically opposed. When a woman feels safe, supported and relaxed, she’s able to sink into her labor and allow her birth to unfold in the manner that’s best for the baby, without all of the stress hormones and cortisol, without all of the fear….and more often than not, with stunningly good outcomes.
- In any case, you should go read the rest of Rixa’s post on The True Face of Birth ASAP: 10 Responses to ACOG’s statement on homebirth, as well as the other responses cropping up around the blogosphere.

The Business of Being Born: A Must-See Documentary for Expectant Parents - Dr. Ben Kim .com

: the best experiences of our lives so far have been the home births of our two sons.

Labor for our second born was about two hours long, and to have our toddler son there with us to greet our new baby made it special in a way that I have difficul

drbenkim.com/ness-of-being-born-documentary - Preview

ACOG VVG birth cesarean childbirth

: the best experiences of our lives so far have been the home births of our two sons.
Labor for our second born was about two hours long, and to have our toddler son there with us to greet our new baby made it special in a way that I have difficulty describing. In a way, I feel that having our toddler son there to help welcome his little brother set the tone for their relationship forever.
6 more annotations...
- f you are an expectant parent and want to familiarize yourself with the advantages of giving birth at home, I recommend that you view a recently released documentary called The Business of Being Born. This documentary is definitely for home births and against hospital births. While the makers of this documentary have a strong bias against hospital births, they ask viewers to consider questions that every expectant parent ought to seek answers to before making a decision on where to give birth; some examples of such questions are:
- Why does the U.S. have the second-worst newborn death rate in the developed world?
  
  Why are more than 40% of the deliveries done in some New York hospitals Caesarean sections?
  
  Why, according to a study, are the peak hours for Caesarean procedures at 4 in the afternoon and 10 at night?
- yet has the second-worst newborn mortality rate and one of the highest rates of maternal death during childbirth.
- in the five countries that have the lowest infant mortality rates (Japan and four countries in Europe), 70% of births are carried out by midwives.
- Modern American obstetrical care prioritizes making labor as convenient as possible for doctors, sometimes to the detriment of mother and baby; here are two examples of this:
- I think that this documentary does an excellent job of encouraging expectant parents to think about how they can have the healthiest and most meaningful birthing experience possible, rather than just submit to what's expected of them by their health care provider, relatives, and friends.
  
  Based on my wife's and my experiences with giving birth at home, we feel that it's well worth every expectant parent's time to give serious consideration to having a home birth.
  
  If you have a home or hospital birthing experience that might be helpful to share with expectant parents who aren't sure about where to give birth, please consider sharing your experience via the comments section below. Thank you.

On the Other Hand: ACOG says homebirth is a fashionable trend

A well-written discussion of why ACOG holds the positions that it does, and how that affects the lives of mothers.

It stated “Our doctors will no longer perform VBAC.”

ince the doctors in that practice were males, it was difficult to imagi

ontheotherhandcolumn.blogspot.com/...-homebirth-is-fashionable.html - Preview

ACOG VVG birth cesarean childbirth

A well-written discussion of why ACOG holds the positions that it does, and how that affects the lives of mothers.
- mydomesticchurch on 2008-02-25

It stated “Our doctors will no longer perform VBAC.”
ince the doctors in that practice were males, it was difficult to imagine them performing a vaginal birth. Doctors do not perform vaginal births. Pregnant women do.
9 more annotations...
- In fact, a study published in the February 13, 2007 issue of the Canadian Medical Association journal reported that women undergoing planned c-sections are three times more likely to die.
- Is it any wonder maternal deaths are on the rise here in the US?
- In November, the British Medical Journal published a study showing that the risk of neonatal death was 70% higher for surgically delivered babies than for normal deliveries.
- The movie focuses on the profiteering that goes on in the birth industry at the expense of mothers and babies, and offers a look at how empowering and thrilling natural birth can be.
- What the statement leaves unwritten is that every homebirth represents an economic loss of thousands of dollars for doctors and hospitals. After all, ACOG is essentially a trade union for the OBGYN industry. An anti-homebirth statement from ACOG is like an anti-tap water statement from Pierrer.
- Calling homebirth “fashionable” or “trendy” is laughable. Hospital birth is the recent historical trend.
- “Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby.” Translation: Homebirthers are selfish mothers who put their babies at risk.
  
  Does ACOG at least support their contention with scientific data? Perhaps a study actually showing that hospital birth is safer? Not a chance. The studies, in fact, offer the opposite conclusion: Uncomplicated pregnancies end just as well at home.
- In fact, US hospitals aren’t doing so well. Our country has the highest rate of cesarean sections, and the second worse newborn death rate in the developed world.
- Translation: “The only reason we’re cutting 1/3 of American mothers is because they’re old, they’re fat, they’re lazy and they want to be cut.” These doctors refuse to take responsibility for America’s outlandish c-section rate, even though the rate varies widely between practices and is lower in natural (drug-fee) labors where women are allowed to eat, drink, and move around.

The Education of Genevieve: Has Ricki Lake gotten to ACOG?

In anunusual statementreleased this week, ACOG denounces the research evidence on planned, midwife-attended home birth, saying that such studies “have not been scientifically rigorous.” ACOG goes further to accuse the woman who chooses home birth of

theeducationofgenevieve.blogspot.com/...rikki-lake-gotten-to-acog.html - Preview

ACOG VVG birth cesarean childbirth

In an unusual statement released this week, ACOG denounces the research evidence on planned, midwife-attended home birth, saying that such studies “have not been scientifically rigorous.” ACOG goes further to accuse the woman who chooses home birth of putting “herself and her baby’s health and life at unnecessary risk,” and argues that “choosing to deliver a baby at home…is to place the process of giving birth over the goal of having a healthy baby.”
There’s a lot to unpack here. The midwives’ campaign countered yesterday with its own statement, calling out ACOG for playing the “bad mother” card. Indeed, ACOG’s statement strikes at pregnant women twice, first implying that they’re selfish for valuing the “process of giving birth,” and second for being too posh — or too fat — to push.
2 more annotations...
- Let’s look at the latter accusation first: nearly 1 in 3 American babies are born by cesarean section, major abdominal surgery, up 50% over the last decade. But according to CDC epidemiologists, this has little to do with women’s health status or their choices, and more to do with what’s trendy and fashionable for providers — the effective ban on VBAC (vaginal birth after cesarean) among many practices and hospitals, for one. While ACOG dismisses the studies on home birth as lacking in scientific rigor, there is not one peer-reviewed study to suggest that a significant number of women are demanding elective cesareans.
- Finally, there’s a double standard lurking here: elective, medically unnecessary cesarean has been considered en vogue for some time. We know that major abdominal surgery carries with it major risks for both mother and baby, but when it comes to that cause célèbre, ACOG has vocally supported a woman’s “right to choose.”

18 Jan 08

Study Shows Increase In Pregnancy-Related Deaths, Are Cesarean Sections To Blame? | Breaking News, Weather, Sports and Entertainment for Georgia and South Carolina | Local News

www.nbcaugusta.com/...13569487.html - Preview

VVG cesarean

Elena LaVictoire's Library tagged cesarean → View Popular

My Domestic Church: This is worrisome

My Domestic Church: Should all women delivery by C-section? I think not!

My Domestic Church: Christina Aguilera Still in Pain After Childbirth

Mommy, What Did You Do in the Industrial Revolution? - Semaine Mondiale pour l'Accouchement Respecté

injennuous: The Myth of CPD

Sunday Housecall w/ Dr. Rosenfeld - FOXNews.com

CfM ~ Supporting The Midwives Model of Care

eMedicine - Eclampsia : Article by Stephanie R Fugate, DO

Preeclampsia and Eclampsia Revisited

Eclampsia: Induced or Cesarean Delivery Information on Healthline

Preeclampsia -- familydoctor.org

Midwives, home birth proven safe - contrary to ACOG's false assertion | BlogHer

Birth, The American Way | Newsweek Culture | Newsweek.com

Beyond the Multiplex: "The Business of Being Born" | Salon Arts & Entertainment

The True Face of Birth: 10 responses to ACOG's statement on home birth

Belly Tales » ACOG’s Statement on Homebirths

The Business of Being Born: A Must-See Documentary for Expectant Parents - Dr. Ben Kim .com

On the Other Hand: ACOG says homebirth is a fashionable trend

The Education of Genevieve: Has Ricki Lake gotten to ACOG?

Study Shows Increase In Pregnancy-Related Deaths, Are Cesarean Sections To Blame? | Breaking News, Weather, Sports and Entertainment for Georgia and South Carolina | Local News

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