http://www.nytimes.com/2008/05/28/health/research/28birth.html?_r=1
Premature single births have been increasing in the United States, mostly among infants delivered by Caesarean section, researchers are reporting. And they say some of the increase may be due to Caesareans that are not medically necessary.
The trend is worrisome because premature babies are at risk for breathing and feeding disorders, delayed brain development, other health problems and death.
http://www.scienceandsensibility.org/?p=754
A reader just alerted me to the fact that Medical News Today has retracted the article they published last week falsely stating that the World Health Organization changed its recommendations for optimal cesarean rates. No doubt, this is due in large part to Henci Goer’s work debunking the article and the press release it was based upon.
http://www.msnbc.msn.com/id/33483153/ns/health-pregnancy/
Hoping to schedule your baby’s birth while your mother’s in town, or before the doctor goes on vacation? Labor is becoming less of a late-night surprise, but some hospitals are starting to tighten the rules for elective deliveries — because some babies are being delivered too early.
More hospitals are expected to crack down as regulators begin new quality measurements next spring that aim to reduce too-early elective inductions and first-time cesareans.
http://betterbirth.blogspot.com/2009/10/ten-pound-baby-too-big.html
I’ve heard it a hundred times and I should be used to it. But I’m not. It happened again last week.
My friend was having her third baby. She’s already pushed out two babies without problems – an 8 pound and a 9 pound baby.
She’s into natural birth, even considered a home birth… but then got nervous thinking about it and went on with the obstetrician. He is a nice man. I like him a lot. If I had to pick a doctor, he’d be in the top dozen that I know. But he works in the hospital and thinks the way he was trained.
The induction of labor can be done for many reasons, including many valid medical reasons. However, the rise in the rate of social inductions, or elective inductions is on the rise. As the induction rate rises there are more babies and mothers placed at risk for certain complications. Here are five risks of induction that you may not know about:
http://pregnancy.about.com/od/induction/a/risksinduction.htm
In her recent UTSpeaks public lecture To Push or Pull?, Professor Fenwick discussed the findings of interviews with 210 women in Queensland and Western Australia that revealed fear as the strongest motive for women to undergo caesarean section where there was no clear-cut medical reason for it.
Professor Fenwick said that while the media liked to propose vanity or convenience as reasons for the deliberate choice of caesarean section, the research findings supported the notion that most women were in favour of natural birth until convinced otherwise.
http://www.poughkeepsiejournal.com/article/20090614/NEWS/906140351/1006
Seventy percent of women who died from pregnancy-related causes in New York state underwent cesarean-section births, more than twice the rate at which cesareans are performed in the state.
The findings come from a report on maternal mortality obtained under the Freedom of Information Law from the state Health Department, which sponsored the study. The research was performed by the New York chapter of the American College of Obstetricians and Gynecologists.
The study, which was not dated, analyzed case files of 33 of the 141 women who died as a result of pregnancy and childbirth from 2003 to 2005. There were two deaths among Ulster County women in that time, and none in Dutchess, but it is not known if they were part of the study.
The Poughkeepsie Journal reported in March that the rate of cesarean sections soared 42 percent in New York state from 1999 to 2007; one in three babies was delivered surgically in 2007, many for nonmedical reasons such as mothers’ concerns over labor and physicians’ liability fears or time constraints. At the same time, the rate of maternal mortality in the state is rising; it went up 70 percent from 1997 to 2007, the Journal found.
http://www.poughkeepsiejournal.com/article/20090614/NEWS/906140356
The fully pregnant and obese woman arrived at the hospital with mild contractions. Having had at least one previous cesarean section, she delivered her newest baby surgically and without incident. On day three and four, a foul smell was detected at her wound, which was cleaned, and she was discharged.
Then, on day 10, the inexplicable occurred. The woman, who appeared fine in a clinic visit two days earlier, was found dead at home. The cause: “sepsis related to wound infection and an enlarged heart,” according to an autopsy.
To Assemblywoman Amy Paulin, a Democrat from Scarsdale in Westchester County who is concerned with rising cesarean rates, the anecdote makes a point. “It was clear that the C-section resulted in the death directly,” she said.
The woman’s story is one of three outlined cryptically in a report on 33 maternal deaths that was sponsored by the state Health Department and researched by the New York chapter of the American College of Obstetricians and Gynecologists.
http://mannursediaries.blogspot.com/2009/05/nearly-bleeding-to-death-from-cesarean.html
We just had an otherwise healthy woman in our ICU who had a c-section, was sent to her room on the maternity floor, and was eventually found unresponsive with a soaking wet abdominal dressing. She was given O2 by facemask and her hemoglobin level was 4.1 (this is 1/3 normal). She was brought back to consciousness and emergently taken to the OR for exploration and possible hysterectomy. No obvious bleeding was seen, but something like 4 liters of blood were sucked out of her abdominal cavity. It was probably a slow intra-abdominal bleed, following a path of least resistance out of her c-section incision instead of her vagina. She was given 5 units of blood and 10,000 ml (!!!) of IV fluids in the OR. That’s more than five 2 liter bottles in one sitting. I’ve never heard of that much being given in my life.
http://www.freep.com/article/20090510/FEATURES08/905100317/1033/BUSINESS/C-sections%20riskier%20than%20many%20women%20realize
Jody Borrero was only five weeks along in her pregnancy when doctors told her something had gone awry.
An ultrasound confirmed that her placenta had implanted itself at the bottom of her uterus, across her cervix. It also had attached itself too deeply, perforating the uterine wall and invading her bladder.
Borrero’s doctors kept her stable for as long as they could. But on Feb. 2, they were forced to deliver Ethan Jr. nearly four months early.
She hemorrhaged during the delivery and, at age 28, Borrero can no longer bear children. Her conditions, called placenta previa and placenta accreta, are still relatively rare.
But physicians say they’re turning up in more women, and medical experts believe the trend is tied to record numbers of moms-to-be delivering their children via Cesarean section.
Last year Idaho passed a law making it a crime to coerce a woman into having an abortion. This year, legislators in twelve states, including Missouri, have passed or are considering bills that they claim would enhance informed consent measures for pregnant women seeking abortions and ensure that women are not coerced into having unwanted abortions. Although it is hard to disagree with legislation that purports to ensure free and informed medical decision-making, I have to wonder why legislators who profess to care so much about pregnant women are only willing to protect some pregnant women – the ones who plan to end their pregnancies – but not the ones who intend to go to term.
While approximately 800,000 women end their pregnancies each year, a far greater number of women, 4.3 million, go to term. By focusing exclusively on abortion, this kind of law also dangerously implies that pregnant women who are going to term are fully and adequately informed and that their medical decisions are never pressured or coerced.
Instances of poor communications, failure to fully inform, and coercion in hospital delivery rooms, however, are increasingly being documented in popular books, films and collections of first-hand accounts. Allegations of abuse have prompted one organization to provide a guide for filing complaints. Rigorous peer-reviewed research, moreover, has found that pregnant women are routinely subjected to interventions during labor and childbirth that have been proven ineffective, or are appropriate only in limited circumstances. Pregnant and laboring women are often deprived of information about and access to a range of good practices that have been shown to work.
“Off-label” use of misoprostol (Cytotec) for labor induction has been steadily increasing for 10 years, even though this use is approved neither by the U.S. Food and Drug Administration, other national drug regulatory agencies, the pharmaceutical industry, the Cochrane Library nor a number of national obstetric organizations, including the British Royal College of Obstetricians and Gynaecologists. Some obstetricians, particularly in the U.S., continue to promote induction with misoprostol, even though the available evidence suggests possible serious risks including uterine rupture, maternal mortality and perinatal mortality.
Today’s report from the NCHS includes a fact of the month that states:
“The number of deaths due to C. difficile, a bacterial inflammation of the intestines often acquired in hospitals or other health care institutions with long-term patients, has increased from 793 in 1999 to 6,225 in 2006. “(Source: National Vital Statistics System, “Deaths: Final Data for 2006?) http://www.cdc.gov/nchs/pressroom/
It’s nearly the close of Cesarean Awareness Month and I’m wondering…how many of the women out there who had cesareans really are AWARE there is even an awareness month? Or reasons to raise awareness?
When Breast Cancer survivors were tired of complete mastectomies without regard to individual case, they changed the policies of “just lop it off.” Yet, 1/3 of our population is being “just lopped” to remove a baby and so many women are not responding to this. It becomes a private matter of shame that they have a “shelf” or begin to think of themselves as fat rather than really investigating the surgical procedure itself to see whether or not the repair is being done correctly. They are reminded that it’s normal to not want to sleep with their husbands til six weeks, after all, they just had a baby! But no one talks to them about the realities of learning to move again after major abdominal surgery (with a baby to carry around, to boot!).
Question from N. E.: I gave birth to my daughter in February at home with a certified nurse midwife. The midwife made me believe an episiotomy was necessary due to a long labor and fatigue. It was devastating to have to go through this after many months of preparing for a normal birth for both my baby and my body. Unfortunately, the CNM didn’t assess or repair my perineum or my rectal muscles correctly. I had to have another surgical procedure to have my body put back together.
While more and more women choose to undergo Cesarean section births despite a national push by the federal government to decrease the number, the local rate has declined and is well below the state average.
North Adams Regional Hospital performs significantly fewer c-sections than other hospitals around the state — an average of 18 percent of all births at the hospital compared to the state average of 34 percent, according to reports released by the state Department of Public Health.
The hospital also has a better prenatal care record, according to the reports: 94 percent of women giving birth have had nine or more prenatal care visits versus the state average of 87 percent having that many visits.
“I think what is being reflected in our numbers is that we are taking a more ‘midwifery’ approach with our practice then before,” Robin Rivinus, a certified nurse midwife with Northern Berkshire Obstetrics & Gynecology at the hospital, said last week. “It means that we do fewer unnecessary interventions — inductions, Cesarean sections, episiotomies. We treat childbirth as the normal, natural thing that it is. We only step in when it’s medically necessary, which is much better for both the mother and the baby.”
The Cesarean Awareness Ribbon debuted in April of 2004 for Cesarean Awareness Month. The burgundy color of the ribbons represents birth and the wearing of the ribbon upside down symbolizes the state of distress many pregnant women find themselves in when their birthing choices are limited. The loop of the inverted ribbon represents a pregnant belly and the tails are the arms of a woman outstretched in a cry for help.
Flagstaff mom Jody Borrero was only five weeks along in her pregnancy when doctors told her something had gone awry.
An ultrasound confirmed her placenta had implanted itself at the bottom of her uterus, across her cervix. What’s worse, it also had attached itself too deeply, perforating the uterine wall and invading her bladder.
Borrero’s physicians at St. Joseph’s Hospital and Medical Center kept her stable for as long as they could. But on Feb. 2, they were forced to deliver Ethan Jr. nearly four months early.
He’s still struggling to survive, and his 28-year-old mother, who hemorrhaged during the delivery, can no longer bear children.
Borrero’s conditions, called placenta previa and placenta accreta, are both still relatively rare.
But physicians say they’re turning up in more women, and medical experts believe the trend is tied to record numbers of moms-to-be delivering their children via Cesarean section.
http://www.azcentral.com/news/articles/2009/03/31/20090331csectionrisks0328.html