Monday, July 4, 2011

Old School versus New Science - Birth Advice

There is no getting away from the fact that different medical professionals hold very different views about what constitutes optimum maternity care for women and babies.
Women need to understand this fact - your information will almost always come from someone with a personal and professional view of birth risks and benefits, and so it's important to do your own homework too.

Just yesterday, I came across this post on a nursing website: "C-section vs. letting Mom go naturally", in which a nurse (I believe) criticizes a doctor's offer of a planned cesarean to her friend, whose baby might be macrosomic at birth (large).

I skim read through about half of the answers, and in amongst all the responding criticisms of this doctor (making more money from c-sections; fearing litigation etc.), nowhere did I see anyone talking objectively about the very real increased risks with macrosomia - for mothers and babies.

Nor did they seem to think for one moment that the doctor may have the woman's best interests at heart in his cesarean offer - nothing to do with money and/or litigation.

Here's what some of the post read:

"I have a friend that is pregnant for the first time, isn't due for a few more weeks, has a very healthy pregnancy, no problems with her or the baby except that at last U/S, they guesstimated the baby is almost 9 lbs and has still not descended any and her cervix is still closed and thick. He offered her a c-section in a few days and she took the offer! Ugh! Ok, I may be old-school here in my thinking but I just don't see why any Dr. would offer that (besides they see it as easy money in their pocket) or why any woman would want that!! C-sections are major surgery to the body, as we all know. They are relatively easy in uncomplicated pregnancies but there is still more room for post-op infections, bleeding problems, etc...why can't Dr.'s just leave well-enough alone and let nature take it's course and let the woman's body do what it was made to do and has been doing for centuries...the baby will come out when it's good and ready, her body will tell her it's time to deliver that baby. She's not even at her due date yet, and it's her first baby, of course the baby hasn't descended yet and there's no dilation! Duh! Give it a few weeks, tell her to go walking, have sex, etc...geez!"

She continues later in the discussion:

"I'm an advocate for natural birth, as natural as medically possible of course and I'm all for women making decisions and all but to me, this is just ridiculous that a Dr. would suggest this to a first-time mom who will never even know if her body can deliver a baby naturally, and more than likely, she never will be able to experience that... As I said before, I'm old-school...I'm an advocate of letting that baby simmer until done, and barring no health issues of either mom or baby, waiting for mom's body to give birth as it was made to do."

Unfortunately, we do not live in a perfect world, and therefore making an informed decision about your birth plan means you must navigate your way through the subjective views and opinions of those working in maternity care.

If you desperately want a vaginal birth, you might find a doctor's offer of a cesarean quite offensive, whereas if you desperately want a cesarean birth, you might find a midwife's insistence that birth is a safe, physiological process quite irrelevant.

Be Educated, but Educate Yourself too

And then there is the biggest group of women right in the middle - who don't have a preference of birth type either way; they prefer to rely on professional guidance.

All I'm saying is that whoever you are, and whatever your views, understand that in the 21st Century, it is incredible difficult to find maternity advice that is not (even slightly) subjective, and you might need to decide for yourself which education YOU prefer:

 Old school or New Science.

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