According to this Northern Star article, "under the Towards Normal Birth policy, the [NSW] state is aiming to reduce the cesarean rate to 20% before 2015."
Remember - there is NO EVIDENCE for ANY ideal cesarean rate - yet (as is happening in the UK and Canada too), an ideological focus on achieving normality is deemed more important than best physical and psychological outcomes for babies and mothers.
Lismore pediatrician Dr. Chris Ingall is quoted here as saying that 'the rights of the both babies and mothers have to be balanced out'... "It's not just the mum's choice. It's also the baby's choice as to how the delivery transpires."
You may disagree, but having read this mother's very genuine and legitimate reason for wanting to schedule a c-section, I don't believe for one minute that - if such a consultation was even possible - her macrosomic baby would make a different choice. Do you?
Extract taken from Northern Star article, Hospital says No to cesarean, by Jem Wilson (February 22, 2012):
Sylvia Leveridge, 38, said she was told by an obstetrician at the hospital she could only have a C-section (cesarean section operation) in an emergency.
"I just had tears streaming down my face - I couldn't believe it," Ms Leveridge said.
"I feel so powerless and betrayed by the medical system that my choice has been taken away."
Ms Leveridge, who is 28 weeks pregnant, wants to avoid the 20-hour labour she experienced before undergoing an emergency cesarean to deliver her first child.
Her first baby was a whopping 4.240kg and Ms Leveridge understands this baby will be just as big.
"Chances are I will be having a C-section again but it will just be as traumatic as it was the last time," Ms Leveridge said.
I understand that many women undergo unnecessary C-sections these days and it can cause a great deal of trauma for mother as well as baby.
I had an emergency c-section due to a 40% placental abruption. The baby came out blue and although they didn't have to resuscitate, he needed considerable help with his breathing initially. I had a perfectly normal pregnancy. FYI - I also had not dilated at all, thus my thought is that attempting to simply induce labor could have cost me the child's life.
I know docs do c-sections for a lot of bad reasons these days, but we should balance this with the knowledge that c-sections are very much needed in some cases.
Perhaps she should be monitoring her diet and exercise, as well as investigating different positions to birth in.
Sometimes it is not the size of the baby, but the position of the baby that makes a c/s necessary, so to assume once a c/s always a c/s is not the answer either, studies show even a trial of labor has a more positive effect for baby than a scheduled c/s.
Heather, your post seems to be possibly blaming the mother for needing her first cesarean surgery - had she monitored her diet and exercise or investigated different birthing positions then maybe she wouldn't have needed that cesarean either?
However, whatever your views are about repeat cesareans or VBACs, the whole point of this post is that this woman is CHOOSING a repeat cesarean, and this choice should be respected.
No one should be forced to have a VBAC against their will, and certainly not for the sole purpose of reaching a general hospital cesarean target rate that is not even evidence-based.
This woman is an individual and her choice (assuming she is not planning a large family) is perfectly legitimate.
As for the effect on babies, there are a large number of studies that demonstrate better health outcomes with cesareans at 39+ weeks compared to a trial of labor, and this is particularly true in the case of macrosomic babies.
I was a body-builder and in excellent health--the best shape of my life in fact--when I became pregnant. I have continued to watch my diet and exercised consistently since I got pregnant. 10 lb babies run in my family. I do not have GD or Pre-E and none of the rest of the women in my family have had those either. All the boys for the last 4 generations on BOTH SIDES of my family have been 9-10lbs or greater at birth. You cant tell me that the fact that I am about to deliver a 10 lb baby boy myself is my fault from not watching my diet or not exercising. You cant convince me that any amount of twisting or pretzel-ing or even squatting can allow a 13 MM head and 21 inch shoulders on a 10 lb baby to come out of a 1/2 inch space between my ischia. This poor woman shouldnt have to fear for her safety/sanity during the birth of her next baby. This is appalling and my heart goes out to her. I feel very greatful that my OB was receptive to my demand to have an elective c-section from the time I became pregnant due to my family history.
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