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Some Docs Say OK To Elective Cesarean Sections To Alleviate Fear of Childbirth
Would you choose surgery over the pain of childbirth?
Dr. Lisa Umholtz, OB/GYN, has no problem when a woman requests to have an elective cesarean section performed in order to avoid the pain of childbirth. With tocophobia (the fear of childbirth) on the rise, some doctors simply do not mind the surgical procedure if it means that women can have healthy babies.
“Just in the last 10 years, we’ve been giving people that option; if they want to go straight to the c-section they can,” Dr. Umholtz said.
But there are risks involved with surgery of any kind and although increasingly common, cesarean sections still pose significant risks to mom and baby.
Risks for mom include infection, heavy blood loss, blood clots, nausea, vomiting, and severe headache after the delivery (related to anesthesia and the abdominal procedure), bowel problems, such as constipation or when the intestines stop moving waste material normally, and maternal death which is admittedly very rare. The risk of death for women who have a planned cesarean delivery is very low (about 6 in 100,000).
Cesarean risks for the infant include injury during the delivery, immature lungs and breathing problems and the need for special care in the neonatal intensive care unit (NICU).
Yet some women don’t feel they have any other option because they are just too afraid to endure childbirth. Many of these women suffered through traumatic first births.
I had the sort of the opposite experience. During my first childbirth experience, despite having Demerol shots, (that not only made me feel loopy and caused me to hallucinate, but also made me severely nauseous) I had intense, indescribable, nearly horrific pain. So I was holding my dizzy head over a bucket while I felt the excruciating intensity of each and every contraction. I had a doctor who didn’t believe me when I said the baby was actually coming. He preferred to stroll around the hospital floor, rushing in only after my husband ran outside to get him, and then had the nerve to tell me to stop pushing so he could get his gloves on.
With my last two children, I opted for natural childbirth and although it was painful, it was also two of the best experiences of my life. I had a wonderful midwife who had a solution for every ailment and a calming serenity that made the births memorable and beautiful. Unmedicated, I was fully aware and present. By moving into certain positions, like laying on my left side with knees bent to help speed up the contractions, I felt I had more control over the birth.
For me, opting for a cesarean section would have made me more nervous. It would have also robbed me of the beautiful birth experiences I had with my midwife. Yet for some women, the apprehension of reliving the pain is too terrifying, and not even an epidural will help alleviate their fright. For these women, they see cesarean sections as their only way of having another child.
How was your childbirth experience? Would you ever consider an elective cesarean section if you didn’t have to?
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Some Docs Say OK To Elective Cesarean Sections To Alleviate Fear of Childbirth | Family Health Corner commented on Dec 18 10 at 4:08 amandrea commented on Dec 17 10 at 9:16 pmRidiculous! How on earth can you be afraid of uterine contractions BUT NOT AFRAID OF A KNIFE SEVERING YOUR UTERUS? What in the love of god are these women thinking? Your uterus and vagina were designed to move a baby. Yes, it hurts. Boo hoo. Lots of things hurt. Any given woman has an enormous amount of control over that pain. It requires will power. It requires character. It requires strength against adversity. It requires, in other words, that you be a fully aware and functioning adult capable of sustaining yourself, and hopefully, another life.
And yes, I have children. Three of them. All homebirths. No drugs, no needles, and certainly, no knives!
Linda, the original one commented on Dec 17 10 at 9:22 pmI had an unmedicated natural childbrith, then an emergency c-section, then two VBACs. I don’t for the life of me understand why anyone would WANT major abdominal surgery just prior to bringing a new baby home. I thought it was dreadful and the recovery was so difficult. I bounced back really quickly after all my normal births, but was incapacitated for 8 weeks following my c-section.
eb commented on Dec 17 10 at 11:58 pmSad to me that our society is so removed from the experience of childbirth that this seems like a viable option when it should absolutely be a last minute, emergency last resort. I really do sympathize with those women who have been traumatized. I feel that if they had a supportive community of women who could assure them that childbirth is okay and they’ll get through it, they might feel differently about what their bodies could handle. Natural childbirth is actually quite empowering. The majority of women I know feel like they could not have birthed without their epidurals or that their c-sections were just fine. Having had a c-section and a VBAC, I wish everyone who loved their c-section had a chance to compare the two experiences.
Laure68 commented on Dec 18 10 at 12:45 amVery few women actually elect to have C-sections. This is something that is so often reported on in the media, yet is pretty rare. I really question why so much attention is given to this subject. (It kind of reminds me of the media hysteria over strangers kidnapping your kid.)
MsFortune commented on Dec 18 10 at 1:55 amI support the right of women to birth in the way that they choose, including elective c sections.
caro commented on Dec 18 10 at 7:18 amWhen pregnant with my first daughter I had a wonderful midwife, I did yoga daily and was intent on a natural childbirth. I felt righteous in my decision. When she was estimated to be over 9lbs, even though I’m 5’2 and naturally 120 lbs, I was smug in knowing that size is irrelevant- besides I did my daily parineal massage. Labor was fairly easy, until I had 4th degree tearing (that is tearing through the sphinter and anus.) I had have months of physical therapy and had three months of bowel incontenence. To quote Andrea above “It requires will power. It requires character. It requires strength against adversity.” Yes, it required all of these things to not cry the first time I lost control of my bowels in a diaper at target. I did not feel empowered.
After my midwife estimated my second baby would be over 10 lbs, she referred me to a doctor and I made the difficult decision to have an “elective” c-section. My dd was born via c-section a petite 9lbs 14oz- and we’re part of those “elective” statistics.
Danielle Sullivan commented on Dec 18 10 at 7:55 am@Caro I’m really sorry to hear about your birthing experience. That must have been very traumatic. I can definitely see how you want to avoid that again. I feel very lucky to have had the natural birth experiences I did.
It’s possible that people overlook the long term complications that can result from some very traumatic births, especially people who like me, had good natural birth experiences.
I do have an acquaintance who is too afraid to even attempt a vaginal birth. It’s her first baby so she has no bad memory of anything prior, and I wonder if she is robbing herself of something very beautiful. She is already scheduled for an elective cesarean.
andrea commented on Dec 18 10 at 8:55 amCaro, you had a section for a very clear medical reason. It’s not an elective procedure when natural labor and delivery results in that kind of damage. Any midwife who would tell a tiny woman she can effortlessly deliver a huge baby should lose her license. There was no reason in the world for you to be so injured. C-sections are there to protect women like you.
I don’t think anyone would argue that c-sections aren’t absolutely necessaryin some cases. The WHO estimates that the section rate should be around 10-12%. In some hospitals, it’s over 30%, and while most women will swear they REQUIRED a section, clearly, that’s not true.
What if this were some other major procedure? I’d like a heart transplant, because I’m afraid of the chest pains that go along with a heart attack? As I said, ridiculous!
Luschka @ Diary of a First Child commented on Dec 18 10 at 9:22 amNever, in a million years, if it’s not essential (and none of this, your baby is back to back so you HAVE to have a c-section style ‘essential’!)
I had 45 hours of back to back labour and was still at 4cm when my midwife wanted me to transfer in to hospital. The baby wasn’t in distress, but I was EXHAUSTED. My husband asked (on my behalf) if we could have two more hours, and in those two hours, lying on my left side with a pillow between my legs, I went from 4- 8 cm, and then delivered in a birthpool in my kitchen after 48 hours of labour in the most peaceful, gentle birth. The midwife even commented that she’d never seen anyone singing during transition before. I was so aware, so present, and the high lasted for weeks afterwards, and I didn’t have any depression, or even baby blues. It was amazing.
I can’t imagine giving birth any other way.
Luschka @ Diary of a First Child commented on Dec 18 10 at 9:29 am@Andrea, the hospital near where I live I would NEVER give birth at, because they have a 90% c-sec rate. Yes. 90%
But there’s also a doctor there who is KNOWN by all the staff for his Friday afternoon sports, so if you go in to his clinic on a Friday morning in labour, he will FIND a reason why you have to have a c-section. :(
Meagan commented on Dec 18 10 at 9:58 amI’m with Ms Fortune. If the doctors don’t care, and insurance doesn’t care, why should you? If a woman is aware of the risks, it’s her choice. I very much doubt that those women who have been perfectly satisfies with their c-sections care a whit that they missed out on the natural birth “experience.”
And by the way… I am very suspicious of the claims that risks to the infant include immature lungs, breathing problems or extra care in a NICU as long as the elective c-section is done at full term.
Angela commented on Dec 18 10 at 10:34 amI think it’s wonderful that so many of you ladies have had positive experiences with natural childbirths and I do agree that the C-section rate in this country is too high. However, I think that has much more to do with doctors and hospitals that put their own convenience and fear of litigation above the safety and comfort of mothers and babies than women who request c-sections for their own convenience and fear of giving birth. In general I feel that medical decisions are a private matter between doctor and patient and that outsiders should refrain from judging and weighing in.
Steph commented on Dec 18 10 at 12:51 pmSo much of it must be about education. If a woman is educated and aware of her birth choices I am so confident that she would feel much better able to deal with childbirth. I don’t know how well “reality” tv depicts what actually happens in the birth rooms of hospitals in the USA but from what I’ve seen on shows about childbirth the women are ALL lying on their backs in a hospital bed, hooked up to a monitoring machine – the least helpful way to deal with pain and move labour along! Get up and walk, squat, rock, lean… It’s as if no one has told these women there’s a better way! I certainly was apprehensive about the birth of my first child, but after doing childbirth classes, reading up on everything and talking to my friends who had given birth I felt really empowered and capable. I was scared still of the pain and how I would cope with it, but I was more afraid of being medicated and the chance, as the writer describes, of feeling out of control, and then of being out of control and have things happen to me that I didn’t want. The best decision I made for my child and myself was to have a doula present at the birth. For me, I was able to put my fears in her hands and let her reassure me that everything was normal and that I was doing well and I trusted that she would let me know if I needed to worry or call the midwife in. In the end we were all but left alone in the birthing room (not hooked up to any machines) and only for the last 30 minutes did we have the midwife and OB/GYN in the room to catch the baby. I managed to have the unmedicated birth I wanted for my child, and I really appreciate having had that experience. I said to my OB and doula afterward that I felt really lucky to have had a relatively easy birth, and they both (separately) corrected me and said that so much of it was down to my being prepared and going in with a good attitude. It’s a tricky topic to discuss because I also believe that women should be able to make decisions about their own bodies and trust given to them that they know themselves best… But I can’t help wonder that so many women aren’t given the information and therefore opportunity to do their best and make a genuinely informed decision.
Laure68 commented on Dec 18 10 at 1:24 pmAndrea said – ” It’s not an elective procedure when natural labor and delivery results in that kind of damage.”
That is absolutely incorrect. The elective C-section rate in this country is around 1 to 2%, and most of them are for things like Caro described. There is no medical indication for a C-section if there was tearing in a previous birth.
I really think this whole “women are choosing C-sections for no reason” has been so overblown for a couple of reasons. First, it makes a lot of people feel better about themselves. (“*I* would never do anything like that!”) Also, it greatly oversimplifies the problems we have concerning medical care, which center around things like the number of people without coverage and fear of lawsuits, which are much more complex problems to solve.
And like others have said, if someone is happy with the way they gave birth, that is OK with me. I don’t get people who saying things like “oh, if they only had the experience I had, they would see how bad their experience really was”. People need to seriously get over themselves.
eb commented on Dec 18 10 at 1:29 pm@Angela, you say “However, I think that has much more to do with doctors and hospitals that put their own convenience and fear of litigation above the safety and comfort of mothers and babies than women who request c-sections for their own convenience and fear of giving birth. In general I feel that medical decisions are a private matter between doctor and patient and that outsiders should refrain from judging and weighing in.” If you acknowledge that doctors and hospitals are making decisions that are perhaps not in the best interest of mothers and babies, then why would you encourage women to make the decision soley with her doctor? I have no problem with the doctor being part of the decision making process, but feel that it is very important for the woman to educate herself and be aware of the best available medical research when it comes to making medical decisions. Doctors and hospitals are not going to change their actions until women demand they do, and until that happens the c-section rate will continue to climb.
Angela commented on Dec 18 10 at 3:38 pmEB, I was not implying that women should not seek out information from anyone but their doctor or should not be allowed to advocate for their rights if they feel that their hospital or provider is not respecting their choices. However, if a women is aware of the risks and still thinks that a C-section is the best option and has found a Dr she trusts who is willing to perform the procedure I really don’t feel that it’s the place of outsiders to pass unwanted judgment. Plain and simple I support a woman’s right to choose.
Linda, the original one commented on Dec 18 10 at 9:45 pm“Any midwife who would tell a tiny woman she can effortlessly deliver a huge baby should lose her license.” Sorry, but that’s completely ridiculous. Women that size have easy, vaginal deliveries every single day. It’s unfortunate that Caro experience what she did, and I don’t blame her for planning a c-section for any subsequent children. She has a medical reason. What I don’t like to see if people spreading around complete misinformation like that small women can’t naturally birth babies.
Linda, the original one commented on Dec 18 10 at 9:56 pm“If the doctors don’t care, and insurance doesn’t care, why should you?” Both the doctors AND the insurance ought to care. Regardless of your suspicion, there IS proof that elective c-sections are riskier for both mothers AND babies alike. When doctors are sued for malpractice, we ALL pay more. When insurance companies cover unnecessary surgeries we ALL pay more. I know you’re currently on your first pregnancy. If you do some research, you’ll learn that your “due date” is an estimate. Each baby matures at slightly different pace, so the only way to know for certain that your baby is “full term” is to spontaneously go in to labor (and we all know that even that method isn’t flawless.) Additionally, it’s known that women who have c-sections have more difficult recoveries, more problems breatfeeding, and an increase in post natal depression. The doctors who are willing to schedule and perform c-sections for no medical reason, are valuing their pocketbooks above the wel lbeing of mothers and babies. It’s an issue we should ALL care about.
Linda, the original one commented on Dec 18 10 at 9:58 pm“I support the right of women to birth in the way that they choose, including elective c sections.” Okay. I object to paying higher insurance premiums because of medically unneeded procedures. I’ll bet most women would be singing a different tune if they had to pay for an elective c-section like they have to pay for any other elective surgery.
Meagan commented on Dec 18 10 at 11:47 pmWeirdly Linda, being on my first pregnancy hasn’t stopped me from already having done that research. So I know for example that an ultrasound gives a pretty damn good estimate of the baby’s gestational age. For that matter, if you “spontaniously” start your labor, and get yourself into the hospital to ask for your c-section, that’s an elective c-section no more premature than a natural birth. Meanwhile the elective c-section scheduled at 40 weeks is no more premature than the vaginal birth induced at 40 weeks, which whether you agree with it or not, many doctors do.
Heather commented on Dec 19 10 at 1:06 amIf you’re that afraid of childbirth, there’s a simple solution – don’t have kids. You can’t make an omelette without breaking eggs. And I say this as someone whose son had a 15-inch head circumference and had to be pulled out by vacuum. The first doctor exhausted herself pulling with all her strength, and they had to get a male doctor to take over. And I still would fight tooth and nail not to have a c-section.
Linda, the original one commented on Dec 19 10 at 1:41 amActually, Meagan, you’re completely wrong on almost all counts. An ultrasound can only guess gestational age based on size and it’s even know to be inaccurate in that regard (plus OR minus an entire pound, FYI.) It tells you nothing about ACTUAL getational maturity or lung maturity. Competent doctors who care about the well beings of their patiends don’t induce OR perform c-sections without medical reason at 40 weeks or any other time. Back to that “research” drawing board, toots.
Linda, the original one commented on Dec 19 10 at 1:44 amhttp://mothering.com/pregnancy-birth/the-case-against-inducing-labor?page=0,0
Linda, the original one commented on Dec 19 10 at 1:47 amhttp://mothering.com/pregnancy-birth/cesarean-birth-in-a-culture-of-fear
“A woman is five to seven times more likely to die from a cesarean delivery than from a vaginal delivery.
A woman having a repeat C-section is twice as likely to die during delivery.
Twice as many women require rehospitalization after a C-section than after a vaginal birth.
Having a C-section means higher rates of infertility, ectopic pregnancy, and potentially severe placental problems in future pregnancies.
Babies born after an elective cesarean delivery (i.e., when labor has not yet begun) are four times more likely to develop persistent pulmonary hypertension, a potentially life-threatening condition.
Between one and two babies of every hundred delivered by C-section will be accidentally cut during the surgery.3
The US is tied for second-to-last place with Hungary, Malta, Poland, and Slovakia for neonatal mortality in the industrialized world.4
Babies born via C-section are at high risk for not receiving the benefits of breastfeeding.5
The risk of death to a newborn delivered by C-section to a low-risk woman is 1.77 deaths to 1,000 live births. The risk of death to a newborn delivered vaginally to a low-risk woman is only 0.62 per 1,000 live births.6 “
Meagan commented on Dec 19 10 at 1:48 amSince I don’t have a medical degree of any kind, I’m really not going to argue what makes a compitent doctor. I realize inducing is a controversial topic, but there are certainly doctors, who as of yet are still licensed to practice medicine, inducing at 40 weeks. I don’t particularly agree with the practice, but some doctors do it.
Can you find me an example of a baby that was induced (or removed via section) at 40 weeks that turned out to be premature?
Linda, the original one commented on Dec 19 10 at 2:06 amAre you serious? Lung prematurity after planned c-sections and inductions at term is so common that it happens every single day at hospitals all over the country. Ask your OB (can’t imagine you’d have a midwife).
Linda, the original one commented on Dec 19 10 at 2:14 amThan talk to her about what “term” actually MEANS. Many babies (especially 1st babies) aren’t ready to be born until closer to 42 weeks.If they’re forced out earlier, their lungs are often not fully mature. Pregnancy 101.
Meagan commented on Dec 19 10 at 2:44 amNo thanks. I’m going in on Monday to hear my baby’s heart beat for the first time. I understand what term means, I understand what you’re saying about a baby’s gestational age being mis-guessed, and I’m not going to waste time talking about how it applies to a situation which is for me purely hypothetical. I’ll accept your argument for now on planned c-section at 40 weeks since I have my own problems with inducing and don’t particularly want to try to defend it.
So then what of my first suggestion? A woman who waits to go into labor and then chooses an elective c-section? Yes there are additional risks for mom, but she’s a grown up. As for the risk of baby being cut… not sure but that seems much more likely to happen during an emergency c-section when everyone is in a hurry. I’m not a hundred percent on that one, but I do know that c-section complications of all kinds are more common during emergency c-sections.
Linda, the original one commented on Dec 19 10 at 3:04 amIf the woman goes in to labor on her own, then that eliminates the need to guess about lung maturity. That’s the way they used to do even planned c-sections. When I was pregnant with my first child (13 years ago), I had two friends who planned c-sections for medical reasons (one had a footling breech and the other had a malformed uterus) and both waited until they started labor, then went in for their c-sections. It’s only been in recent years that some doctors have started planning surgeries, at least around here (hippy Seattle). There was a good reason to wait, but it was more cost efficient and profitable to have a c-section date at the local hospital when each doctor could do assembly line sections. I just want to reiterate this statistic: “The risk of death to a newborn delivered by C-section to a low-risk woman is 1.77 deaths to 1,000 live births. The risk of death to a newborn delivered vaginally to a low-risk woman is only 0.62 per 1,000 live births.” The risk of death to THE BABY during a c-section is almost three times as high. Enjoy hearing your baby’s heart beat. Soon you’ll get to feel all the kicking too. I really enoyed that aspect of being pregnant.
Meagan commented on Dec 19 10 at 10:46 amBut c-sections SHOULH have a higher mortality rate, because even with low risk women, many of them are done in emergency situations where the baby is already in trouble. Are there stats for just non-emergency c-sections?
Thanks. :) Looking forward to being able to feel the baby. :) I think I’ve still got about a month to go on that.
Linda, the original one commented on Dec 19 10 at 3:12 pm“Are there stats for just non-emergency c-sections?” If you don’t like the statistics I’m ptovding, fire up your search engine and find your own. I think you want to believe that a planned c-section is just as safe as a vaginal birth. It’s not, but it’s not actually my job to convince you. Use your own brain.
Kae commented on Sep 02 11 at 10:22 amReally? I’m more afraid of having a C-Section! With all the complications that could arise, knowing someone is cutting into me when I am fully aware is a big no no, and knowing I react to certain anesthesia and medications make me fear for life. I’d opt for the actual birthing process.
Elizabeth commented on Sep 21 11 at 10:36 amI went through 4 doctors during my pregnancy, and my first one, though a great doctor, made a questionable choice for one of her patients. She had a 14yr old patient who was sleeping around with a few of her friends (she had to sit down with the doc and NARROW DOWN the possible fathers.) who ended up pregnant. My doctor calmed the mother’s fears by telling her that they were scheduling a c section to make birth easier on her daughter. My mother overheard this and looked at me “If that had been you at 14, you better know that you’d be going through the WHOLE experience. A c-section would be a possibility only if you couldn’t push that child out.” I personally would not CHOOSE to get a c-section… but some women have TERRIBLE first births, and even though we all hear that every pregnancy and delivery is different, it’s hard to get passed almost dying. (My MIL almost bled to death) I do not understand and never will, doctors who offer first time moms c-section instead of trying vaginal delivery first. I think vaginal delivery rates would be higher if first time moms and those that are a bit scared to try it again were better educated and supported.
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