For the record

[velvetpage]

That statistic about "C-sections are four times as deadly as vaginal births" is a fabulous example of using statistics in EXACTLY THE WRONG WAY.

It is, nominally, true. About one in forty thousand vaginal deliveries results in maternal death, whereas about one in ten thousand c-sections does. But let's examine, that, shall we? First, what happens when a woman's labour is going so poorly that she's at risk of dying in childbirth? THEY DO A C-SECTION. So an awful lot of women who might otherwise die during vaginal deliveries are instead getting emergency sections (conditional on things like stage of labour, of course.) The section is what happens when the delivery goes to hell in a handbasket.

The overwhelming majority of c-section deaths happen in emergency scenarios where the section is the last-ditch effort to save a woman's life. Occasionally, that fails. But a death from a c-section performed in a non-emergent situation is no (EDIT: not much) more common than a death from a vaginal birth.

It's like the homeopathy people who point out that every year, X million Americans die in hospital under the care of a doctor. Well of course they do - 98% of deaths in America happen in hospital, and you're not in hospital unless you're under the care of a doctor!

There are plenty of other reasons to disapprove of the trend towards more and more c-sections, without making one up out of a poorly-understood stat. The rate of infections goes up, the rate of breastfeeding goes down, complications in subsequent births go up, sections cost more and are harder to recover from - believe me, I know them all and that's why I sought to avoid one. But this stat? If you're in the habit of using it, please stop. It just makes you look stupid.

Comments

[zorinlynx.livejournal.com]

This sort of thing should be obvious. But sadly, people don't *think*.

If more people would *think*, the world would make SO much more sense, wouldn't it? :)

[heather-button.livejournal.com]

I had never even HEARD that statistic before. Thanks for enlightening me ;) Some people will believe anythng, I guess.

[catarzyna.livejournal.com]

I don't know the statistics but most of my friends have had one or more c-sections. I've always thought they were more of a trend than a necessity but in at least 2 occasions I know they were needed.

My great maternal grandmother had 9 children vaginally, my Gram had 5 vaginally and my mother had me vaginally. I'll be a bit put out if I have to have a c-section.

[velvetpage.livejournal.com]

I'm very much in favour of reducing c-section risks and only having them if they're necessary. Most c-sections performed are not necessary. The c-section rate should be between one and five percent of births; instead it's around 30%. That's too much.

But if you're going to avoid a c-section, do it because breastfeeding will be easier, or because having your stomach muscles sliced is a bad idea all round, or because you don't want to be in hospital for four days. Don't do it because you're scared of a four times greater risk of dying when the risk is still so small.

[catarzyna.livejournal.com]

Actually I think it is a bad idea unless it is a necessity. I want a vaginal birth. I don't want surgery. There is a greater risk of infection. Plus I don't want a long post-delivery recuperation time. Consider this part and parcel of being raised by nurses, working in the field for about a decade and going to nursing school. I'm seriously considering a midwife, but definitely not a home birth.

[kisekileia.livejournal.com]

Yeah, my sister was born via a C-section because Mom's obstetrician was going on vacation shortly afterwards. I don't know if that sort of thing is still done, but that's not a good reason!

And that "four times the risk of dying" stat is so transparently ridiculous. However, it seems like a lot of the crunchy types will believe anything as long as it smears the medical establishment.

[hillarygayle.livejournal.com]

Or because it hurts like hell the day after. *nodnod* That's my personal favorite reason.

[velvetpage.livejournal.com]

There's always that. Oh, God, that nasty spinal headache. . . the only benefit to it was the way it took attention away from the interior bruising and incision site.

The infection at two weeks post-partum was no picnic either.

[hillarygayle.livejournal.com]

No infection for me, but I can only imagine. ARG.

I also did not get the spinal headache. In fact, the epidural worked like an anesthesiologist's textbook dream. Flawless. And then it wore off and I was like "Oh, hey, they cut through 7 layers of tissue to get in there...AND I FEEL EVERY STINKING ONE."

[amyura.livejournal.com]

Where are you getting the 1-5%? The lowest I've ever heard (WHO) is 10-15%.

I think one of the big elephants in the room is the issue of fertility treatments and more women waiting until they're older to have the first baby. If you're 28 (as I was) when your first is born and are planning on 3 or 4, there's a huge incentive to avoid a c-section, as each one increases the risk that you'll have another one. If you're 38 (as some of my colleagues were) when your first is born, it's very likely that your first will be your only, and you're more likely to want to take on the risks of surgery after going through more to achieve a pregnancy.

[velvetpage.livejournal.com]

I believe the section rate in the Netherlands is lower than 10%, since about that number are even born in hospital there. I may be misremembering, though.

I was 27 when I had Elizabeth, and she's one of the reasons I'm still glad I got into my career quickly rather than doing a masters right after my BA. If I knew then what I know now, I'd have gone with a midwife when I was pregnant with her.

[hillarygayle.livejournal.com]

I hate hate hate hate the "this many people die in hospitals". That's ridiculous. By the time you need to be in the hospital, you're pretty far gone in whatever problem you're having. If your COPD exacerbation is so bad as to need hospitalization, yes, you're likely to die of it! And without my help & the care of a physician, a whole lot sooner at that!

Ugh, c-section recovery time. I'm hoping for a VBAC. Odds are better since my c-section wasn't emergent.

[pyat.livejournal.com]

Did you know that almost 90% of Americans DIE IN THE CARE OF A DOCTOR????

:)

[mrs-dm.livejournal.com]

Just to tell the other side of the story: I wish to god(s) I had had a C-section, or at least been offered one (after 3 hours of trying to push out a 9-pound baby). I had a hospital birth, but with a midwife in attendance. They had to call the obstetrician in anyways to use the vacuum (the modern alternative to forceps). Unfortunately, this gave me a 4th-degree tear causing 4 years of dyspareunia (painful sex) and subsequent surgery (a vaginal revision). The difficult delivery was a big reason why we chose not to have more children.

My point is, some women *should* be offered C-sections and are not. I liked the midwife care prenatally and postnatally, but I think if I had gone with an obstetrician all along, it would have saved my vagina.

Sorry for the TMI.

[velvetpage.livejournal.com]

That scenario seems to be rare, but absolutely it happens.

[amyura.livejournal.com]

THANK YOU!!!!

I totally support women who want to have a home birth or a UC. But it's bullshit to say that they're "safer" than a hospital. The same woman, with the same risk profile, will be safer at a hospital. It's just that almost ALL the high-risk women are automatically at a hospital, including planned home births gone wrong.

[velvetpage.livejournal.com]

I confess that UCs squick me out. I can't come around to the idea that they're safe. But a home birth with a midwife, absolutely - it is safe provided there is a hospital no more than 20 minutes away in case of a need to be transferred.

[xx-kitty-kat-xx.livejournal.com]

Someone said something to my SIL recently about how she'd risked her life so much more by having a c-section. She pointed out that a vaginal birth came with a 100% chance of paralysis for her, and since she already has limited use of one arm, she'd take the potential risk of death over the certainty of being left with one fully funtional limb. The same person also felt the need to inform my brother that there was something 'disturbing' about him being present in the operating room when she had her c-section done.

I personally feel that it's downright rude to say things like that to a woman (or a man). It is true that there are many c-sections which are unnecessary, but there are also many which are necessary, and people really should remember that before making comments that can make a woman feel like shit for having the birth she had.

[velvetpage.livejournal.com]

Wow. Where does anyone get off telling someone they shouldn't be in the room to support their spouse and witness/support the birth of their first child?

Some sections are necessary. The maternal death rate is extremely low in developed nations in part because surgical/medical options are available for difficult deliveries. Kudos to your SIL for telling it like it was for her.