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Re: Placenta percretaFrom: Chrisa93@aol.comWed Jun 16 20:29:39 2004
In a message dated 6/16/2004 7:13:26 PM Eastern Standard Time, ainsron@sbcglobal.net writes: "That may be the case, but it is apples and oranges if you are talking about lack of informed consent for a relatively “elective†cesarean section, such as: “I think you have a large baby and it may get stuck coming out,†and the baby turns out to be a pound smaller than her last baby; vs. the patient with the cord prolapse or abruption who needs a C/S immediately and the only information she needs is that her baby may die if she doesn't get to the OR right now. The relative risks of future pregnancy takes a back seat to the immediate problem in most circumstances. It is not a “huge issue,†as you state." Obviously, when a baby's life is truly in danger (prolapse, abruption, previa, etc.), the risks are well worth the benefit. I don't have a problem with informed consent in that situation. But true life-threatening emergencies do not occur in 26.1% of births, which was the c/s rate for last year. You give an example of a 'relatively "elective" c/s'- but I don't really think that is elective when a mom is told by her doctor whom she trusts that her baby could die or be seriously injured if she attempts a vaginal birth. It's those women who are not told the risks, yet are made to believe their babies lives are in danger. We may differ on what true indications are for c/s, but I hear from so many women who are given the most absurd reasons for why their baby MUST be born by c/s. It happens all the time. And we have already discussed many times how we will opt for the c/s which is a "better safe than sorry choice" even if the indication is unclear- and this is usually to avoid law suits. What about the women who are counseled to have ERCS instead of have a TOL d/t the very small risk of UR? Are they told the risks of each additional c/s? Placental complications? Etc? I don't think so. And I think the problem is much larger than you say. Even if it is 25% of c/s births, that to me is HUGE. Chris A., NP
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