 |
 |
 |
|
|
|||
|
|
||||
|
||||
Re: elective caesarean section deliveryFrom: K.Tice (anonymous@obgyn.net)Wed, 14 May 1997 18:26:06 -0500 (CDT)
At Tue, 13 May 1997, Kelly wrote: > >At Tue, 13 May 1997, D. Ashley Hill, M.D. wrote: > >>This is a common issue in Ob/Gyn. The old adage "once a cesarean, >>always a cesarean" is simply no longer valid. Although there is a >>slight chance of uterine scar dehiscence (where the former incision on >>the uterine wall opens up during labor), this event has an incidence of >>only about 1/2 of 1%. Even then, the majority of moms and babies do >>fine, although an emergency c/section is often necessary. This is >>balanced by the medical fact that vaginal delivery is almost always >>safer than a major abdominal operation. >> >>Most patients are unaware of the significant risks of bleeding, >>infection, abdominal scar breakdown, postop pain, and potention bladder >>damage and scar tissue formation that can occur with a big operation >>like a c/section. True, most go quite well, but I guarantee every >>single Ob/Gyn on this group has seen otherwise routine c/sections go >>downhill rapidly! I consider the average c/section to be more dangerous >>than the average hysterectomy, as there is almost always more blood loss >>and infection. Patients don't always see this, and many really push >>their doctor for one, but if there are complications the inevitable >>statement is "I sure wish I hadn't had a c/section". The statement "but >>I did great after the first c/section" is common, but not necessarily >>statistically valid, since each additional surgery is more difficult. In >>addition, most babies come out of vaginal deliveries crying or at least >>breathing well, whereas with a c/section (at least at our hospital) we >>are required to have a respiratory team there to stimulate the baby, >>since many don't breath as well after a c/section. This is probably >>because the vaginal walls squeeze fluid from the lungs during a vaginal >>delivery, making it easier to breath at first. >> >>However, not all VBAC attempts go well, either. As one medical journal >>article said "VBAC: low risk, not no risk"! Some result in a c/section >>anyway, which is frustrating for everyone. The overall chance of >>delivering vaginally after a prior c/section is *about* 75-80%, which >>are pretty good odds. Even fewer result in a uterine scar breakdown, >>requiring emergent delivery. The final decision must be yours, and you >>should feel comfortable with your doctor and his or her advice. This is >>part of the all-important informed consent process, where you get the >>information and opinion from your doctor or other health care provider >>about the risks/benefits of *any* procedure, including a VBAC. Once you >>make the decision, either way, you should receive full support from the >>medical staff. > >I have to echo everything Dr Hill said -- he did a great job giving you >the important facts you need to make an *informed* decision. Now that >you know all the issues, whatever decsion you make will be the right >decision, because it was not made blindly. > >I have one question for you: if you don't like and trust your current >doctor ( a doctor who won't answer your questions and who always makes >you feel rushed), why don't you switch? > >-- >Kelly Shanahan, MD, FACOG >S. Lake Tahoe, CA > Dear Dr Shannon, I am giving serious consideration to changing doctors. I have written to another obstetrician and once I hear back will make my decision then. The only reason I am not sure what to do, is because I feel certain I will opt for an elective caesarean (though reading the response I got from Ann Nash -thank you Ann, I may consider VBAC), and as the OB I am currently seeing has a very high caesarean rate probably due to the fact that he is an infertility specialist, he is very experienced at doing caesareans. I would be in good hands if I choose to have one. I saw one OB prior to him and didn't like him, so changed to my current one; my worry is I cannot be guarenteed that if I change again that he/she will be any better. All I know is I do not like this man, and your right - that is a very good reason for not continuing to see him! I will give your advice some more thought over the weekend. I will certainly have to decide soon as I would like to get to know my new doctor before the baby is born. I am 24 weeks pregnant now - due September 1 or last week of August if I have a caesarean).
-- K.Tice
|
|
Return to ![[ Women's Health Forum ]](http://www.obgyn.net/images_women/wh-forum.gif)
Report TECHNICAL Problems ONLY to: webmaster@obgyn.net
Last Updated: Mon Nov 2 07:05:10 2009
Women's Insurance Checklist from Auto Insurance Quote
home | medical professionals | women | industry | forums | international