Posts Tagged ‘
Cesarean Section ’
Monday, June 23rd, 2014
As a worrier, my twin pregnancy arc has looked something like this: Without too many real symptoms in the early stages, I worried I might not really still be pregnant. Following that, I coasted seamlessly into the stage of worrying about delivering dangerously early.
Now, at nearly 34 weeks, I’m hoping I can continue to cook these nuggets until they’re really big and strong — a chance many multiples moms I know would have given almost anything to have. Alas, in particular when it comes to carrying multiples, the threat of pre-term labor is very real, and the fear of it — or the reality of it — consumes many parents to be.
Despite that, and despite growing evidence that supports the idea of better health outcomes for babies who reach full term, it turns out that many women are delivering early electively.
According to new research from the University of Minnesota and published in the journal Medical Care, more than 3 percent of babies delivered in the U.S. are coming into the world early and without valid medical justification; if that doesn’t seem like a huge figure, consider it’s about 120,000 babies across the entire population each year.
So what does early mean? A baby is considered full-term at 39 weeks of pregnancy. And the study showed that early delivery without medical reason “at between 37 and 39 weeks is associated with health problems for mothers and babies” alike, according to HealthDay News.
According to the study, women were more likely to opt for early induced labor if they were 35 or older, were white with higher education, were insured privately, and delivered their babies in rural or non-teaching hospitals.
Those choosing to deliver early by C-section tended to be younger than 20 or older than 35, black, have higher educations, and gave birth at smaller hospitals.
The study further suggested that babies born early by elective C-section were much more likely to have longer hospital stays as well as respiratory issues than babies born at full term. Further, babies born early after elective induced labor also faced longer hospital stays.
“There are misunderstandings about when a baby is ready to be born,” study leader Katy Kozhimannil said in a news release. “Since our findings show there are differences in who is having an early elective delivery, the importance of a full-term birth needs to be communicated to all women, not just those who may traditionally be considered high risk for elective procedure or high risk for poor outcomes.”
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Tuesday, April 29th, 2014
There has been an ongoing debate over whether inducing labor really increases or decreases your chance of having a C-section. According to a new study conducted at Queen Mary University in London, forget everything you’ve read about inducing labor (which is when a doctor gives you medicine like pitocin, or other drugs, to artificially start or speed up your contractions) boosting your chances of needing a C-section.
In fact, according to their analysis of 157 studies involving 31,000 births, pregnant women whose labor is induced are 12 percent less likely to need a cesarean delivery than those whose doctors take a “wait-and-see” approach.
According to Health Day, “the 12 percent lower risk of cesarean delivery was seen in term or post-term pregnancies that were induced, but not in preterm births, the authors noted.
Inducing labor lowered the chance of cesarean delivery in both high- and low-risk pregnancies, and it also reduced the risk of fetal death and complications in mothers, the findings showed.
The researchers also found that the widely-used drug prostaglandin E2 was linked to a reduced risk of cesarean delivery. However, use of the hormone oxytocin, and amniotomy (the deliberate rupture of the amniotic sac) did not lower the chance of C-section.
Labor is induced in about 20 percent of deliveries, for myriad reasons—including (but not limited to) being one to two weeks past your due date; having gestational diabetes (and your doctor fears your baby may be getting too big); having too little amniotic fluid, or your baby isn’t growing as it should; if your water breaks but your labor doesn’t start on its own; or if you develop preeclampsia.
In other great induction news, last week the American College of Obstetricians and Gynecologists debunked a recent study by Duke University’s Medical Center that stated that women who had induced labors were more likely to have newborns on the autism spectrum. ACOG claims there is insufficient evidence to support this theory, and therefor doctors should not change their practice of using inductions when needed. As with all things, speak to your doctor if you’re concerned about your chances of being induced so you have all of the facts about the risks and benefits.
On a personal note, being induced isn’t as scary as it sounds—though I understand being freaked out about it. My ob-gyn induced me at 39 weeks—my water had broken at 4:00 am, and by 8:00 am I was still just dilated one measly centimeter. I also had gestational diabetes, so she worried that I could end up having to have a C-section if all did not go well. Luckily, all did go well. In fact, after getting the pitocin at around 9:00 am, I went to sleep and when I woke up at noon, I was fully dilated. I couldn’t believe I had slept through most of my major contractions! If you have to be induced, I hope things go equally well for you!
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Friday, February 7th, 2014
As it is, childbirth is a super-scary unknown for first-time moms. Of course you want the cuddly prize at the end. But the step-by-step pain and suffering that gets you said cutie? Not so much. Not to completely freak you out, but the bad news—according to a new study conducted by the University of California, San Francisco—is that a healthy birth can actually take much longer than doctors originally thought.
Usually, OBs intervene and try to speed up labor if it doesn’t seem to be progressing in a timely manner. Often, that’s based on the length of the second stage of labor. As reported in the New York Times, anything over three hours for first-time moms, who’ve been given epidurals, is considered “abnormally long,” as is more than two hours for first timers without an epidural (Yes, getting an epidural seems to prolong birth, but doctors warn not to jump to conclusions, because longer labor could be caused by other factors that influence whether a woman chooses an epidural rather than the epidural itself).
The thing is those times used to judge what’s normal versus dangerous are based on outdated data from decades ago when fetal monitoring was pretty non-existent, medical interventions were the norm, and on average pregnant women were younger and weighed less. According to this new study that compared data from over 42,000 women who delivered children between 1976 to 2008, a normal second stage can actually be more like 5. 6 hours for first-time moms using epidurals and 3.3 hours for those without epidurals; 4.25 hours for women receiving epidurals, who’ve previously had children, and 1.35 hours for repeat moms who didn’t use an epidural. Ugh!
Before I scare you to death, there is a silver lining! If longer second labor is normal, fewer drugs, forceps, vacuums, and C-sections may be needed than previously thought. Now doctors are quick to jump the gun and want to intervene. Not without cause, though. Longer labor does mean increased risk of tearing and postpartum hemorrhage (neither of which sounds very comfortable!). But C-Sections—which are now used for about one in every three births in the US, an increase of nearly 50 percent over C-sections used in the mid-1990s—can also come with big risks for mom and baby. So even though the thought of labor taking even longer is hard to swallow, the need for fewer C-sections is something to celebrate!
TELL US: What’s your biggest childbirth fear? Would you rather have a longer birth, or a C-section? Share your experiences below.
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Tuesday, December 3rd, 2013
With IVF treatments, twins have basically become the new norm—46 percent of IVF births are multiples, mostly twins. But now fertility experts want to change that. The new goal: single births, even when using IVF. Why? Twins have a much higher risk of being preemies and having serious health problems that could potentially last a lifetime.
The most recent info from the Center for Disease Control and Prevention states that 37 percent of IVF babies, who are multiples, are born premature, while only 3 percent of babies born without fertility treatments are twins, and of those about 12 percent are preterm.
Many women who’ve struggled to have kids are excited to have twins—even asking their physicians for twins—because they may not have the money for multiple IVF treatments (each round can cost up to $20k!), or they would love to have two kids at once, and never have to go through pregnancy again! But doctors fear that couples are making a rash decision without really knowing the increased medical risks for babies and moms (risk of gestational diabetes and preeclampsia are higher).
The American Society of Reproductive Medicine’s recent guidelines state that women should be counseled on the risks of multiple births and embryo transfers and that this discussion should be noted in their medical records. According to the guidelines, “for women with reasonable medical odds of success, those under 35 should be offered single embryo transfer and no more than two at a time.” They are open to more embryos being implanted, if the woman is over 35.
According to Valley News, with stronger screening of embryos, success rates for single embryos could be nearly as good as when two or more are used, say experts. The new techniques include maturing the embryos a few days longer, improving viability and allowing cells to be sampled for chromosome screening. Embryos can be frozen to allow test results to come back and more precisely time the transfer to the womb.
Taking these steps with single embryos results in fewer miscarriages and tubal pregnancies, healthier babies with fewer genetic defects and lower hospital bills from birth complications, many fertility specialists say.
I’m really torn on this subject, because I don’t think any of us want more Octomoms running around out there, or kids with health problems. But—and it’s a big but—all of the women I’ve known who’ve had IVF (and I should note that all of them have been over 35), have had twins, and are beyond thrilled with their decision to have multiple embryos implanted. Many of them did have complicated births—including extended bed rest, spotting, C-sections, and breathing problems in the children that caused them to stay in NICU for weeks, up to months after their births.
All of that said, as far as I know every single one of them is a happy, healthy kid with no lingering medical issues (at least so far—fingers crossed!). And even though the pregnancies and births were more complicated, required more doctor visits, and now they have twice the expenses with two little ones running around at the same time, the parents’ love for their two cuties made all of that initial anxiety worth it for them, and they would never, ever want to have traded that experience in for a single birth.
TELL US: Do you think women should be discouraged from having twins? Do you have twins? Tell us your story!
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Bed rest, C-section, Cesarean Section, fertility, Gestational Diabetes, In Vitro Fertilization, infertility, IVF, Multiples, Preeclampsia, Preemies, pregnancy, pregnant, Spotting, Twins | Categories:
Monday, December 2nd, 2013
The Huffington Post UK is reporting that a pregnant 35-year-old Italian woman in England for a work trip was ordered by Essex’s Court of Protection to have a Cesarean section against her will. And it gets worse! She was then forced to put her child up for adoption. Scary, right? The court says it was all done to protect her unborn child. Why? The woman—who is the mom to two other girls—has Bipolar disorder, and if she fails to take her meds she can have manic episodes and paranoid delusions.
She had what appears to be a breakdown at a hotel and was taken into custody. The court ordered the C-section, and the baby was taken by social workers the following day. Another judge began the adoption process for a British couple to take full custody of the child—despite the mom being back on her meds, with a job, home, and family support (her 11 and 4 year old are being raised in Italy by her parents). She testified that having her daughter taken away is what finally made her accept that she is in fact bipolar, and got her back on her medication.
The mom, whose daughter is now 15 months old, plans to continue to challenge the adoption, in hopes that she and her baby can return to Italy, so her entire family can be together. I know the intention was to “save” the baby, but this sounds like a total violation of the mom’s human rights to me. A forced Cesarean section? That sounds like something that would happen in a barbaric nation, not England!
Mental health is a serious issue—and more help and insurance coverage should be devoted to it, IMHO—but why not notify the woman’s parents in Italy, so the baby could grow up with her sisters? Why rip her from the arms of her mom, and out of her siblings’ lives? I don’t get it! Where’s the common sense here? They are supposed to be the family court, but they clearly don’t value the importance of family.
TELL US: Do you think the Court of Protection did the right thing, or was it a huge human rights violation?
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