NYT articles on fetal monitoring, increase in c-sections and rise in severe complication

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Fetal monitoring saved my kid’s life, so I’m fine with it.

Yeah, that's what it's for. This is the problem with people's anecdotal reactions to stuff like the OP, in my opinion. The regulations that get in the way of an ideal childbirth experience (wandering around in a dimly lit room with your selected birth posse and your playlist/meditations on repeat while doctors stay out of the way and the ghost of Ina May encourages your healthy baby out on a wave of feminist empowerment) are there to prevent a worst-case outcome. For people who benefit they can see the rationale plainly. The people who weren't close to a bad outcome can only see that they were prevented from experiencing their ideal outcome.

Doctors don't care about ideal they care about alive. As they should.

In no other area of medicine is this true. If I go in for knee replacement and have a leg amputated absolutely no one will say “yeah but your other healthy femur is all that matters”. Avoiding the worst case is literally the bare minimum expectation of medicine. It’s amazing how little you want patients to settle for when they’re only women.

Completely ridiculous analogy. And ignores that there are two patients in a delivery ward. And acts like avoiding death is a simple, easily achievable "bare minimum" when in fact childbirth was the leading cause of death for women for a lot of human history, so avoiding death in childbirth is a pretty big deal! But I'm sorry your leg was amputated during your C-section; you can actually sue over that.

Feel free to accept whatever you want to accept as good enough. Others want progress and improvement

[Anonymous]

Anonymous wrote:Re: fetal monitor. I remember the nurse wouldn't let me use the restroom because the baby's heart slowed down when I stood up (had to use a bedpan).

C-sections: I had two c-sections. I figured the second was likely because of the first (failure to progress) but I suppose I could have tried for a vbac first.

I'm so glad I got a private room with a bathroom for both deliveries in two different hospitals.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I find PP's post about no monitoring at GW strange, because I was monitored continuously there with no known issues and it was ridiculous considering I was trying to do the whole doula/midwife/move around and work that baby out approach.

With my second I was at Sibley and while they strapped the monitor to me when I checked in, they treated it more like a backup indicator than robot boss - when it moved and we lost the heartbeat they were never concerned because it was pretty obvious nothing was wrong and the baby just wiggled out of range.

I had the opposite experience at Sibley 18 years ago.

When I had my two at Sibley 10-ish years ago they were very chill about the monitor and me moving around the room. They may have changed philosophies or there may have been some risk factors involved.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I gave birth to my first 20 years ago and this was a thing then. The system sucks and women pay

The system is designed to keep women alive, and if you look over the course of history, the current one does a very very very good job. They may overprescribe c-sections but it’s 10000% better than the alternative.

When you find the solution that strikes the *perfect* balance you go ahead and let us know!

No, the system is designed for the convenience of doctors and to attempt to prevent lawsuits. It is absolutely not the goal to keep mother's and babies alive

Lawsuits happen because things ended badly. I'll take mild discomfort over a bad ending any day when they err on the side of safety and an abundance of caution.

What about the women who end up bleeding to death in subsequent pregnancies because they got an unnecessary c section due to the doctors erring on the side of safety and caution? The point is that c sections are not necessarily the safer and more cautious approach.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Fetal monitoring saved my kid’s life, so I’m fine with it.

Yeah, that's what it's for. This is the problem with people's anecdotal reactions to stuff like the OP, in my opinion. The regulations that get in the way of an ideal childbirth experience (wandering around in a dimly lit room with your selected birth posse and your playlist/meditations on repeat while doctors stay out of the way and the ghost of Ina May encourages your healthy baby out on a wave of feminist empowerment) are there to prevent a worst-case outcome. For people who benefit they can see the rationale plainly. The people who weren't close to a bad outcome can only see that they were prevented from experiencing their ideal outcome.

Doctors don't care about ideal they care about alive. As they should.

In no other area of medicine is this true. If I go in for knee replacement and have a leg amputated absolutely no one will say “yeah but your other healthy femur is all that matters”. Avoiding the worst case is literally the bare minimum expectation of medicine. It’s amazing how little you want patients to settle for when they’re only women.

Completely ridiculous analogy. And ignores that there are two patients in a delivery ward. And acts like avoiding death is a simple, easily achievable "bare minimum" when in fact childbirth was the leading cause of death for women for a lot of human history, so avoiding death in childbirth is a pretty big deal! But I'm sorry your leg was amputated during your C-section; you can actually sue over that.

Not in the last hundred years in the developed world. Is there any other aspect if medicine you’re good with the same standards as 1925? Truly, no one is saying anything other than we can and should continue to improve not set an aspiration of “not dead“ and call it a win.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Fetal monitoring saved my kid’s life, so I’m fine with it.

Yeah, that's what it's for. This is the problem with people's anecdotal reactions to stuff like the OP, in my opinion. The regulations that get in the way of an ideal childbirth experience (wandering around in a dimly lit room with your selected birth posse and your playlist/meditations on repeat while doctors stay out of the way and the ghost of Ina May encourages your healthy baby out on a wave of feminist empowerment) are there to prevent a worst-case outcome. For people who benefit they can see the rationale plainly. The people who weren't close to a bad outcome can only see that they were prevented from experiencing their ideal outcome.

Doctors don't care about ideal they care about alive. As they should.

In no other area of medicine is this true. If I go in for knee replacement and have a leg amputated absolutely no one will say “yeah but your other healthy femur is all that matters”. Avoiding the worst case is literally the bare minimum expectation of medicine. It’s amazing how little you want patients to settle for when they’re only women.

Completely ridiculous analogy. And ignores that there are two patients in a delivery ward. And acts like avoiding death is a simple, easily achievable "bare minimum" when in fact childbirth was the leading cause of death for women for a lot of human history, so avoiding death in childbirth is a pretty big deal! But I'm sorry your leg was amputated during your C-section; you can actually sue over that.

Again, not specific to childbirth. When they do live-donor organ donation they don’t say oh we did a real hack job here and did a lot more surgery than you needed but you don’t get to complain because both patients are alive. It would be malpractice to do so, but again considered “a win” in obstetrics.

[Anonymous]

The statistics do not differentiate elective primary cesareans.

[Anonymous]

If you aren't a doctor, you can't say what is a necessary c section and what isn't. Patients who "want" a certain kind of birth don't get to dictate it either.

Doctors aren't perfect, but they have very extensive training and continuously updated information on how to keep mothers and children healthy. Your Instagram feed does not.

[Anonymous]

Anonymous wrote:If you aren't a doctor, you can't say what is a necessary c section and what isn't. Patients who "want" a certain kind of birth don't get to dictate it either.

Doctors aren't perfect, but they have very extensive training and continuously updated information on how to keep mothers and children healthy. Your Instagram feed does not.

Weird take. You think non-MDs can’t read clocks? Insurance companies have some views on unnecessary surgery as well, and *subsequent doctors* reviewing the notes have identified unnecessary csections in boards.

What do you think happens in medical school — canonization? Doctors want money and convenience at exactly the same rate that other humans want those things. Second opinions and informed consent laws didn’t arrive because doctors always make the right call.

[Anonymous]

Anonymous wrote:If you aren't a doctor, you can't say what is a necessary c section and what isn't. Patients who "want" a certain kind of birth don't get to dictate it either.

Doctors aren't perfect, but they have very extensive training and continuously updated information on how to keep mothers and children healthy. Your Instagram feed does not.

The linked articles point to peer reviewed research.

It is always ok to question your medical providers, get second opinions, ask the “why” behind any treatment or intervention.

[Anonymous]

Anonymous wrote:Fetal monitoring saved my kid’s life, so I’m fine with it.

I think everyone agrees fetal monitoring is important. There are different ways to do it, some of which are evidence based.

[Anonymous]

The point of the article is that because of unnecessary or additional c-sections, a previously rare and deadly complication is becoming more common and women are dying. It’s not about “ideal birth experience.”

[Anonymous]

I don't think the c section rates are
Rising because women and doctors are choosing c sections. I think it's because:
1. Women are waiting longer to have children and AMA pregnancies frequently have complications
2. Obesity
3. And improved medical technology that, while increasing rates of c sections, also saves the lives of children and mothers.

Who are these doctors handing out c sections like candy? I don't believe it.

[Anonymous]

I guess the fetal monitors could be a hindrance if you really wanted to get up and walk around and give birth in the tub and all that, but if you had an epidural, how would they even affect you? I have 2 kids and had an epidural both times and there was no way I was getting out of that hospital bed. They could have strapped whatever to my stomach and it wouldn’t have made a difference. I have to assume most women are getting an epidural, and a lot of women who aren’t, are giving birth outside a hospital - at home or in a birth center, where you wouldn’t expect much monitoring or much in the way of medical interventions anyway. So this seems like a problem for only a small sub set of women …

[Anonymous]

Anonymous wrote:I guess the fetal monitors could be a hindrance if you really wanted to get up and walk around and give birth in the tub and all that, but if you had an epidural, how would they even affect you? I have 2 kids and had an epidural both times and there was no way I was getting out of that hospital bed. They could have strapped whatever to my stomach and it wouldn’t have made a difference. I have to assume most women are getting an epidural, and a lot of women who aren’t, are giving birth outside a hospital - at home or in a birth center, where you wouldn’t expect much monitoring or much in the way of medical interventions anyway. So this seems like a problem for only a small sub set of women …

Did you read the article? Its very clear how relying on the monitor leads to more c-sections, and how that leads to more fatalities.