Did you have a c-section? What were the reasons?

[Anonymous]

Anonymous wrote:The baby had decels on the heart rate monitor. The cord was around his neck.

Two vaginal births -- both had cords around their neck, OB just untangled it as they came out. Apparently this happens a lot and OBs sometimes use it to justify a c-section, but it is super, super common.

[Anonymous]

Active herpes outbreak. Apparently, this is a more common reason for sections than you hear about. For obvious reasons. I tell people it was for failure to progress.

[Anonymous]

Mine was elective after an extremely traumatic vaginal birth for my first.

[Anonymous]

Mine was for decels but once they opened me up they found that there was a pelvic bone issue -- I pushed for three solid hours and it turned out that i could have pushed all night and I never could have gotten him out. Three cheers for my c-section!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, I count 5 mentions of "decels" as the sole reason for their c-sections on this thread. In addition to the factors OB PP mentioned, continuous fetal monitoring is often cited as a factor in the increased c section rate. Look into hospital-based midwives if you want to avoid this. They will already have fought the battle with the hospital policies to allow them to do intermittent monitoring.

Well, continuous fetal monitoring has reduced death rates. You seem to be implying that those c sections were unnecessary, but you really have no idea.

Not PP. No it hasn't. Look at the research!

I have looked the research, and this is what it says for EFM (not specifically continuous):

"In the United States, the use of electronic fetal heart rate was associated with substantially decreased early neonatal mortality and morbidity that lowered infant mortality."

http://download.journals.elsevierhealth.com/pdfs/journals/0002-9378/PIIS0002937811004807.pdf

"The temporal increase in EFM use in the United States appears to be modestly associated with the recent declines in neonatal mortality, especially at preterm gestations."

http://www.ncbi.nlm.nih.gov/pubmed/23635727

[Anonymous]

Anonymous wrote:

Anonymous wrote:The baby had decels on the heart rate monitor. The cord was around his neck.

Two vaginal births -- both had cords around their neck, OB just untangled it as they came out. Apparently this happens a lot and OBs sometimes use it to justify a c-section, but it is super, super common.

Not pp. But in my case, the baby's heart rate dropped down and didn't seem to want to come back up (I tried switching positions, etc). Next thing I knew I had an oxygen mask on my face, my gurney was tilted so that my head was lower than my feet and I was being rushed down the hall to the OR. So, probably a different scenario than you might be envisioning....

[Anonymous]

Anonymous wrote:Active herpes outbreak. Apparently, this is a more common reason for sections than you hear about. For obvious reasons. I tell people it was for failure to progress.

Did you go into labor and show up at the hospital with an active herpes outbreak?

[Anonymous]

Induced at 40 weeks for very slightly low amniotic fluid. In retrospect, should have asked for a second ultrasound or NST. Induction went nowhere fast. A whole lot of pitocin later, baby went into distress.

Really wanted a vbac with number 2, but 42 weeks rolled around, baby was OP and my body seemed incapable of going into labor on its own. I was ready to throw in the towel and go for the RCS, but my amazing OB (not the same dr who delivered #1) broke my water to induce and baby #2 was born 9 hours later. Easy vbac, easy recovery.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, I count 5 mentions of "decels" as the sole reason for their c-sections on this thread. In addition to the factors OB PP mentioned, continuous fetal monitoring is often cited as a factor in the increased c section rate. Look into hospital-based midwives if you want to avoid this. They will already have fought the battle with the hospital policies to allow them to do intermittent monitoring.

Well, continuous fetal monitoring has reduced death rates. You seem to be implying that those c sections were unnecessary, but you really have no idea.

Not PP. No it hasn't. Look at the research!

I have looked the research, and this is what it says for EFM (not specifically continuous):

"In the United States, the use of electronic fetal heart rate was associated with substantially decreased early neonatal mortality and morbidity that lowered infant mortality."

http://download.journals.elsevierhealth.com/pdfs/journals/0002-9378/PIIS0002937811004807.pdf

"The temporal increase in EFM use in the United States appears to be modestly associated with the recent declines in neonatal mortality, especially at preterm gestations."

http://www.ncbi.nlm.nih.gov/pubmed/23635727

Original pp making the point about CFM here. Please note that I did not call the PP's sections unnecessary--those words were put in my mouth. I was making a statistical point, not a point about individuals.

The data are not as clear as you'd like to think; for one, they back up my point as well as yours. The first paper says:

The finding of significantly increased operative vaginal and primary cesarean deliveries with EFM also has implica- tions. When emergency cesarean deliv- ery is done for nonreassuring fetal heart rate tracing, the umbilical arterial pH is less than 7.0 in 4 to 10% of the cases.55-57 A possible reason for the lack of objective evidence of fetal compromise at birth with operative interventions may be the fact that the operative interventions are early enough to prevent adverse out- come. Indeed, it has been argued by Freeman and Nageotte58 that the “high- false positive” rate of EFM results could be the results of timely interventions, which prevent perinatal mortality.
Another issue to consider is that clini- cians do not usually undertake intrauter- ine resuscitative measures before pro- ceeding with emergency cesarean. In a majority of the cases, clinicians do not use scalp or fetal acoustic stimulation to elicit acceleration, attempt amnioinfu- sion for variable decelerations, or ad- minister tocolytics to resolve the fetal heart abnormalities.55,59 It is our belief that clinicians should improve compli- ance with intrauterine resuscitation, although additional research is being done to decrease operative rate, with- out increasing neonatal morbidity and mortality.

The study concludes:

In conclusion, our data suggests that in the United States, in real life practice, the use of EFM increases operative delivery, while decreasing early neonatal mortality-and therefore infant mortality-and also de- creasing neonatal morbidity. The bene- fits of EFM are gestational age dependent with the highest impact demonstrated in the preterm fetus. Although awaiting fu- ture RCTs to address the role of EFM in conjunction with STAN, in defining long-term neonatal outcomes, attempts should be made to minimize unneces-
sary interventions.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, I count 5 mentions of "decels" as the sole reason for their c-sections on this thread. In addition to the factors OB PP mentioned, continuous fetal monitoring is often cited as a factor in the increased c section rate. Look into hospital-based midwives if you want to avoid this. They will already have fought the battle with the hospital policies to allow them to do intermittent monitoring.

Well, continuous fetal monitoring has reduced death rates. You seem to be implying that those c sections were unnecessary, but you really have no idea.

Not PP. No it hasn't. Look at the research!

I have looked the research, and this is what it says for EFM (not specifically continuous):

"In the United States, the use of electronic fetal heart rate was associated with substantially decreased early neonatal mortality and morbidity that lowered infant mortality."

http://download.journals.elsevierhealth.com/pdfs/journals/0002-9378/PIIS0002937811004807.pdf

"The temporal increase in EFM use in the United States appears to be modestly associated with the recent declines in neonatal mortality, especially at preterm gestations."

http://www.ncbi.nlm.nih.gov/pubmed/23635727

Original pp making the point about CFM here. Please note that I did not call the PP's sections unnecessary--those words were put in my mouth. I was making a statistical point, not a point about individuals.

The data are not as clear as you'd like to think; for one, they back up my point as well as yours. The first paper says:

The finding of significantly increased operative vaginal and primary cesarean deliveries with EFM also has implica- tions. When emergency cesarean deliv- ery is done for nonreassuring fetal heart rate tracing, the umbilical arterial pH is less than 7.0 in 4 to 10% of the cases.55-57 A possible reason for the lack of objective evidence of fetal compromise at birth with operative interventions may be the fact that the operative interventions are early enough to prevent adverse out- come. Indeed, it has been argued by Freeman and Nageotte58 that the “high- false positive” rate of EFM results could be the results of timely interventions, which prevent perinatal mortality.
Another issue to consider is that clini- cians do not usually undertake intrauter- ine resuscitative measures before pro- ceeding with emergency cesarean. In a majority of the cases, clinicians do not use scalp or fetal acoustic stimulation to elicit acceleration, attempt amnioinfu- sion for variable decelerations, or ad- minister tocolytics to resolve the fetal heart abnormalities.55,59 It is our belief that clinicians should improve compli- ance with intrauterine resuscitation, although additional research is being done to decrease operative rate, with- out increasing neonatal morbidity and mortality.

The study concludes:

In conclusion, our data suggests that in the United States, in real life practice, the use of EFM increases operative delivery, while decreasing early neonatal mortality-and therefore infant mortality-and also de- creasing neonatal morbidity. The bene- fits of EFM are gestational age dependent with the highest impact demonstrated in the preterm fetus. Although awaiting fu- ture RCTs to address the role of EFM in conjunction with STAN, in defining long-term neonatal outcomes, attempts should be made to minimize unneces-
sary interventions.

No, they don't back up your point. Your post strongly suggested that EFM is just a meanie "intervention" that causes c-secitons, and has no other purpose. The research shows that it increases c-sections and decreases neonatal mortality. Which makes sense - the babies in trouble got c-sections. Some of them would have survived without c-sections, but that's not a reason to ditch EFM or claim that it is unjustified.

[Anonymous]

I had preeclampsia. They induced first, and I got to 9.5 cm and pushed hard for close to four hours, but she was a big baby (8lbs 12oz), and she wasn't moving, and the doc really wanted to get me on magnesium for the preeclampsia.

[Anonymous]

I had twins, with twin B being transverse. My OB would have allowed me to try vaginally, but I had no interest in doing so.

[Anonymous]

Spontaneous uterine rupture (small hole formed) from contractions, causing failure to progress and eventual fetal distress. Second one was planned CS as a result.

[Anonymous]

I was 10 days late and started having very minor contractions with no dilation. They slowed down at the hospital so we started pitocin. I had very strong contractions for 6 hours and was still only dilated to 6 and the baby had not descended at all. I had a doula and we tried all kinds of positioning exercises, but the baby just wasn't coming down. The two doctors present and the doula agreed that a c-section was the best choice. That said, they were willing to let me continue to labor. At that point I was just exhausted so I went with the c-section.

Would I have had a different outcome with another doctor? Maybe, but I don't stress about it. My recovery was easy and everyone was fine. And with #2 I wanted a VBAC but I started leaking amniotic fluid and after 3 days of losing fluid, the doctor said we had to deliver. I was not in labor at all, no contractions, no dilation. They wouldn't do pitocin because of the first c-section. So I just leisurely walked into the hospital and had a baby a few hours later.

I know that I probably could have waited it out in both cases and maybe it could have happened vaginally, but for whatever reasons my babies just didn't want to descend so the pushing process might not have gone well with me.

[Anonymous]

No, I really didn't want one. I labored for 16 hours when my cervix swelled and baby's head got stuck. Cervix just kept swelling, leading to an emergency c-section. I'm now pregnant with baby #2 and must decide between repeat c or a vbac.