Reply to So what exactly is the problem with C-Sections?

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[quote=Anonymous][quote=Anonymous]The article noted many things - you only picked the parts that you like.  But thanks for telling me what I believe.

It seemed you missed a very simple message of the essay: the doctor's bag is getting lighter. It used to be full of all kinds of tricks and tools, including the scalpel.  Now, it's just the scalpel.  Not because they believe the other tools won't work; it's because they don't know how to use them. They simply never learned. And that's why women with any deviations from the "uncomplicated vaginal birth" pathway find themselves with fewer options.  Not because physicians believe these options aren't suitable, but mostly because they don't know how to use them.   It's a very simplified picture, for sure, with lots of gray and nuanced parts, but that's the direction of travel.  We should be able to acknowledge this as reality.[/quote]

I did not simply take out one thing. I took issue with the very heart of the argument. That the lack of tools comes from the fact that they found a more reliable tool, and while perhaps certain tools like forceps are better then c sections in the hands of experts, they overall lead to worse outcomes when applied on a large scale.

So, because this is what I think the conundrum is here, what is the acceptable maternal and fetal injury rate to preserve the 'art' of doctoring?

If every doctor in the country uses forceps first, in order to ensure that many doctors know how to use forceps well, and ensuring that many doctors use forceps poorly despite training is that an ethical choice when we know that if the standard of care moved to c sections more women and babies survived? Even if that is at the expense of some mothers who would have been able to avoid a c section (but perhaps not avoid a traumatic vaginal delivery). These are really difficult questions, but this essay seems to say that losing the 'art' of medicine is a shame while only quietly alluding to the fact that the reward of that loss is less death and birth injury. Why would we want to preserve procedures that injured more humans? That is against the oath.[/quote]

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