Caesarean births twice as risky as natural deliveries
By Jeremy Laurance, Health Editor
Published: 31 October 2007
Women who choose a Caesarean delivery, sometimes described as "too posh to push", are increasing the risk to themselves and their baby. Surprise results from an international study of 97,000 deliveries show that a routine Caesarean puts a woman at twice the risk of illness or death compared to a vaginal birth.
And babies born by Caesarean had a 70 per cent higher risk of dying before discharge from hospital if they were lying normally head first in the womb than if delivered vaginally.
A Caesarean delivery was, however, found to be safer for babies lying in the less common and riskier breech position – feet first.
The findings are from eight randomly selected countries in Latin America, where Caesarean rates are higher than in the UK, at an average of 33 per cent of all births. Well-heeled Latin American women are more anxious about the potential effects of a vaginal birth on their sex lives and in some private hospitals the Caesarean rate is up to 60 per cent.
In Britain, the Caesarean rate has doubled in the past 20 years to 22 per cent, driven in part by the demand of some women for what is perceived as a convenient and pain-free method of delivery. Obstetricians too have seen it as safer – and as a way of reducing risks of litigation. The latest study, published online in the British Medical Journal, suggests the safety of Caesareans may have been overstated.
Jose Villar, former director of maternal health at the World Health Organisation and now a senior research fellow at the University of Oxford, who led the study, said there was no benefit from the very liberal use of Caesareans, either for mothers or babies, and they could even do harm.
Caesareans led to longer hospital stays for mothers and babies, increased the risk of readmission and increased the risk to subsequent pregnancies.
The only exception was that babies in the breech position did better and women had fewer severe vaginal complications.
Dr Villar said the findings should be applicable to Europe and the UK because of the large number of deliveries surveyed, the comparability of outcomes to those in Europe and because the overall Caesarean rate was not dissimilar.
"The message is that a woman thinking of having a Caesarean because it is safer should think again," he said. "It is a question of balancing the risks and benefits. She should sit down with her care provider and consider the options. We think this is the most comprehensive study that has been done."
In a commentary on the findings, Alison Shorten, of the School of Midwifery at the University of Wollongong, New South Wales, Australia, said an important reason why women chose Caesareans was because of worries about damage to the pelvic floor from a vaginal birth, which could lead to sex and bladder problems. "Women need to weigh up the possible but uncertain benefit of preventing urinary problems against the increased chance of problems related to surgery in themselves or their baby," she said.
Pat O'Brien, consultant obstetrician at University College Hospital, London, and a spokesman for the Royal College of Obstetricians and Gynaecologists, said: "We have always known from the mother's point of view a planned Caesarean was slightly riskier... Recent research from the US has suggested the risks of the two approaches were getting closer and closer. This latest study pushes that back a bit."
Bump to Motherhood
Showing posts with label Vaginal Birth. Show all posts
Showing posts with label Vaginal Birth. Show all posts
Thursday, December 13, 2007
Tuesday, August 14, 2007
A friend's Vaginal Twin Birth Story
I was booked for induction at 37 weeks. However at 36+4 weeks in the early hours of 17th April 2006, my waters broke! I woke up my husband and got myself sorted whilst waiting for his mum to arrived.
We had to go to Dundee to have them as they were twins and that was where special care was. My contractions were every 3 minutes, lasting a minute. This was 45 minutes after my waters had gone.
At first they weren't going to let me deliver them as special care was full. After a bit of a discussion it was decided that I would be allowed to have them in Dundee as it was too risky to move me.
Was 4cms dilated by myself and started entonox. Was given the dreaded epidural and managed a little sleep. Eventually it was time to start pushing. There were 2 midwives and a medical student at this point. I had a scan to check Jamie's position as he was breech. Not any more!! He'd turned head down. After a while of pushing and having problems feeling where to push due to the epidural, something clicked and Rachel Eve was born. The hormone drip was started to get the contractions started again. It took a while to get Jamie out as I couldn't feel where to push. It got a bit scary as I could hear his heartrate dropping. At this point there were now 12 people in the room. I was threatened with the ventouse if my next push didn't work. Something clicked and out flew Jamie Alexander, 38 minutes after his sister.
After all the worry neither of them needed to go to special care.
Had a lovely wash, tea and toast, cuddles and lots of phonecalls and photos.
We had to go to Dundee to have them as they were twins and that was where special care was. My contractions were every 3 minutes, lasting a minute. This was 45 minutes after my waters had gone.
At first they weren't going to let me deliver them as special care was full. After a bit of a discussion it was decided that I would be allowed to have them in Dundee as it was too risky to move me.
Was 4cms dilated by myself and started entonox. Was given the dreaded epidural and managed a little sleep. Eventually it was time to start pushing. There were 2 midwives and a medical student at this point. I had a scan to check Jamie's position as he was breech. Not any more!! He'd turned head down. After a while of pushing and having problems feeling where to push due to the epidural, something clicked and Rachel Eve was born. The hormone drip was started to get the contractions started again. It took a while to get Jamie out as I couldn't feel where to push. It got a bit scary as I could hear his heartrate dropping. At this point there were now 12 people in the room. I was threatened with the ventouse if my next push didn't work. Something clicked and out flew Jamie Alexander, 38 minutes after his sister.
After all the worry neither of them needed to go to special care.
Had a lovely wash, tea and toast, cuddles and lots of phonecalls and photos.
A friend's lovely Homebirth Story
"Ok so monday morning woke at 5 (had an hours sleep) and after reading for a bit i had a BH or so i thought. Was different to the ones i had been getting but thought it was the way i was lying.
Went down stairs and had some more. still convinced were BHs as timings were a little off.
By 7 ish i was having to ooh and aah my way through them and couldnt sit down with them so was getting up and practically mounting the computer chair.
I had the runs a few times that morning too but put that down to IBS! I was in such denial for some reason!
Woke tim at 8-30 to say i thought something may be happening but still convinced it would be BHs and would die away as it wasnt really pain just uncomfortable.
At 9 i rang Judith to say i may need her later but didnt need her right then as i thought it may be a false alarm. Sent tim to the chiropractors after he had emptied and cleaned the pool and i filled it while trying to hoover and tidy and get everything together.
Arron woke at about 10 and walked in on me having a contraction. Poor thing didnt know what to do or say. I knew then he wouldnt be able to deal with seeing me in labour so i made arrangements for him to go out for a bit.
That was the point i realised i couldnt talk through them but still didnt think they were painfull. Just before this i had gotten a little emotional and scared as i realised i was really in labour.
Still pottering around and quite happy and feeling pretty painfree really untill about 11-30 when something changed and i knew i had to ring Judith.
She got to us at 12 ish when i was in the shower (i was really conscious of how i smelt for some reason) I lost my plug on the floor as she walked in - nice!!
She did an internal at about 12-15 and i was fully expecting to be told i was 2cms and had ages to go. Before she checked she said my perineum was bulging and she discovered i was 5 cms and the cervix was very thin. She told me to take a couple of paracetamol and she left me to wander round and do what i wanted for a bit.
Within 10 minutes or so she must have noticed a change in me as she started pushing for me to get into the pool if i wanted to use it. I wanted to wait till i couldnt cope with the pain before i got in but she seemed to think that things were moving very quickly.
I think that once Judith arrived i allowed myself to let go if that makes sense.
Got in the pool and almost immediately i noticed a change. Contractions were still pretty spacey and not really regular but although i was fine between contractions, when i had one tim had to be there. He had tried putting the bedding in the dryer 4 times as i kept calling him back.
I was drinking loads of water but i kept lobbing the bottles away from me as soon as a contraction started if no one took it off me quick enough - there were bottles everywhere after i had had her lol
Within about 10 - 15 mins i was getting really awfull pushing urges but this was only half an hour or so after being told i was 5 cms so i was fighting them. Awfull feeling. I knew i was 'going' each time i had one of these and there was nothing i could do about it. But because i had had the runs that morning i got so paranoid and was fighting the pushing urge even more at first.
My waters went at about half one and was so painfull when they did as they stretched me just before they exploded. The noise of them going underwater scared the hell out of me - was like a small bomb.
By about 1-45 i couldnt be in the pool - i was uncomfortable and felt like my legs were going to cramp up so i got out and kneeled over tim as he sat on a chair.
Wasnt comfy like this either and kept saying i just wanted to lie down as i felt so tired. Judith kept trying to get me to squat and change positions but i wasnt being the most co-operative patient by this point! *blush
Eventually at around 2-30 i moved onto the settee and was lay on my left side facing the back of the settee. Now really was the time to push. I was told to hold my leg and pull it up as i was pushing.
The contractions were slowing down now they still werent massively painfull though, but the pushing urge was getting unbearable. The time between the contractions was fantastic - i lay there with my eyes closed and withdrew into myself preparing for the next one and feeling what my body was doing. Tim thought i was asleep but i was super aware of every little noise around me.
Eventually the head started to crown this was the most agony i have felt in my life. I could feel every little bit of her squeezing through from her ears to her nose and chin. I felt like i couldnt possibly stretch any further. Whilst i was pushing the head out i remember thinking if i ever do this again im going to hospital to demand all the drugs going. lol Of course things are different now and i would definately have a home birth if we were to have any more and would not want any drugs again.
Her head was born at 3-17 and i had a minute to compose myself before the body started to come. During this lull i could feel my body gently turning her and ever so slightly pushing her. Was an odd feeling.
Once i got the next contraction and started pushing the intense pain started again and i wasnt stopping pushing for anyone! I was getting her out NOW!!
She was born and passed through my legs onto my stomach and i was in awe of her immeadiately. She was so perfect and beautifull.
Unfortunately as my contractions were a little spacey a few minutes after the cord had stopped pulsing Judith decided that it would be better to give me the synto rather than wait and as everything had gone so well i agreed. The placenta came away within a couple of minutes.
So there you go. Sorry its so long but my memory of it is so clear and so unlike Arrons birth. It felt amazing to feel every part of my daughter being born. I have the most amazing pictures and video of the birth and everyone is going to hear about this till they are sick to the back teeth of it! lol
I am so proud of myself and my body and still cant quite beleive i did it."
Went down stairs and had some more. still convinced were BHs as timings were a little off.
By 7 ish i was having to ooh and aah my way through them and couldnt sit down with them so was getting up and practically mounting the computer chair.
I had the runs a few times that morning too but put that down to IBS! I was in such denial for some reason!
Woke tim at 8-30 to say i thought something may be happening but still convinced it would be BHs and would die away as it wasnt really pain just uncomfortable.
At 9 i rang Judith to say i may need her later but didnt need her right then as i thought it may be a false alarm. Sent tim to the chiropractors after he had emptied and cleaned the pool and i filled it while trying to hoover and tidy and get everything together.
Arron woke at about 10 and walked in on me having a contraction. Poor thing didnt know what to do or say. I knew then he wouldnt be able to deal with seeing me in labour so i made arrangements for him to go out for a bit.
That was the point i realised i couldnt talk through them but still didnt think they were painfull. Just before this i had gotten a little emotional and scared as i realised i was really in labour.
Still pottering around and quite happy and feeling pretty painfree really untill about 11-30 when something changed and i knew i had to ring Judith.
She got to us at 12 ish when i was in the shower (i was really conscious of how i smelt for some reason) I lost my plug on the floor as she walked in - nice!!
She did an internal at about 12-15 and i was fully expecting to be told i was 2cms and had ages to go. Before she checked she said my perineum was bulging and she discovered i was 5 cms and the cervix was very thin. She told me to take a couple of paracetamol and she left me to wander round and do what i wanted for a bit.
Within 10 minutes or so she must have noticed a change in me as she started pushing for me to get into the pool if i wanted to use it. I wanted to wait till i couldnt cope with the pain before i got in but she seemed to think that things were moving very quickly.
I think that once Judith arrived i allowed myself to let go if that makes sense.
Got in the pool and almost immediately i noticed a change. Contractions were still pretty spacey and not really regular but although i was fine between contractions, when i had one tim had to be there. He had tried putting the bedding in the dryer 4 times as i kept calling him back.
I was drinking loads of water but i kept lobbing the bottles away from me as soon as a contraction started if no one took it off me quick enough - there were bottles everywhere after i had had her lol
Within about 10 - 15 mins i was getting really awfull pushing urges but this was only half an hour or so after being told i was 5 cms so i was fighting them. Awfull feeling. I knew i was 'going' each time i had one of these and there was nothing i could do about it. But because i had had the runs that morning i got so paranoid and was fighting the pushing urge even more at first.
My waters went at about half one and was so painfull when they did as they stretched me just before they exploded. The noise of them going underwater scared the hell out of me - was like a small bomb.
By about 1-45 i couldnt be in the pool - i was uncomfortable and felt like my legs were going to cramp up so i got out and kneeled over tim as he sat on a chair.
Wasnt comfy like this either and kept saying i just wanted to lie down as i felt so tired. Judith kept trying to get me to squat and change positions but i wasnt being the most co-operative patient by this point! *blush
Eventually at around 2-30 i moved onto the settee and was lay on my left side facing the back of the settee. Now really was the time to push. I was told to hold my leg and pull it up as i was pushing.
The contractions were slowing down now they still werent massively painfull though, but the pushing urge was getting unbearable. The time between the contractions was fantastic - i lay there with my eyes closed and withdrew into myself preparing for the next one and feeling what my body was doing. Tim thought i was asleep but i was super aware of every little noise around me.
Eventually the head started to crown this was the most agony i have felt in my life. I could feel every little bit of her squeezing through from her ears to her nose and chin. I felt like i couldnt possibly stretch any further. Whilst i was pushing the head out i remember thinking if i ever do this again im going to hospital to demand all the drugs going. lol Of course things are different now and i would definately have a home birth if we were to have any more and would not want any drugs again.
Her head was born at 3-17 and i had a minute to compose myself before the body started to come. During this lull i could feel my body gently turning her and ever so slightly pushing her. Was an odd feeling.
Once i got the next contraction and started pushing the intense pain started again and i wasnt stopping pushing for anyone! I was getting her out NOW!!
She was born and passed through my legs onto my stomach and i was in awe of her immeadiately. She was so perfect and beautifull.
Unfortunately as my contractions were a little spacey a few minutes after the cord had stopped pulsing Judith decided that it would be better to give me the synto rather than wait and as everything had gone so well i agreed. The placenta came away within a couple of minutes.
So there you go. Sorry its so long but my memory of it is so clear and so unlike Arrons birth. It felt amazing to feel every part of my daughter being born. I have the most amazing pictures and video of the birth and everyone is going to hear about this till they are sick to the back teeth of it! lol
I am so proud of myself and my body and still cant quite beleive i did it."
Labels:
Birth Story,
Birthing Pool,
Homebirth,
Natural Birth,
Vaginal Birth
Monday, August 13, 2007
Wednesday, July 25, 2007
Vaginal Twin Birth
I was really moved by a twin birth on a programme yesterday. She really wanted a vaginal birth and twin one was head down so it was looking very promising. I think they said something like 50% of twin births are done by caesarean section in the UK. I guess it's much harder to get 2 babies to co-operate!!
The woman looked completely in control and barely broke a sweat! Twin 1 was born and within 2 minutes (yes 2 minutes!!) she had pushed out twin 2! They were healthy weights and simply adorable. Their big sister came in soon after their birth and loved them!!
Absolutely incredible. I am very fascinated by twins in general so was very pleased to see that birth on tv yesterday! I would be overjoyed to experience one as a doula.
For more information on twin pregnancy, birth and post natal visit Tamba - Twins & Multiple Births Association
The woman looked completely in control and barely broke a sweat! Twin 1 was born and within 2 minutes (yes 2 minutes!!) she had pushed out twin 2! They were healthy weights and simply adorable. Their big sister came in soon after their birth and loved them!!
Absolutely incredible. I am very fascinated by twins in general so was very pleased to see that birth on tv yesterday! I would be overjoyed to experience one as a doula.
For more information on twin pregnancy, birth and post natal visit Tamba - Twins & Multiple Births Association
Wednesday, July 11, 2007
Caesarean Statistics
I was watching a birth programme this morning and heard the narrator say that 1in 5 births are done by caesarean today compared with 1 in 10 in 1980.
I couldn't help thinking how high that was so conducted a bit of research myself lol. This is due to the rise in elective caesareans. I found this article in The Observer "The increase in Caesareans has coincided with a growing shortage of midwives in the UK"
I personally don't undertstand why some people would elect a caesarean with no medical factors. I would support anyone that wanted to but personally think caesareans should be saved for emergencies, after all giving birth is what our amazing bodies were made to do.
I do know that many women have an emergency caesarean with their first child and go on to an elective caesarean for any subsequent babies. Years ago I thought this was a necessity but since my growing interest in birth I have read so much about VBAC - Vaginal Birth After Caesarean. It is possible and many women do it. There is more information on VBAC here - VBAC on Babycentre
What ever women decide, they should remember that they have a choice either way. Never be forced into doing something you're unsure of or uncomfortable with. Ask questions!!
I couldn't help thinking how high that was so conducted a bit of research myself lol. This is due to the rise in elective caesareans. I found this article in The Observer "The increase in Caesareans has coincided with a growing shortage of midwives in the UK"
I personally don't undertstand why some people would elect a caesarean with no medical factors. I would support anyone that wanted to but personally think caesareans should be saved for emergencies, after all giving birth is what our amazing bodies were made to do.
I do know that many women have an emergency caesarean with their first child and go on to an elective caesarean for any subsequent babies. Years ago I thought this was a necessity but since my growing interest in birth I have read so much about VBAC - Vaginal Birth After Caesarean. It is possible and many women do it. There is more information on VBAC here - VBAC on Babycentre
What ever women decide, they should remember that they have a choice either way. Never be forced into doing something you're unsure of or uncomfortable with. Ask questions!!
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