Saturday, 5 December 2009

How to deliver a baby?


So, poor people prefer to deliver their babies naturally (i.e. a vaginal birth) and rich people prefer to deliver using Cesarean section?

Sounds absurd, but isn't that a common symptom in our modern times?

Apparently natural birth is too much of a stress and is too messy for rich women to bother with.

What do you think? IYM especially?

To read more, click here on the full article:

http://www.thenational.ae/apps/pbcs.dll/article?AID=/20091130/FOREIGN/711299852/1187/enewsletter

Image credit: http://jeremysierra.com/DSC01487%20(Medium).JPG

17 comments:

Media Junkie said...

i think any surgical procedure should be a last resort and not elective. especially regarding child-birth.

DoTs... said...

1. less pain
2. less "hassle"
3. Controlled birth
4. and scars r sexy :P

not my opinion though

Inspire Your Mind said...

LOL BuJ.. this is your funniest post I've ever read :)

Allow me to elaborate given my professional exppertise; for those who do not know me; I'm an an Obstetrician Gynecologist and North American Board certified in the field with additional expertise in high-risk pregnancy:

When we consent patients for cesarean section; we go over pros and cons of the procedure; potential complications; and alternatives. Each discussion is case-dependent and sometimes the safest mode of delivery for both Mom and baby is C/Section which is nowadays safer than appendectomy.

As anesthesia related saftey is increasing; cesarean section on demand (ie, according to mom's wish) is becoming a plausable option to women especially highly professional ones (and not richer ones). How much a doctor will make out of it really depends on which country he's practicing in. For instance, the difference in fees between vaginal birth and c/section in Canada is only 100-150 Canadian Dollars, whereas in UAE or in the States I would make a fortune out of doing c/sections if I'm working in the private sector ( 10,000 to 15,000 Dhs per case which shouldn't take more than 30-40 minutes if uncomplicated).

Now the advantages of cesarean section on demand (and I'm not talking about emergency sections here) are the following:
1. mainly preservation of sexual and urogenital function as vaginal birth especially repeatedly is known to cause pelvic organ prolapse and dysfunction.
2. Professional women choose it since they're not planning to have large families ( 1 to 2 babies at most); in which repeat c/section complication rate is very low.

Now, c/section is not without complications and it can cause the following:
1. surgical bleeding (which should be manageable in good hands); infection (which is manageable with antibiotics); and DVTs (deep venous thrombosis) which could be life threatening but we don't encounter it that often. BTW, DVTs can also complicate vaginal delivery but more so with c/sections.
2. Repeat c/sections ( 2 or more) has a risk of causing low-lying placenta (placenta previa) with next pregnancy with the potential of invasive placentation (accreta/ increta/ percreta) if the placenta is implanted on the previous c/section scar. Invasive placentation can cause catastrophic obstetrical bleed either before or at the time of c/section. Only well-trained obstetricians can handle this complication since it needs surgical expertise; in worst case senario a woman might end up loosing her uterus in order for us to save her life. Other modalities of management if the patient is hemodynamically stable include certain non-surgical interventions ( like uterine artery embolization) which not any center has the resources or the sett-up for. I know of a patient who died in Dubai because of lack of experience and resources in managing this complication.

Vaginal delivery can be pain-free with the use of regional anesthesia (epidural). However, the course of vaginal delivery can sometimes be unpredictable and can get complicated with major lacerations and tears; the worst of which is 4th-degree laceration which involves the anal sphincter; the potential long-term complication of which (if not repaired properly) is fecal incontinence. 3rd and 4th degree lacerations complicate operative vaginal delivery (vaccum and forceps) more so than spontaneous vaginal delivery.

The bottom line is each case is different; and with each woman each delivery would be different than her previous experience. That's why we don't give general advises and we prefer to individualize our management and tailor it according to patient's needs.

One last thing; don't forget our second patient here; that little angel growing inside of her who can, in certain cases, dictate our entire management plan.

How much you're paying BuJ for this consultation ?

Enjoy your weekend..

rosh said...

*passes out seeing the picture

rosh said...

IYM, my sister in law, is ecpecting her 3rd child this Christmas, and it's her 3rd C/section. I hope / pray, zero complications. Thanks for the overview. I alwats thought the mom had little say in all this.

Inspire Your Mind said...

Hi Rosh.. why pass out seeing the picture ? This is very benign compared to what we encounter from time to time.. patients collapsing and on the verge of dying if you don't interfere.. babies born with major malformations gasping for their last breath.. and so on !

I wish your sister-in-law a safe delivery Inshallah.. that's what doctors are trained to provide :)

And I wish your wife a safe one as well :)

Esoterica said...

Hi there BuJ,
I'll post as a mother who has given birth twice without medications and with each child over 4kg and without any of the complications mentioned- thank God. I'll also be speaking in the voice of a psychologist who is interested in deconstructing this phenomenon.

As a mother: I don't think having a vaginal delivery is a superior experience to a c-section, I think each comes with its risks and advantages and that it is always possible to bond with your child and that most of the bonding experience relates to your readiness, expectations, and as a prep to the next voice- your psychological well being.

As a psychologist- I wonder where we have this notion that pain is bad. I have had very long deliveries with each of my children and while I'm not a masochist, it was reassuring that that pain is not a symptom of disease, but instead a natural PROCESS. There are so many processes that include pain and suffering and childbirth is one that mostly lands us with bouncing babies and joyful moments, so what is so bad about hurting and learning more about ourselves our strength and endurance? I learned so much about my inner musings while contemplating my ability to cope. There are no remedies for other pains such as the loss of love and life, that experiencing a pain that is temporary and results in a positive outcome is hardly reason enough to expose one's self a huge surgical procedure.

I'm now pregnant with my third. I don't know what kind of delivery my situation will necessitate and I don't know if I'll go for pain relief or not. I like to wait and see the circumstances.
And those are my TWO cents…

Firefox said...

Inspire your mind - Thanks for the post. It was an interesting read.

Although it has put me off having children, at least for today.

It was a bad idea to read that while eating banana cake.

*shudders*

Inspire Your Mind said...

Esoterica.. I love the way you integrated the psychological aspect of delivery into the scene.. for sure being a mom who's gone through birthing experience added depth to what you said. As for me, I handle it from the other side of the delivery bed if you know what I mean; my priority is safety of both mom and baby.. I join the first few minutes of birth celebration; I take pictures with the family if they insist; and then I leave the delivery room after I make sure everything is in control :)

FireFox.. enjoy your banana and your chocolate cake.. most of the time it goes well belive me..

Where is Mr BuJ? He threw us in a delivery room and he ran away from the scene :)

KJ said...

I am not a woman and therefor I do not believe I have any right to say what is best for them when it comes to child birth!

A Blessing in Tragedy said...

Wow... That picture makes me want to barf.

Just proves my point that humans should be born in tubes, or better yet, not at all.

I really feel sick after seeing that picture BuJassem. Thanks. Eh.

Inspire Your Mind said...

The baby is the picture is a huge one (ie; large for gestational age or macrosomic) just from the look of him/her.. I'm sure he's born to a diabetic pregnancy..

Usually newborns are smaller and cuter :)

Don't get scared ABIT.. he's just a little bit fat..

Helenas_hidden_Treasures said...

natural birth and special connection with a baby because of it it a total BS. I had a vertical S-section and 3-induced vbacks. The last Induced Vback 45 minutes without epidural because Doc was going to be late for Thanksgiving dinner :( If anyone would tell my that's how I should connect to my baby closer is a full of crap! I have no closer connection after 2 years and still have nightmares and want to cry every time I remember the birth... My baby came with her nose up and she was so badly bruised & I couldn't sleep for 2 months without crying and thinking about my pains as well ... maybe it's just me but I don't see how you can feel closer to baby when every time you remember what you had to go through...

BuJ said...

hello Helena and welcome to this blog.

Thanks for your comment and it's opened a new viewpoint for me!

I wish and pray for your health and the health of your beautiful baby.

Rationality said...
This comment has been removed by the author.
Rationality said...

Hi there BuJ;
As a medical student we had studied that delivering babies naturally support the baby’s immune system while the baby passed through the mother’s vagina. However, those who got delivered by cesarean operation won’t get a high immune system but that ceased the terrible aches that mothers could go through.

BuJ said...

hello Rationality.. sorry for the delay to reply.. but thnx for ur comment.. i never studied medicine but you make a very interesting point.