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Cynthetiq · 07-02-2007, 12:00 AM

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But the fact that our c-section rate has gone up 10% in just the past few years (it is 30%) with no end in sight convinces me that we are going in the wrong direction. I check the CDC web site every once in a while and never before in american history have so many women had prenatal care, it is in the high nineties percentage wise. So the equation better prenatal care equals better outcome should be playing out in terms of our statistics for surgery, prematurity, and low birth weight.

I assume you are referring to these statistics Table 26, Table 7 and Table 8

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+
The rate of induction of labor increased for 2003–2004 to
21.2 percent. This is more than twice the 1990 rate (9.5 percent).
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Between 2003 and 2004, the rate of cesarean delivery increased by 6 percent to 29.1 percent of all births, the highest rate ever reported in the U.S. After falling between 1989 and 1996, the cesarean rate has risen by 41 percent. The primary rate increased 8 percent, and the rate of vaginal birth after cesarean delivery (VBAC) fell by 13 percent for 2003–2004.

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Method of delivery
The rate of cesarean delivery for 2004 increased to 29.1 percent,
the highest rate ever reported in the United States. This rate represents a 6 percent increase from 2003 (27.5 percent). After falling between 1989 and 1996, the cesarean rate rose by 41 percent from the 1996 low of 20.7 (Figure 10 and Table 28). Data from the National Hospital Discharge Survey show similar trends in cesarean delivery for 1990–2004 (74,75).
The continued escalation in the total cesarean rate is being driven by both the increase in the primary cesarean rate and the decrease in the rate of vaginal birth after cesarean delivery (VBAC). The risks, benefits, and long-term consequences of cesarean delivery, especially with regard to medically indicated or cesarean delivery with no medical or obstetrical indication, and VBAC delivery are the subject of intense debate (76–78). A National Institutes of Health expert panel recently acknowledged a lack of national data or other studies on mothers’ preferences and recommended against cesareans that are not medically
indicated for women desiring several children, and for pregnancies of less than 39 weeks of gestation (79).
Figure 10. Total and primary cesarean rate and vaginal birth after cesarean rate: United States, 1989–2004

76.
Lydon-Rochelle M, Holt VL, Easterling TR, Martin DP. First birth cesarean and placental abruption or previa at second birth. Obstet Gynecol 97(5) Part 1:765–9. 2001.
77.
Minkoff H, Powderly KR, Chervenak F, McCullough LB. Ethical dimensions of elective primary cesarean delivery. Obstet Gynecol 103(2): 387–92. 2004.
78.
Hale RW, Harer WB. Elective prophylactic cesarean delivery. Editorial. ACOG Clinical Review 10(2):1 and 15. 2005.
79.
National Institutes of Health, State-of-the–science-conference statement.
Cesarean delivery on maternal request. March 27–29, 2006. Obstet Gynecol 107(6):1386–97. 2006.
80.
U.S. Department of Health and Human Services.

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Why? Because in allopathic birth the doctors are practicing cover your butt medicine and I am not very interested in my body or my childs body being traumetized with drugs and procedures just because the doc is afraid of a lawsuit.

Again, correlation does not imply causation. Those are your reasons and rationale.

Is it possible that other factors like personal choice drive this and NOT the medical industry? More women are taking elective primary cesarean delivery. I leap in that direction because people now want a definitive everything today. They want to know exactly when something is going to happen via an appointment. The woman that I replaced at work scheduled her c-section because she wanted to "control" the date (said as she exactly told me.) Also, is it possible that some women are afraid of the pain of vaginal birth, opting for "less" pain via c-section? Or that some women believe that they would rather manage scar tissue rather than pain?

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greenjournal.com
Recent documentation shows that rates of cesarean delivery are again on the rise for both women who have not had a cesarean delivery before (primary) and for women who have undergone a previous cesarean delivery (repeat).1 Primary cesarean deliveries are an important target for reduction, because they lead to an increased risk for a repeat cesarean delivery. Of particular interest are the cesarean deliveries that are elective, although the clinical use and implications of the term elective requires clarification. Elective cesarean deliveries can include medically and obstetrically indicated procedures that generally occur before labor. Elective cesarean deliveries can also include procedures for which there is no clear medical or obstetric indication. There is a growing concernthat there is a rising rate of the latter. These cesareandeliveries are referred to as "maternal-choice" cesareandeliveries and are performed for convenience, pelvicpreservation, and reduction of neonatal morbidity. Maternal-choice elective primary cesarean deliveries generate both clinical and ethical controversy and concern.2 As yet, information on trends in the use of elective primary cesarean delivery to support or dispel concerns about either quantity or appropriateness of use has been lacking. This is due to the fact that one cannot easily identify elective primary cesarean deliveries from typical data sources. Birth certificates and hospital discharge data record whether the cesarean delivery is primary or repeat but they do not include information about whether the woman labored before the operative procedure or what specific indication(s) led to the cesarean delivery.

Also, your response to #4 is your experience, are there any other negatives that are broader? People thinking you are nuts is a negative yes, but that's opinion. I think that vegans are nuts, but that has no impact on anything. Your husband working through is your husband's issue, does that happen to all freebirthing husbands? What are the medical downsides. Again you've cited the pro's but what are the negative implications?

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Originally Posted by analog

Considering you say "properly prescribed", I question your use of the extreme hyperbole of "murdered" to describe people who lose their lives due to medicines they're taking. To be frank, it's crass and asinine.

The simple truth is, in healthcare today, many people simply do not take any personal accountability for their own medical care. They don't ask any questions that really matter, and are largely in the dark about what they take. When asked if someone has any medical history, a person with a severe heart condition will most often answer, "not really". When I finally get the right info from them, and ask them about medications they take, they generally respond "something for my heart". They don't know if their heart runs too fast, too slow, etc.

Secondary to that is the fact that people see a variety of doctors for their medical care- primary doctors, and specialists- who all prescribe medicines and may have absolutely no idea about the other medicines the person takes. So you have the primary doctor giving some viagra and the cardiologist giving a nitro spray. The combination of the two in any 24 hour period is a recipe for death.

I do give credit to the elderly, though. It seems that the older the patient is, the more "with it" they are with regard to their medical care. They are more often able to state the names of their medications, and know approximately what sort of effects they're used to achieve. In other words, they may tell me they take drug X for high blood pressure, whereas a person younger than them is much more inclined to say "I dunno, I think it's for my heart. Don't know the name of it." I got that guy just a few shifts ago. It turned out to be a blood thinner that doesn't act on his heart, but is used to keep blood in his heart from clotting due to a heart condition he has. So you see, it would be very easy for someone to think, "oh, he has high blood pressure on my monitor, and says he takes something for his heart, I better give him something to slow it down." And then he'd be fucked. Giving him something to slow down his heart with the heart condition he has would nearly (if not actually) kill him.

Know your meds, and know basically what they do. It's not hard to do, and anything short of that is laziness or assuming every medical professional you run into will magically know everything you're on from every single doctor you see. We don't. If people educated themselves a little, most of this issue would be resolved.

analog, exactly.

Many people don't bother. Elderly do I believe because the younger caretakers tend to drill it into their heads that it is important, yet two things happen here. First, they don't listen to their own advice, and second, that medical information isn't passed onto the rest of the family. Thus if something happens to the primary caretaker of the elderly, the other siblings may not know what history the elder has.

As far as I'm concerned I was trained from a young age to say emphatically whenever I was getting any medical care that I am allergic to penicillin and all it's derivatives, and to let them know all presciptions currently being taken. Now all this practice for years, did not prepare me for what I discovered later after two bouts with pancreatitis, that I had neglected to tell the doctor that prior to getting to the ER both times, that I had taken 400mg of ibuprofen because I had a severe headache. I had not thought of any interaction, nor need to tell the doctor of an over the counter medication.