[pc86]

No, but this opinion is demonstrably wrong. Read any of the ACOG literature, there are dozens of peer-reviewed studies about the safety and efficacy of induction, assisted deliveries like vacuums, and both scheduled and emergency c-sections.

Scheduled c-sections outperform emergency c-sections in every metric tracked. Scheduled c-sections are no worse for the baby than natural delivery, and if you take into account recovery time from surgery, no worse for the mother.

You can have an opinion on whatever you like, but to be blunt, if it's as stupid as this one you should get called out for it.

[public_defender]

My opinion isn't stupid, I have just considered and valued sources that you have disregarded. The ACOG is a trade group that supports medical intervention in birth. It doesn't make their contributions to research on the efficacy of medical intervention in birth irrelevant, but you should consider their contributions in the same light as Exxon's sponsored research into the environmental impacts of oil extraction.

There is no good reason to have a medical doctor attend every birth. Of course in a country with a 30% c-section rate, there is much more for doctors to do. I don't think that any credible source will defend 30% as an optimal rate of surgical intervention in birth, but feel free to rebut me.

C-sections are only "no worse" for the mother and baby if you only consider mortality. Let's also consider:

1) Mother-child bonding time in the first two hours after birth.

2) Inoculation of the baby to mother's flora in the birth canal.

3) Mother's ability to care for the baby while recovering from surgery.

4) Postpartum mental health of mother who has been denied natural birth.

[russdill]

There's a huge difference between arguing that many scheduled c-sections are not for medical reasons vs that there are not medical reasons for a scheduled c-section.

[public_defender]

Well, good thing nobody is taking the second position. My point is that natural labor is not allowed by the medical system to progress in many cases where there is no medical reason to intervene.

I said wait until medical intervention becomes necessary, not force active labor on everyone. As others have pointed out, we can detect the need for medical intervention at an early stage sometimes. That's great, people should have the medical care they need. They should not have surgery forced on them.

[russdill]

Sorry, I was misreading "wait until medical intervention becomes necessary" as "Do not perform scheduled c-sections, only perform unplanned and emergency c-sections".

Anyway, I really don't think the issue with the majority of scheduled c-sections is surgery being forced on patients. It's patients and their doctors discussing the risks of an attempted natural birth vs a scheduled c-section and opting for a scheduled c-section. In some many cases the patients involved have no increased risk for a natural birth but may still opt for a c-section. And yes, on the flip side, no one should be forced into an attempted natural birth.

[chrisherring]

"Scheduled c-sections outperform emergency c-sections in every metric tracked."

The comparison is natural birth to c-sections. Comparing scheduled c-sections to emergency c-sections is a ridiculous thing to track, go compare GP visits vs admission to emergency while you're at it.

[russdill]

It's 100% relevant. If you have a pregnancy for which there is a high chance of an emergency c-section, an alternative is a scheduled c-section.

[chrisherring]

No it’s not. That’s a different comparison.

[pc86]

How is it a different comparison? If you knew whether or not you'd need an emergency c-section, you'd never have any emergency c-sections. There are four types of labor:

1. Unassisted (with and without medication)

2. Assisted (vacuums, etc.)

3. Scheduled c-section

4. Emergency c-section

The problem with #4 is that it often happens after attempting 1 and/or 2 unsuccessfully. The baby is in a much worse position, sometimes medically and often physically within the mother's body. You can't compare 1 and 4 without also comparing 1 and 3, 3 and 4, etc. Everything is interrelated.

[chrisherring]

Comparing outcomes of emergency c-sections to scheduled c-sections is always going to come out in favour of scheduled c-sections. On one side something is going wrong 100% of the time and the other something is not always going wrong. Not sure how to make this anymore obvious. This is a pointless comparison.

Comparing outcomes of natural births as a whole vs scheduled c-sections is far more useful comparison.

[rafaelm]

I don't know about the other numbers, but my wife has had two scheduled c-sections and the recovery for both suuucked when compared to everyone we know that had natural birth.

Of course, the process of going through labor pains for many hours might make things even between the two...

[russdill]

I can assure you, it's a much much better situation than three hours of active labor followed by an unplanned or worse, emergency, c-section. Consider yourself fortunate. Labor isn't just painful, it's trauma which makes surgery much more risky and difficult to recover from.

[ars]

> Of course, the process of going through labor pains for many hours might make things even between the two...

It's not. Labor pain is more time limited and the mother is kind of "out of it", and doesn't usually remember it clearly - plus there's a prize at the end :)

C-section pain is worse, and it lasts several weeks exactly at a time when the mother needs to do stuff. It's worse in every way.

[aikinai]

My understanding is that when things progress naturally, the mother’s body and mind should be in a state that helps them cope with the pain, but it doesn’t reduce it or help you forget anything.

My wife remembers every instant of all of her births.

[ars]

What? c-sections are MUCH MUCH worse for the mother in every single metric including pain. C-section pain is longer and more severe than natural birth pain, and natural birth pain can be ameliorated which makes it even better - but even with no intervention at all natural birth pain is less than c-section pain.

If you are scheduling a c-section it means you are not trying for a natural birth and that means your outcome for the mother is strictly worse.

[russdill]

If it were a simple choice between natural birth and a planned c-section then sure. But it's a choice between a planned c-section, and the high possibility of an unplanned c-section, an emergency c-section, or in some cases very serious complications like uterine rupture. Doctors and patients decide on a planned c-section with the known risk factors for the patient in mind.

[ars]

Oh, how I wish that were true. It's not. Do your own research and you'll see - the majority of c-section are unnecessary, or caused by excessive use of Pitocin (uterine rupture is vanishingly rare - except when Dr.'s administer Pitocin).