C-section to Vaginal Ratio recommendations?

Circe wrote:

Just for the record, shaving and enemas are *extremely* rare as
standard
practice in the US any longer. I know there are places where these
things
are still done, but they've both pretty well gone out of favor in
most
cases.

I live in the American midwest - it's still 1950 here. We have to be
careful!!

The good news is that my doctor said, and I quote, "You can do it
(meaning give birth) however you want to." He doesn't do routine
episiotomies, his c-section rate is 18%, the hospital's is 20%, and he
said the national average is around 23%. I told him some of my ideas,
things I plan on putting in my birth plan, and he was cool with all of
it (I don't want to debate all of it, so I'm going to keep it to myself
until later, when it's finalized... I hope everyone understands).
Basically, I feel a thousand percent better about the whole thing.
He's not going to tie me down and do anything, which is a huge relief.


He's also not going to let my husband catch the baby, due to liability,
which is also a relief. I'd rather have him holding my hand at that
point, anyway. The last thing I want to have to worry about is Daddy
vs. Slippery Baby.

He also assured me that donating the cord blood would be done in such a
way so that it would not reduce the baby's blood volume at all. The
collection is done after the cord is clamped and cut, as I thought. I
said, "Collecting the cord blood isn't going to affect the baby's blood
volume, is it? Because I read on the internet that it can rob the baby
of its blood..." and he said, "Absolutely not."

In other words, it's ALL good. Thanks for your help, Circe and Elle.
If I had gone in there thinking 5%, I would've left a perfectly good
(and accommodating!) doctor!

Thanks again,
Amy

Larry McMahan wrote:
writes:

: The reason I'm worried is because he mentioned last visit that if I
go
: past 41 weeks, he's going to induce. I plan on using that apple
: analogy that someone posted when the time comes... Thanks for
that!!
: And doesn't induction lead to a greater percentage of c-sections?

First I would suggest refusing the induction unless it is done for
a valid medical reason.

I plan to. And he knows that now.

I think I told you in a previous post how
to test, and what to look for. Second, if he is not supportive of
your decision, I would recommend a new caregiver, even at this late
date. I think his C-section rate will be a very telling indicator
of his views.

I'm only 13 weeks, so it isn't late. But as I posted, I'm really happy
with all the answers he gave me, and 18% seems well below the national
average (whether it's the 23% he quoted or the 26% quoted here), so I'm
ok.

I think that even at this late date, it would be useful to write a
birth plan and go over it with him to see if he and you are on the
same wavelength. Then if he is generally agreeable, ask him to
put it in your chart as orders. This is the real test of his
supportiveness.

I'm working on the birth plan. I have a good start. I've also got 27
weeks or so to perfect it (29 if any of this is going to become an
issue!).

Amy

Ericka Kammerer wrote:

If he has a 5 percent or less rater of c-sections, I'd
drop on the floor and kiss his feet.

Hahaha!

I doubt age will make much difference. You have said
elsewhere that you are still overweight. Depending on how
much so, he may have a higher c-section rate for women who
are overweight (some recent studies have come out suggesting
that, though I think they have been looking at women who
qualified as obese, so that may not be relevant to you).

I didn't think to ask him this, but we did ask generally about "other
factors," and he didn't mention my weight, so I guess we're ok.

I only gained 3 lbs. in the whole first trimester. I'm really happy
with that!!

Thanks again, everyone, for all the help!

Amy

wrote:


He also assured me that donating the cord blood would be done in such a
way so that it would not reduce the baby's blood volume at all. The
collection is done after the cord is clamped and cut, as I thought. I
said, "Collecting the cord blood isn't going to affect the baby's blood
volume, is it? Because I read on the internet that it can rob the baby
of its blood..." and he said, "Absolutely not."

Ask *when* he will clamp and cut the cord. They always
take the blood after the cord has been clamped and cut, but some
will clamp and cut early and others will clamp and cut later.
If their policy is fairly quick clamping and cutting, the
cord blood collection wouldn't make any difference in the
baby's blood volume, but the baby would still be shorted
relative to a later clamping and cutting policy (IYSWIM).
There *shouldn't* be a problem with clamping and cutting later
(at least after the cord has stopped pulsating), assuming no
complications requiring early clamping and cutting, but you'll
want to know what hospital policy is and you'll probably want
to put your request to wait for the cord to stop pulsating in
your birth plan in case your OB isn't there for the delivery
(only a minority of women have their OBs attending their
deliveries, and a significant fraction have never met the
OB who attended their delivery).

Best wishes,
Ericka

wrote
Also, is there anything wrong with asking him for a copy of his
standing orders? I don't want to commit an etiquette faux pas...

Hmm I don't know anything about standing orders. Can you explain a
bit?

Standing orders are what the doctor wants the hospital to do with all
of their patients between the time the patient checks in, and when the
doctor shows up. If a doctor wants every woman shaved, enemaed (is
that a word?), given an IV, and to have no food or fluids, that would
be a part of his standing orders. Trouble is that these things happen
when the doctor is still on the golf course, or in bed, so there's no
one there to argue with. The nurses will get in trouble if they don't
do it, and you can be labelled a "problem patient" if you fight them on
it... (according to my mom, anyway).

Heck, they can't make you do anything you don't want to do. Hospital policy
at the hospital where I delivered E was a hep lock. I said 'no', the nurse
insisted and I told her not to do it. That was the end of it. I don't know
if I was labelled a 'problem patient' but I really didn't care that much
either. Just make sure your DH knows what you want and is willing to fight
for it. Regardless of what the 'standing orders' are, the hospital probably
treats all of its laboring moms the same way unless they're specifically
told not to.

Just keep remembering that they can't make you do anything you don't want to
do (unless it's an emergency sitatuaion where your life is at stake).
--
Melissa (in Los Angeles)
Mum to Elizabeth 4/13/03
and one due early 3/05

Beach Mum wrote:

Heck, they can't make you do anything you don't want to do.

Yeah, I'm working on 30 year old info, remember.

Hospital policy
at the hospital where I delivered E was a hep lock. I said 'no', the
nurse
insisted and I told her not to do it. That was the end of it. I don't
know
if I was labelled a 'problem patient' but I really didn't care that
much
either. Just make sure your DH knows what you want and is willing to
fight
for it.

We've talked a lot about it, but I'm not sure that he's willing to
fight as much as I want him to. Time will tell...

Regardless of what the 'standing orders' are, the hospital probably
treats all of its laboring moms the same way unless they're
specifically
told not to.

My doctor said that all of his standing orders are PRN - as needed -
which means that they're optional.

Just keep remembering that they can't make you do anything you don't
want to
do (unless it's an emergency sitatuaion where your life is at stake).

I hope so. The venue options around here are pretty limited. There's
one hospital. That's it. It's either there or in a cab on the way.

Melissa (in Los Angeles)
Mum to Elizabeth 4/13/03

Your daughter shares my name (middle) and my birthday. We Aries'
are pills - watch out for her when she's about 15. Hahaha...

Amy

Beach Mum wrote:

Heck, they can't make you do anything you don't want to do.
Hospital policy at the hospital where I delivered E was a hep
lock. I said 'no', the nurse insisted and I told her not to do it.
That was the end of it. I don't know if I was labelled a 'problem
patient' but I really didn't care that much either.

When my mother delivered my brother in 1970, the nurse brought her a
stack of forms to sign which included a circumcision consent. My
mother said, "I'm not signing that."

The nurse said, "But I don't know what to *do* if you don't sign the
form."

My mother said, "What you do is nothing. You don't circumcise the
baby. Take the form and write DO NOT CIRCUMCISE in big letters. And if
they circumcise him anyway, then you all are going to have a *big
problem* on your hands."

They didn't circumcise him. But they were completely mystified by her.

Rivka
Li'l Critter due 4/3/05
--
Visit my weblog at http://respectfulofotters.blogspot.com

Rivka W wrote:
Beach Mum wrote:

Heck, they can't make you do anything you don't want to do.
Hospital policy at the hospital where I delivered E was a hep
lock. I said 'no', the nurse insisted and I told her not to do it.
That was the end of it. I don't know if I was labelled a 'problem
patient' but I really didn't care that much either.

When my mother delivered my brother in 1970, the nurse brought her a
stack of forms to sign which included a circumcision consent. My
mother said, "I'm not signing that."

The nurse said, "But I don't know what to *do* if you don't sign the
form."

My mother said, "What you do is nothing. You don't circumcise the
baby. Take the form and write DO NOT CIRCUMCISE in big letters. And
if
they circumcise him anyway, then you all are going to have a *big
problem* on your hands."

They didn't circumcise him. But they were completely mystified by
her.

Rivka
Li'l Critter due 4/3/05
--
Visit my weblog at http://respectfulofotters.blogspot.com

Wow, Rivka, your mom may just be my new hero!!

Melania
Mom to Joffre (Jan 11, 2003)
and #2 (edd May 21, 2005)

snip
He's also not going to let my husband catch the baby, due to
liability,
which is also a relief. I'd rather have him holding my hand at that
point, anyway. The last thing I want to have to worry about is Daddy
vs. Slippery Baby.

Hah! Our doctor group was a fun bunch; one of the doctors said
"basically we're really lazy and don't do any work. We just hang out,
act encouraging, and after we make sure the cord isn't wrapped around
the neck, we even get Dad to catch the baby." I leaned over to dh and
said "do you *want* to catch the baby?" "uh, no!" "oh, GOOD. Let's just
let the people who've done that a few hundred times handle it, then."
He was busy helping me, anyway.

Melania
Mom to Joffre (Jan 11, 2003)
and #2 (edd May 21, 2005)

He also assured me that donating the cord blood would be done in such
a
way so that it would not reduce the baby's blood volume at all. The
collection is done after the cord is clamped and cut, as I thought.
I
said, "Collecting the cord blood isn't going to affect the baby's
blood
volume, is it? Because I read on the internet that it can rob the
baby
of its blood..." and he said, "Absolutely not."

In other words, it's ALL good. Thanks for your help, Circe and Elle.
If I had gone in there thinking 5%, I would've left a perfectly good
(and accommodating!) doctor!

Thanks again,
Amy

He's also not going to let my husband catch the baby, due to liability,
which is also a relief. I'd rather have him holding my hand at that
point, anyway. The last thing I want to have to worry about is Daddy
vs. Slippery Baby.

would he let you catch the baby? this wasn't something I asked for, but when
the time came the midwife did what she needed to do on the penultimate
contraction, which was unloop the cord from the baby's neck and then told me
to lift it on to me tummy on the next contraction, which I did and it was a
fantastic moment, my husband was up my my head so he was close too, it was a
wonderful moment,

Anne