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Forum: Cesarean Section Birth

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  #1  
July 20th, 2008, 08:08 AM
JessKeller24's Avatar Mega Super Mommy
Join Date: Mar 2006
Location: PA
Posts: 3,861
So a little history...

My first I was induced at 42 weeks and after more than 24 hours of labor ended up with an emergency csection cuase his HR went down and wouldnt come back up.

My second I went into L&D on my due date cuase of bleeding. Sent for another emergency csection and found out the bleeding was from my scar rupturing open!

This is my third pregnancy, I am due the 15th of August with a little boy. My second is only 18 months old. Well I am terrified that the same thing is going to happen. For one cuase this is a boy and hell most likely be big like my first boy. And for two cuase Ive already been having contractions. My doctor refuses to do a csection a day before 39 weeks. And since I will be 39 weeks on a weekend they scheduled my section for Monday. 4 days before I am due! How can I convince them that I am not comfortable with waiting this long? I would rather get a section at 37-38 weeks and risk my due date being off a little and him needing a little help for a few days, than risk another rupture and this time not be as lucky! I also read that they can do an amnio and if it comes back that the lungs are good do the section the next day or even give a round of steriods and then do the section! HELP!!!!

Sorry this was so long....



Update.............................

Well it was scheduled at 11:25 and I get there and they said no 10:25 your an hour late can you come back at 2:00. SO I went back at 2:00. For some reason they didnt weigh me this time. My urine and BP are good, but the nurse took my BP so fast theres now way it could be accurate, who knows! Im 37 weeks friday and fundal height is at 36 weeks. And they wont move my section date. Well she may move it to friday but not any sooner than that. She went to say that I will be 38 weeks 6 days ( they are a day diff than what I was told, I dont know) and that 1 day of 39 weeks with my history she can do but no sooner. Then she went on to say that she cant move my section date anymore cause there is no medical reason! WTH! I think a previous uterine rupture is mediical reason specially when you can loose baby and/or myself!!!!!!!! But she also told me if Im having contractions regular or not to call right away and make sure they know my history and that I should go in and get checked.
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  #2  
July 20th, 2008, 02:51 PM
Tiffers's Avatar Platinum Supermommy
Join Date: Jan 2006
Location: Cincinnati, Ohio
Posts: 5,197
Did you have a vertical incision? I know those are higher risk for opening up.

I have one, and during my second c/s, the scar was so think you could see through it (he was delivered 10 days early because I was having contractions and elevated BP). My OB repaired it, and I had no problems during my third c/s (born 10 days early). During my 4th c/s, the scar opened up as they were pulling her out (she was also 10 days early). I'm now pg with my 5th, and have been bugging my OB about scheduling my c/s. In the beginning he was saying they'd deliver as early as possible, but there seems to be a change in how they view "early" compared to my previous pregnancies because many are going with no sooner than 39 weeks.

Other than expressing your concerns with your OB, and asking what can be done to prevent it from happening again. I swear my OB doesn't remember my history when I ask him certain questions, so maybe yours is thinking you're the "typical" repeat c/s.
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  #3  
July 20th, 2008, 03:52 PM
SamuelsMommy's Avatar Platinum Supermommy
Join Date: Nov 2006
Location: Indiana
Posts: 16,541
I'm sorry you are going through this stress. Discuss your concerns with your OB. Tell him plainly what you want. I'm not sure if you are too far to change OBs but if you aren't and your OB won't accomodate change to an OB who will. That's about all you can do. Good luck!
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  #4  
July 20th, 2008, 04:35 PM
Regular
Join Date: Feb 2008
Posts: 72
my c section was an emergency one due to fetal distress becuase of placenta abruption, this time arond my doctor is taking the baby 9 days early,he said that the baby can be safetly delivered up to 2 weeks before the due date,i would defintely talk to him,i dont see why is is so unwilling to do it sooner,some doctors can just be stubborn!
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  #5  
July 20th, 2008, 05:25 PM
Live4Love's Avatar Super Mommy
Join Date: Jun 2008
Posts: 993
I think I know a possible reason for OBs being more strict about not performing c-sections until 39 weeks. Apparently there has been a lot of negative publicity on the increase of c-sections being performed too early and how that is drastically effecting pre-term birth rates. The article below is just one of the many I have seen on this topic. I bolded the sentence stating that the college of OBs has stated that no c-section should be performed before 39 weeks unless there is genuine medical need. Although I really think that you would be classified under the "general medical need" category purely because of your history. I think it's a little odd that your OB is not listening to your big concerns about this. A risk of a rupture is frightening to me and I don't even have a history of that. If I were you, I would just keep voicing my opinion and then if you are sure you'd want to go through with an amnio, you can always ask your OB for one.

Quote:
Study Links Caesareans With Births Before Term
By DENISE GRADY

Premature single births have been increasing in the United States, mostly among infants delivered by Caesarean section, researchers are reporting. And they say some of the increase may be due to Caesareans that are not medically necessary.

The trend is worrisome because premature babies are at risk for breathing and feeding disorders, delayed brain development, other health problems and death.

A study of single births from 1996 to 2004 found an increase of one percentage point in premature deliveries, to 10.7 percent from 9.7. Ninety-two percent of those premature deliveries were by Caesarean. Most were "late preterm," born after 34 to 37 weeks of pregnancy, instead of the normal 38 to 42 weeks.

Late preterm babies make up more than 70 percent of all premature births in the United States, and are the fastest growing subgroup of preterm births, the researchers found. Even though they may seem close to full-term, they still face increased risks of serious problems from being born too early.

The study focused on single births rather than multiple ones, because multiple births are much more likely to involve complications that require Caesareans.

The report was based on a review of birth records and previous studies, conducted by the March of Dimes Foundation, Albert Einstein College of Medicine and the federal Centers for Disease Control and Prevention. It is to be published in the June issue of Clinics in Perinatology, a medical journal.

The researchers say they cannot be sure how much prematurity can be blamed on unneeded Caesareans, because it is often hard to tell from medical records exactly why a Caesarean was done. The Caesarean rate has been climbing steadily in recent years, from 20.7 percent in 1996 to 30.3 percent in 2005.

"The practice of obstetrics has changed so dramatically in the past 20 years, so that induction of labor and Caesarean section have become the norm," said Dr. Alan R. Fleischman, the medical director and senior vice president of the March of Dimes.

In observations at community hospitals across the country, researchers have seen obstetricians stretching diagnoses a bit to justify Caesareans that are not truly necessary, Dr. Fleischman said.

"Perhaps for convenience, perhaps out of fear of litigation, perhaps in response to a maternal request, they are scheduling their deliveries rather than allowing labor to begin," he said. "And this comes when there is an epidemic in America of prematurity."

Dr. Sarah J. Kilpatrick, chairwoman of the department of obstetrics and gynecology at the University of Illinois, and chairwoman of the committee on obstetric practice for the American College of Obstetrics and Gynecology, took issue with some of Dr. Fleischman's comments and said there was no proof that unnecessary Caesareans were occurring or leading to premature births.

Noting that the college of obstetricians has guidelines stating strongly that labor should not be induced and Caesareans should not be performed before 39 weeks unless there is a genuine medical need for it, Dr. Kilpatrick said, "We stand by that."

She continued, "On the other hand, what I would agree with, I think there is pressure by patients on physicians to deliver early-ish when someone's uncomfortable, and there is medico-legal pressure. Obstetricians are afraid of being sued."

The fear of lawsuits is so great that at the first hint of a problem, Dr. Kilpatrick said, obstetricians "may proceed with a Caesarean to deliver the fetus when the fetus is probably fine."

She also said that obstetricians might have grown a bit complacent about delivering babies a few weeks early because pediatricians and neonatologists had become so good at taking care of premature infants.

"They may let their guard down around 36 weeks because they're so sure the baby will be fine," Dr. Kilpatrick said. "This paper is a good reminder to everybody that 36 weeks is still preterm."[/b]
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  #6  
July 20th, 2008, 07:12 PM
MrsStuartD's Avatar Platinum Supermommy
Join Date: Aug 2007
Location: Ontario, Canada
Posts: 23,164
I have no other advice than what has already been said. I just wanted to reassure you that we are here for you. I knew I would have to have my second cesarean early and my doctor would not schedule sooner than 2 weeks. We enede up pushing the date up to 2 weeks and 4 days. So maybe as you get closer and closer your doc can keep a close eye on you and he may be willing to budge on the date.
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  #7  
July 23rd, 2008, 02:00 PM
mommaluvs2730's Avatar Platinum Supermommy
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Location: Wasington
Posts: 8,741
Is your doctor the same doc or the same clinic? I would think that if it was then they'd realize the importance of that happening. I dont know if you can really convince them you may have to have a different doc.
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  #8  
July 23rd, 2008, 04:03 PM
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Alot of Doctors now will not go before 39 weeks.I am not sure why. When I had my second child I was able to go two weeks early .Now I am going 9 days early. I was set or only a week ,but my doctor is really nice and said I could not on Dec 32 because of insurance.

but with you history I would think they would let you go. I day is not that big of a deal in my eyes.
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