Monday, November 17, 2008

Natural C-sections

In the UK there has been some press about an obstetrician who calls his c-section technique "natural". In my mind there is nothing natural about a c-section, I'd prefer the word optimal, but as natural is the phrase he coined, I'm using it so the connection is made if anyone wants to search for information about it.

Here is an article from The Guardian, http://www.guardian.co.uk/society/2005/dec/03/health.medicineandhealth, as you might expect in the press, it focuses on the experience not the medical facts. However there are lots about the experience which would suggest that the medical facts are also an improvement on the typical situation post c-section.

The real big one for me is delaying cord clamping - the number of things that have been associated with immediate cord clamping is scary, to the extent it's not just a bonus if you have a healthy full term baby, but something that other than in very rare circumstances is NECESSARY for premature and sick babies. However there are still not many hospitals doing it routinely and I wouldn't be surprised if there are many doctors who haven't even heard of it.

Sadly there are some aspects of birth that are dismissed by doctors as mad desires of those desiring natural childbirth. However I'm coming to see that delayed cord clamping and to a lesser extent some kind of skin to skin contact is as helpful to the prospects of the baby as the existance of medical treatments to help when there are genuine problems. According to Nick Fisk some of the problems that require the baby to be admitted to special care can actually be prevented by his methods, yet the conventional wisdom is to whisk the baby away in case these problems happen.

One of the problems I can foresee is that the perceived wisdom is that giving drugs to separate the placenta from the uterus and to cause the uterus to contract down, which is essential at a c-section, require the cord to be clamped. This is in fact a myth, however just right now I'm struggling to find the indepth medical information on this, which I know exists, I've read it before, but didn't bookmark.

I'm planning to put together a document with all these details that I can hand to a doctor to explain why I'm asking for it, I hope that by providing the information with the links to peer reviewed papers in reputable journals I can make them rethink the ideas they have probably had since medical school, rather than see me as some crazy woman who wants to turn a c-section into a natural birth type experience. A good experience helps, but it's not fundamentally what I'm looking for, I'm looking to reduce the chances of all sorts of things and give my baby a good start in life, in particular I want to reduce the chances of it needing to go to the NICU.

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