Monday, January 7, 2008

Frank Conversations on Cesareans

Most of the “risk” that we hear discussed for Cesarean section includes the possibility of

~post-operative infection,

~blood clots,

~anesthesia complications,

~damage to the bladder and bowels,

~potential problems with future pregnancies like infertility, miscarriage, placenta accreta

and placenta praevia

~and in some rare cases, even death.

Yet, few obstetricians really cover these potential complications in a way that will give a birthing mother a realistic view of what all her C-section could entail – a whole lot more than her idea of “I’ll be kind of sore for a few days or weeks.”

A friend of mine who recently had an elective cesarean developed blood clots afterwards and was shocked to hear that they could have been a result of how she chose to have her baby. Of course, she could have read up on the potential complications and figured that out herself ahead of time, but really, physicians should either thoroughly inform their patients themselves or see to it that they are reading books and doing research and getting informed during their pregnancies. And more than just reading, “What To Expect When You’re Expecting” or watching birth stories on TV.

Sure, of course, the anesthesiologist comes in and rattles off the usual, “you could die, be permanently paralyzed, etc.” stuff as the laboring mother is doing her best to hold herself together and prepare for the long ride down the hall to the OR, wondering if her baby will be okay. Of course, she nods and says she understands and scribbles her name on the paper in between contractions. But does she really understand what she’s signing up for?

That’s what I wonder. What kind of conversations do doctors have with their pregnant patients about the possibilities of a cesarean? …Not only that it could happen to them for various reasons (some good and some not so good), but that by simply having a cesarean, they are increasing their risk for many more complications.

Do they have frank conversations with their patients about weighing risks and benefits of a cesarean for a non-life threatening issue that comes up in labor (i.e. labor isn’t happening as fast as usual) if they are planning to have more children in the future? Or do they just imply that, “If you end up with a cesarean, trust me, it will be for a good reason to make sure you have a live, healthy baby. Vaginal births are great, but don’t get your hopes too high. You don’t want to be disappointed if it doesn’t work, because, really, your goal is a healthy baby, not how you have your baby.”

1 comment:

Noah said...

Not to mention the risks to the baby, which I think pretty much never get mentioned!