I’ve long been a fan of Jill’s great site, Unnecesarean.com, but I just recently stumbled across this interesting and thought-provoking blog post about “necesareans,” or truly medically necessary c-sections. It’s definitely worth a read; there’s a lot of information here, and lots of links to external sources, and it’s written by someone with a natural-birth slant. She talks a lot about how many c-sections are done for “fetal distress,” which is a very blurry and ill-defined term that can sometimes be twisted by doctors into a reason for major surgery, whereas “acute fetal distress” is in fact a real thing (she gives ranges of test results, etc., by which this can be measured), which really would suggest a need for an immediate, and necessary, c-section. At the end of that section, though, there is this paragraph:
If the baby is in acute distress, it’s time to get the baby out, by the swiftest method possible. Please, if your doctor says the baby is in danger, don’t spend time printing out this post and checking the lab work
Now, this is very interesting to me–I’m wondering whether this is just a classic CYA-disclaimer, or what, since the entire force of the post up until that paragraph does seem to suggest that women do arm themselves with information, asking questions of their doctors and checking the results of tests and interventions against what they have researched ahead of time. Here, though, the author seems to be retreating a bit, falling back on the old “trust your doctor” line. What troubles me about that, though, is that many women do not have a caregiver they really know and trust; if you do, of course, and that caregiver says the baby is in distress, you do not stop to quibble. But what about women who are pressured into delivering with a specific doctor because of proximity, or policy, or insurance/money, or just luck (large practice, the doctors you trust are away, this one’s on call, etc.)? In these situations, the woman is right back to where she was before having read this post, sadly–relying on the word of a “caregiver” who is not, in fact, always using research-based practices, or even always delivering “care.”
Sigh. I don’t know the answer, other than for me, personally, this is one more reason I choose to labor and birth at home with a midwife I trust completely.
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