iatrogenic diseases, C-section outcomes

[Guest guest]

ayurveda, durgesh mankikar

<d_mankikar> wrote:

 

> Dr Bhate presents a great research from our own archives.

> But this is also an excellent way to say that Practicing Doctors

know less than Midwivwes.

 

Thinking that such an impression may occur, some statements were made

in the same post:

 

1. But there may be a large difference between the way

human mother is prepared for this great event by a Obgyn and midwife.

MIdwifves have good record of Vaginal births (VB) without tear since

they bring out the true nature of human mom, that is tenacity,

 

2. Have a well-trained midwife, who honors physiology, not

medicine. Keep out of the proximity of drugs, distractions and

unnecessary procedures. First, do no harm.

 

3. The hospital is a good back-up system for true emergencies, which

are

the cases where hospitals become safety nets.

 

4. Author would like to state here that he is not conveying that

Midwives are more competent than

MDs. Even today, there are MDs who have trained midwives in simple

homebirths. And there are hospitals and maternity homes where MDs are

deliverying babies as good as midwives. [ In above statement, MD

should read Obgyns or doctors, error regretted.]

 

Stmt 1 clearly distinguishes between the approaches. The OBgyn

approach is very good to save a life in an emergency due to special

knowledge and scalpel skill. He/she becomes God who saves life of

both baby and mother, as pointed out in Stmt 3. Stmt 4 was specially

worded to counter any mis-impression that the post may carry. In

spite of this if the post does carry such a view, author apologises

to the community of Obgyns.

 

 

> For every case , as the one you mention, and I do empathize with

their problems, one should ask hundreds of women, whether they

actually benefitted from going to doctors, and getting epidurals. We

cannot generalize on the entire profession of medicine based on

anecdotal stories.

 

This author is lucky. Someone points out deficiency in his thinking,

and some one else provides the answer. Tide is turning now. Research

world over is now moving into the area of studying side effects or

deficiencies in the old philosophies. The first study having some

relation to the point mentioned above has come out. The studies on

the risks of repeat C-sections, especially with Cytotec are many.

 

 

NEW YORK (Reuters Health) Jun 09 - Compared with intending to deliver

vaginally, a repeat elective cesarean delivery apparently

raises the risk that the newborn will be admitted to an advanced care

nursery, according to a brief report. The researchers say women

should be alerted to the possible negative effects.

 

The study, in the May issue of the American Journal of Obstetrics and

Gynecology, is the first to directly compare the neonatal outcomes of

elective c-section with those of a trial of labor in uncomplicated

pregnancies, note Dr. Nicholas Fogelson and colleagues, from the

Medical University of South Carolina in Charleston.

 

In a retrospective cohort analysis, the investigators assessed the

neonatal outcomes of 3134 mothers intending to deliver vaginally and

117 mothers who underwent elective repeat cesarean section.

 

In the overall analysis, the risk ratio for admission to an advanced

care nursery was 3.58 for infants in the elective c-section group

compared to those from the intended vaginal group (p < 0.001).

Transient tachypnea was also more common in the elective cesarean

group (p = 0.0009).

 

When the analysis was confined to mothers who underwent unscheduled c-

section after a trial of labor, the advanced care nursery finding was

no longer statistically significant. Also, infants born to such

mothers were more likely to have lower APGAR scores than those in the

elective c-section group.

 

"The decision to undergo elective cesarean delivery appears to have a

negative impact on immediate neonatal outcomes," the authors state.

They advise that for women considering a scheduled cesarean

delivery, "physicians should counsel patients about potential

neonatal issues in addition to concern for maternal well-being."

 

Am J Obstet Gynecol 2005;192:1433-1436.

 

[ message above study carries is: Please bear the pain as far as

possible, and go for C-section only when advised by doctor and do not

pursuade him/her beforehand]

 

 

Patient choice cesarean impairs newborn outcomes

<http://louisc.obgynworld.com/UM/T.asp?A2.4.1817.2.297573>

The choice to undergo elective cesarean delivery may have negative

consequences for the newborn, with an increased risk of admission to

an advanced care nursery. Researchers conclude that clinicians should

counsel women considering elective cesarean in an uncomplicated

pregnancy about these potential neonatal issues as well as concerns

for the mother's own well-being.

 

>

> Your one statement says it all. The women bring all of this upon

themselves--by becoming pregnant. I guess, not becoming pregnant will

help in propagation of the human race.

 

Not by becoming pregnant, but becoming panicky to pain or developing

white coat syndrome.

 

>

> We have to understand that pregnancy is an extremely "trying "

circumstance for the woman , and all pregnancies are not same. Many

babies and mothers actually end up being rescued by Modern Medicine.

Many mothers that do come to midwives for a " natural childbirth" ,

do ask for Epidurals, and also end up in C-Sections, because of

complicated childbirth.

 

This author agrees. The contribution of modern medicine in reducing

pregnancy deaths must be acknowledged. Only question is that the

science must investigate better ways to reduce pain, not eliminate it

completely where it is a neuro signal in a "launch countdown program"

like childbirth.

 

>

> You do bring up an excellent question though----which Doctors also

ask themselves--why do the animals need less doctors than humans ?

And an additional corollary to that same question is --the first cave

man sought help because of pain or fever. And inspite of all our

advances, people in 2005 still seek medical help for pain and fever,

and for Cosmetic surgery !!

 

Your thinking resonates with this author's.

Regards

Dr Bhate