Aren't they clever! They (obs) are saying we want
women to have the choice for choice's sake not merely based on medical
criteria. If a woman wants it, she should be allowed and we, the men of
importance, support their choice! And if she wants it now, on this date, she
should be allowed to have that too in our 'have to have it yesterday,
because I said so' society. And of course, their friends the cosmetic
surgeons will be available 4.5 months later for the liposuction and breast
enhancement when the breasts start to need an uplift. But if men are
supporting the 'women can have this surgery because we think it is best for
them' and they want it ( and hey, vaginal childbirth is one
thing women can do that men can't and that can't be fair), then I
think its high time women made decisions about testicles and if we want to
remove them surgically from men I am sure we could come up with some research
proposal that says certain men would be better off without them, and there's
bound to be a section of the female population who would come out with a media
statement backing that. Then the major decision would be - under epidural,
spinal or GA?????
---- Original Message -----
Sent: Sunday, November 02, 2003 6:57
PM
Subject: Re: [ozmidwifery] Another unec.
C-section...
Another nail in the coffin:
washingtonpost.com Elective Caesareans Judged Ethical Doctors
Group Issues Statement on Popular Procedure
By Rob Stein Washington
Post Staff Writer Friday, October 31, 2003; Page A02
It is
ethical for doctors to deliver a baby by Caesarean section even if the
mother faces no known risks from conventional labor, the nation's largest
group of pregnancy specialists has decided.
The American College of
Obstetricians and Gynecologists' ethics committee is issuing a statement
today that for the first time addresses the increasingly popular elective
Caesarean sections -- those performed when there is no medical necessity.
The organization has never before issued guidelines or official
opinions about elective Caesareans, but for years it has been among
many medical groups that campaigned to reduce the number of surgical
deliveries for any reason.
The new statement could help accelerate
a rapid increase in Caesarean sections by making doctors more willing to
perform the procedure on an elective basis, some experts said.
In a
retreat from the "natural childbirth" movement, the number of women
undergoing surgical deliveries has reached an all-time high. More than
one-quarter of all U.S. babies are delivered surgically, the highest rate
since the government started collecting statistics on the issue in
1989.
The reasons for the increase are complex and controversial, but
the trend is being driven in part by a rise in elective
Caesareans.
Even if their babies are not in a feet-downward "breech"
position, or they do not face other possible complications, some women are
choosing to forego natural labor and instead schedule a surgical
delivery, either for convenience, because they fear the pain of
childbirth, or because of concerns about possible long-term
complications from the physical trauma of labor and delivery.
The
increase has led to an intense debate. Opponents argue that elective
Caesareans are costly, require more recovery time, and put women at risk
for infections, hemorrhages and other complications.
Proponents say
Caesareans pose no serious risks for most women and that expectant mothers
should have the choice. Some go further, saying doctors should actively
offer the option because labor and delivery carries significant risks for
long-term complications, including decreased sexual sensation,
incontinence and other health problems.
In the new statement, the
ethics committee concludes that the relative risks and benefits of
elective Caesareans vs. vaginal deliveries remain unclear, and it cautions
against actively advocating surgical deliveries.
"The burden of
proof should fall on those who are advocates for . . . the replacement of
a natural process with a major surgical procedure," the committee
wrote.
Moreover, "given the lack of data, it is not ethically necessary
to initiate discussion regarding the relative risks and benefits of
elective [Caesarean] birth versus vaginal delivery with every pregnant
patient," the committee wrote.
But the committee also concludes that
"if the physician believes that [Caesarean] delivery promotes the overall
health and welfare of the woman and her fetus more than vaginal birth, he
or she is ethically justified in performing" the procedure.
Robert
Lorenz, vice chief of obstetrics at William Beaumont Hospital in Royal
Oak, Mich., a member of the committee, cautioned that the statement was
not meant to encourage elective Caesareans but to provide an ethical
context for making that decision.
"My concern is that people will take
this as a carte blanche 'Let's do Caesarean sections on everyone,' "
Lorenz said by telephone. "That's not the intent at all."
Laura
Riley of Massachusetts General Hospital, who chairs the organization's
committee on obstetric practice, said the group would not issue specific
guidelines about elective Caesareans until more research is done on their
risks and benefits.
But supporters of offering Caesareans as an option
applauded the committee's statement as a significant shift.
"I
think it's a step to where we're going. And my guess is that as increasing
evidence comes out, it will probably become a more accepted procedure,"
said W. Benson Harer Jr., medical director of the Riverside County
Regional Medical Center in Moreno Valley, Calif., who triggered a furor
when he was president of the organization by arguing that women should
have the option of a Caesarean. "Before this statement, it was gray area.
This clarifies it and gives it some permissibility."
David C.
Walters, an obstetrician-gynecologist in Mount Vernon, Ill., who actively
advocates Caesareans, was disappointed it did not go further.
"I do
think it's a step forward in that the college has grudgingly agreed that
it might be a reasonable thing to do. That's new," Walters said. "They
should have said that in the absence of compelling evidence to support the
superiority of either vaginal birth or Caesarean section that either one
is a reasonable alternative for delivery and should be considered
equally."
But Tonya Jamois, president of the International Cesarean
Awareness Network, which opposes overuse of the procedures, criticized the
statement.
"There's lot of evidence that shows that Caesareans are
much more dangerous for the mothers and the babies," Jamois said. "What
I'm worried about is that this will be interpreted to justify ethically
a physician agreeing to give a woman a Caesarean when there's no
medical indication. I think it is a bad thing for
society."
© 2003 The Washington Post Company
----- Original Message -----
Sent: Tuesday, October 28, 2003 11:58
AM
Subject: Re: [ozmidwifery] Another
unec. C-section...
Jen, That true, CTG's are notorious for high
false positive rates, but on top of that Goer says "low blood ph...is a poor
predictor of brain damage.. false positives are common". She
says She says page 132.
Blessings Dierdre
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