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Excellent Laraine, still laughing aloud - if
only!
Jo x
----- Original Message -----
Sent: Monday, November 03, 2003 1:03
PM
Subject: Re: [ozmidwifery] Another unec.
C-section...
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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