Was this c-section necessary?

[Mabv812]

I heard this story the other day: Mother goes into labor with breech baby. The labor was progressing normally until 9 cm after 12 hours of labor. After a few more hours of no progress (family did not want to use any medications to speed the labor along bc they wanted it natural) they moved to do a c-section.

These kinds of stories scare me because I feel like it was rushed to do a c-section after only a few hours of waiting for progress. Esp sad considering the parents wanted a natural birth.

Was this c-section necessary? Would the labor have progressed naturally had they just waited?

Thanks!

 

[fionar]

I'd want to know more about baby's movements, mom's well-being (mental and physical), baby and mom's heart rates, and all that. There's not enough information here to say whether it was necessary (and really, only the medical professionals involved can say that with any degree of certainty).

That said, I feel like docs tend to be more skittish with breech babes and they're skittish about slow progress (even when "slow" is totally within normal ranges...), so if I was forced to guess based on the scenario described, I'd guess it maybe wasn't medically necessary.

 

[Mabv812]

Yea, good point. I don't have any other information on the situation

 

[fionar]

Necessary or not, it's a bummer mama didn't get the birth she wanted. Even when a choice is really and truly for the best and an intervention really and truly is needed, it's disappointing for things not to go how they'd been planned. So either way I'm sorry for mama.

 

[special_kala]

I was at 9cm from 4pm-7.40pm (W being born at 7.50), i have no doubts that had i been in hospital they would have pushed failure to progress and csection.

 

[Feronia]

I don't know too much about breech births, but I really dislike seeing "failure to progress" thrown around as a reason to do a c-section. I was in labour for 56 hours and I'm sure they would have pushed for a c-section if I were in a hospital! (So so glad I wasn't; it went perfectly fine at home!) Labours are HIGHLY variable, so it just doesn't make sense why women in hospitals are often put on a timer if everything is going alright and the baby isn't distressed.

 

[MindUtopia]

It's so hard to say. My daughter was breech right up til the end, then turned and was born at home 3 weeks later, so I did a lot of research into breech birth trying to decide what I would want to do if she hadn't turned. There are lots of women who have breech babies naturally and all goes well. Unfortunately, there aren't many OBs and midwives who have extensive experience in vaginal breech births anymore (because so many women just opt for a c-section), so the risks of breech birth to the baby are greater in those circumstances (not because breech birth is 'dangerous' in all cases, but just because those skills have been lost). They also tend to end in more instrumental (forceps and ventouse) deliveries which can result in more injuries to the baby than a c-section.

If my daughter hadn't turned, I would have opted for the c-section, only because the research shows the risks would have been greater to me but less for her and that was what I was most comfortable with. I've seen some nasty injuries to babies from instrumental deliveries and I just wasn't comfortable with that. But all that research is still just based on the population, not on individual cases. Any one woman and baby could have an awesome breech birth with none of those issues popping up, especially with excellent care, but I do think so much of it depends on the skills of your birth attendants.

I have a friend who got labeled as 'failing to progress' even though she'd gotten to 8 cm naturally in only 12 hours of labour. She was in hospital and they rushed her off for a c-section. My labour was also 12 hours. I dilated quickly but pushed for 4 hours. I think if I hadn't been at home with a midwife who was skilled and who I trusted to let me go with what my body needed to do, I probably would have 'failed to progress'. In reality, my daughter was posterior and probably taking that extra time to turn in my pelvis because she was born the right way around. I'm so glad I wasn't in hospital in this situation because it allowed me to just go with things and have time and space to let things happen naturally without all those labels.

 

[Dream.dream]

I had 39 hour labour in the hospital. I'm actually shocked they don't push me for a c section . But my son was born naturally

Since she was already at 9 yes she very well coul har progressed further. If baby wasn't in distress and mom was fine its seems silly to risk to a section

 

[Proserpina]

As cute as the term "unnecesarean" is, it's never entirely possible to tell whether or not a c-section was "necessary" because we simply do not know what the outcome would have been had the c-section not been done.

Was the c-section medically indicated? Unless mom and/or baby was/were showing signs of distress, I would say "no." A few hours of no progress is generally not that big a deal. Unfortunately, hospitals want beds emptied and filled, so "failure to progress" is by far the most common reason for c-section. I feel pretty confident that a lot of "failure to progress" sections would go on to deliver healthy babies if given more time.

That said, I think the family should have reconsidered its aversion to medications before agreeing to the section. I want a natural childbirth this time, too, but if I seemed stalled at a 9, I would much rather try an hour of Pitocin than agree to major surgery. Remember, those interventions exist because they do help sometimes. They may be overused, but that doesn't make them automatically bad.

 

[SimoneMK]

I don't know too much about breech births, but I really dislike seeing "failure to progress" thrown around as a reason to do a c-section. I was in labour for 56 hours and I'm sure they would have pushed for a c-section if I were in a hospital! (So so glad I wasn't; it went perfectly fine at home!) Labours are HIGHLY variable, so it just doesn't make sense why women in hospitals are often put on a timer if everything is going alright and the baby isn't distressed.

You are correct - c sections are pushed after only a few hours of not progressing some times. I can see how the mother will get inpatient and cave in, I hope i can be strong willed enough to just say no. 56 hours is very very long tho i cant even imagine.

 

[misspriss]

I was induced early for Pre-E, I was in labor for 36 hours and then got a C-section for failure to progress. But I was at 4.5-5 cm for probably 18-24 hours before they did the C-section. Needless to say I think it was medically necessary - I had my waters broken for over 24 hours (although I was dosed with antibiotics for "unknown" GBS status) and the magnesium sulfate and two nights of trying to sleep in labor had made me so weak I couldn't even sit up for the epidural.

I was kind of surprised they let me go so long.

 

[Monalissa]

That said, I think the family should have reconsidered its aversion to medications before agreeing to the section. I want a natural childbirth this time, too, but if I seemed stalled at a 9, I would much rather try an hour of Pitocin than agree to major surgery. Remember, those interventions exist because they do help sometimes. They may be overused, but that doesn't make them automatically bad.

That was my first thought. I wouldn't opt for a c-section over trying pitocin.

 

[NDH]

Its hard to find an ob or midwife even willing to attempt a vaginal breech birth and those who do will often stipulate certain conditions. But I too would certainly try pitocin before consenting to a c section in the above scenario.

 

[bassdesire]

I was at 9 9.5 for a few hours...I had a natural birth

 

[Feronia]

Some labours are really, really slow though! I mean, I was at 4-5 cm for seriously 50 hours. I laboured through two nights of regular, strong contractions. I would have had a c-section if I were in a hospital, but instead I had a lovely natural birth at home. Sometimes doctors just want to wait so there's this idea that labour should only last a certain amount of time before a c-section is "necessary," when it can be HIGHLY variable and still be totally okay! That's why I'm suspicious whenever "failure to progress" is given as a reason for a c-section.

 

[NDH]

I've just learned why the couple in the above scenario opted for the caesarean over pitocin.

https://www.aims.org.uk/Journal/Vol10No3/handOffbreech.htm

 

[patch2006uk]

It's impossible to know. With me, the consultant midwife and my own research had convinced me that the interventions I'd had with Isaac had caused him distress and led to a c-section. Based on that, we decided to stay hands off with Charley, and he died during labour.

I still think I could have avoided a c-section with Isaac if they'd induced a couple of days earlier (my bishops score was an easy 8) then he'd have come no problems, but they left me too long, trying to achieve a natural birth, and ended up causing a c-section.

I think in the circumstances, the c-section saved Isaac's life, but I believe a gentler intervention a few days earlier would have had a better outcome for me, if that makes sense? But you can never know if these things were absolutely necessary until you're out the other side. That's just life.

But yes, augmentation of labour isn't a good idea with a breech birth. Frustrating to get so close, though.

 

[JessPape]

This is exactly my story -- now i'm researching a home birth. Going to the hospital may have been her number 1 worst intervention. Some people just cant relax and let their bodies do what they need to in the hospital.

I refused drugs, because I do not want hormonal fake stuff in my body. I've never had a good reaction to it with Birth Control and cant see it being any different.