1 00:00:04,000 --> 00:00:07,040 Speaker 1: Welcome to Stuff Mom Never Told You from how Stuff 2 00:00:07,040 --> 00:00:14,360 Speaker 1: Works dot com. Hello, and welcome to the podcast. I'm 3 00:00:14,440 --> 00:00:18,759 Speaker 1: Kristen and I'm Caroline and Caroline. A number of women 4 00:00:19,360 --> 00:00:25,400 Speaker 1: have written in asking for a podcast about cesarean sections. Well, 5 00:00:25,440 --> 00:00:28,520 Speaker 1: today's their lucky day, Kristen. Today is their lucky day, 6 00:00:29,080 --> 00:00:31,160 Speaker 1: because that's what we're gonna talk about, and specifically, we're 7 00:00:31,160 --> 00:00:34,920 Speaker 1: going to focus on the rising rate of C sections 8 00:00:35,120 --> 00:00:40,280 Speaker 1: and of elective c sections, of women telling their doctors, hey, doc, 9 00:00:41,000 --> 00:00:45,280 Speaker 1: I would like a C section to deliver this baby right, 10 00:00:45,640 --> 00:00:48,960 Speaker 1: as opposed to waiting for an emergency to happen, or 11 00:00:49,560 --> 00:00:52,760 Speaker 1: you know, or just allowing the doctor to decide saying, hey, 12 00:00:52,760 --> 00:00:57,600 Speaker 1: flip a coin. Heads is vaginal tails is through a 13 00:00:57,680 --> 00:01:03,680 Speaker 1: tum tum. That's exactly how it happened us. Actually, exactly 14 00:01:03,720 --> 00:01:07,160 Speaker 1: how it happens is. A csarian section is a surgical 15 00:01:07,240 --> 00:01:09,880 Speaker 1: procedure used to deliver a baby through an incision in 16 00:01:09,920 --> 00:01:14,560 Speaker 1: the mother's abdomen and a second incision in the uterus. 17 00:01:15,160 --> 00:01:18,400 Speaker 1: These incisions, both the one in the abdomen and the uterus, 18 00:01:18,440 --> 00:01:20,920 Speaker 1: are done horizontally. The one in the abdomen is done 19 00:01:20,959 --> 00:01:24,200 Speaker 1: typically near the pubic hairline. Whereas the one in the 20 00:01:24,280 --> 00:01:28,000 Speaker 1: uterus is done similarly uh in the lower part of 21 00:01:28,000 --> 00:01:30,080 Speaker 1: the uterus. Yeah, and that would be referred to as 22 00:01:30,080 --> 00:01:34,040 Speaker 1: a low transverse incision UM, as opposed to a classic 23 00:01:34,560 --> 00:01:37,920 Speaker 1: C section, which is something that really isn't used anymore, 24 00:01:37,959 --> 00:01:40,360 Speaker 1: and that was back in the day. Doctors would make 25 00:01:40,400 --> 00:01:44,200 Speaker 1: a large vertical incision that usually would prevent women from 26 00:01:44,400 --> 00:01:49,480 Speaker 1: future vaginal delivery due to UM heightened increase of uterine rupture. 27 00:01:49,560 --> 00:01:54,440 Speaker 1: But cesarean technology has improved UM and leading up to 28 00:01:54,480 --> 00:01:58,080 Speaker 1: the surgery, doctors might have you get blood tests in 29 00:01:58,080 --> 00:02:01,080 Speaker 1: case you need a transfusion. During the surge, they'll discuss 30 00:02:01,280 --> 00:02:06,000 Speaker 1: anesthesia options. Common choice, for instance, is a spinal block, 31 00:02:06,320 --> 00:02:10,400 Speaker 1: in which medication is injected directly into the sack surrounding 32 00:02:10,400 --> 00:02:12,959 Speaker 1: the spinal cord um. And then there's another choice called 33 00:02:12,960 --> 00:02:16,440 Speaker 1: an epidural, where the medication is injected just outside of 34 00:02:16,480 --> 00:02:22,840 Speaker 1: the sack. Either one sounds very painful, but probably not 35 00:02:22,880 --> 00:02:25,360 Speaker 1: as painful as actually shooting a baby at your vagina. 36 00:02:25,840 --> 00:02:29,160 Speaker 1: This is true right now. I I was delivered vaginally, 37 00:02:29,200 --> 00:02:32,919 Speaker 1: a personal time gather round. So I was delivered vaginally, 38 00:02:32,960 --> 00:02:34,840 Speaker 1: and my mother, I think, felt a single twinge of 39 00:02:34,880 --> 00:02:38,080 Speaker 1: pain and was like shot, please she had she had 40 00:02:38,120 --> 00:02:42,239 Speaker 1: the epidural. So anyway, if a health emergency prompts the 41 00:02:42,320 --> 00:02:45,600 Speaker 1: C section, rather than this is an elective C section happening, 42 00:02:45,919 --> 00:02:50,840 Speaker 1: the doctors will probably check the baby's lung maturity via amniocentesis, 43 00:02:50,960 --> 00:02:54,120 Speaker 1: because there is a concern that if the baby comes 44 00:02:54,160 --> 00:03:00,240 Speaker 1: out earlier than expected, that their lungs are not fully 45 00:03:00,280 --> 00:03:02,800 Speaker 1: developed and they could develop breathing problems at birth. And 46 00:03:02,840 --> 00:03:05,919 Speaker 1: in addition to that, cesareans don't take long at all, 47 00:03:06,040 --> 00:03:09,400 Speaker 1: usually less than an hour, but after the surgery, moms 48 00:03:09,440 --> 00:03:12,120 Speaker 1: will usually need to stay in the hospital for a 49 00:03:12,120 --> 00:03:14,960 Speaker 1: little bit longer than they would with a vaginal delivery, 50 00:03:15,160 --> 00:03:18,359 Speaker 1: usually for about three days, and it takes around four 51 00:03:18,400 --> 00:03:21,760 Speaker 1: to six weeks for the incisions to heal, during which 52 00:03:21,760 --> 00:03:25,160 Speaker 1: time no big surprise here. You can't have sex, And 53 00:03:25,200 --> 00:03:27,320 Speaker 1: I mean, I've heard the recovery is really painful. I mean, 54 00:03:27,360 --> 00:03:29,360 Speaker 1: the mom's out there correct me if I'm wrong, But 55 00:03:29,840 --> 00:03:32,520 Speaker 1: I don't think i'd want to be having any sex 56 00:03:32,639 --> 00:03:37,200 Speaker 1: or moving, walking, breathing, sneezing, taking care of a baby, 57 00:03:37,200 --> 00:03:40,600 Speaker 1: any of the thing. Now we're gonna get a little 58 00:03:40,640 --> 00:03:44,280 Speaker 1: bit into the history of the C section but first 59 00:03:44,720 --> 00:03:49,800 Speaker 1: let us clarify with the etymology of the cesarean that 60 00:03:49,880 --> 00:03:53,800 Speaker 1: it is not so named because it's derived from the 61 00:03:53,800 --> 00:03:58,160 Speaker 1: surgical birth of Julius Caesar. Yeah, the whole thing with 62 00:03:58,200 --> 00:04:01,640 Speaker 1: cesarian sections is that originally they were performed as a 63 00:04:01,720 --> 00:04:04,200 Speaker 1: last result. They were last resort. Sorry, they were not 64 00:04:04,280 --> 00:04:07,320 Speaker 1: to save the mother's life. It was typically performed on 65 00:04:07,400 --> 00:04:11,080 Speaker 1: dead or dying women to retrieve the baby, and so 66 00:04:11,200 --> 00:04:15,720 Speaker 1: Julius Caesar likely could not have been born through this 67 00:04:15,920 --> 00:04:19,960 Speaker 1: cesarean procedure because his mother is reputed to have lived 68 00:04:20,040 --> 00:04:22,960 Speaker 1: to hear of her son's invasion of Britain, so she 69 00:04:23,000 --> 00:04:26,839 Speaker 1: couldn't have had one more likely. Uh. The origins of 70 00:04:26,880 --> 00:04:29,840 Speaker 1: the term is the Roman law under Caesar decreed that 71 00:04:29,920 --> 00:04:33,080 Speaker 1: all dead or dying pregnant women must undergo the procedure 72 00:04:33,160 --> 00:04:36,280 Speaker 1: to save the child, and cesarian sections so that the 73 00:04:36,279 --> 00:04:40,320 Speaker 1: actual procedure of the child being delivered through the stomach 74 00:04:40,400 --> 00:04:43,400 Speaker 1: rather than through the vaginal canal has been around since 75 00:04:43,440 --> 00:04:46,960 Speaker 1: ancient times, long before Caesar even came around. It's even 76 00:04:47,040 --> 00:04:52,000 Speaker 1: in Greek mythology. There's a story about Apollo removing Asclepius 77 00:04:52,240 --> 00:04:55,320 Speaker 1: from his mother's abdomen and the Sky would go on 78 00:04:55,400 --> 00:04:59,880 Speaker 1: to found a religious medical cult, and imagining a Poul 79 00:05:00,640 --> 00:05:06,400 Speaker 1: being your doctor, I think I'd be cool with Apollo 80 00:05:06,480 --> 00:05:11,159 Speaker 1: delivering my baby sun God. Sure absolutely might need to 81 00:05:11,240 --> 00:05:15,560 Speaker 1: wear a little sunscreen. But there are also numerous references 82 00:05:15,600 --> 00:05:19,760 Speaker 1: to cesareans that appear in ancient Hindu text, Egyptian text, 83 00:05:20,400 --> 00:05:24,520 Speaker 1: of course, in Grecian text, Roman texts, and other I'm 84 00:05:24,560 --> 00:05:27,400 Speaker 1: just gonna keep saying texts over and over again, but 85 00:05:27,520 --> 00:05:31,039 Speaker 1: in all sorts of European folklore, and they're also ancient 86 00:05:31,200 --> 00:05:35,440 Speaker 1: Chinese etchings that depict the procedure. But then it's not 87 00:05:35,520 --> 00:05:38,760 Speaker 1: until fift that we have the first written record of 88 00:05:38,800 --> 00:05:43,400 Speaker 1: a mother and baby surviving the operation. But this is 89 00:05:43,680 --> 00:05:49,400 Speaker 1: a questionable story. Supposedly a Swiss sal Gilder, a far 90 00:05:49,480 --> 00:05:54,039 Speaker 1: cry from Apollo, performed the operation on his wife, but 91 00:05:54,120 --> 00:05:58,160 Speaker 1: again the origins of that are pretty murky um and 92 00:05:58,200 --> 00:06:03,360 Speaker 1: it was called though a cesarean operation shintil fifteen, when 93 00:06:03,520 --> 00:06:08,880 Speaker 1: Jacques Gilmo's book on midwhiffery introduced the term section sidebar, 94 00:06:09,400 --> 00:06:12,200 Speaker 1: I was laughed at by some nurses when I said midwifery. 95 00:06:13,080 --> 00:06:17,200 Speaker 1: They laughed laughed at me. It's midwiffery, So thank you 96 00:06:17,240 --> 00:06:19,720 Speaker 1: for pronouncing it correctly. So no nurses out there laugh? 97 00:06:20,440 --> 00:06:22,480 Speaker 1: Do you have like a do you regularly walked by 98 00:06:22,480 --> 00:06:26,000 Speaker 1: like a band of salty midwives on your way to 99 00:06:26,040 --> 00:06:28,600 Speaker 1: work at the bus stop. They're all hanging out smoking, 100 00:06:28,800 --> 00:06:33,000 Speaker 1: you know, jaws and dausin dice, you know those nurses. 101 00:06:33,800 --> 00:06:36,960 Speaker 1: So I mean speaking of midwhiffery. You know, that was typically, 102 00:06:37,120 --> 00:06:39,800 Speaker 1: as we've talked about the podcast before, that was a 103 00:06:39,839 --> 00:06:45,360 Speaker 1: women's centric thing. But cesarean sections were more male centric 104 00:06:45,400 --> 00:06:48,560 Speaker 1: as far as performing the operation. Women were barred from 105 00:06:48,600 --> 00:06:52,280 Speaker 1: performing it for for the most part until late nineteenth century. 106 00:06:52,320 --> 00:06:57,159 Speaker 1: But interestingly enough, the first recorded successful C section in 107 00:06:57,240 --> 00:07:00,840 Speaker 1: the British Empire was conducted by a wolf mean sometime 108 00:07:00,920 --> 00:07:05,279 Speaker 1: between eighteen fifteen and eighteen twenty one. James Miranda Stewart 109 00:07:05,440 --> 00:07:09,279 Speaker 1: Barry performed the surgery while masquerading as a man and 110 00:07:09,320 --> 00:07:12,840 Speaker 1: serving as a physician to the British Army in South Africa. Yeah, 111 00:07:12,840 --> 00:07:16,040 Speaker 1: the story of Dr Barry, just also on a side note, 112 00:07:16,160 --> 00:07:20,720 Speaker 1: is pretty fascinating because when she wanted to go to 113 00:07:20,840 --> 00:07:23,800 Speaker 1: med school, women were not allowed, and so she was like, 114 00:07:23,840 --> 00:07:27,320 Speaker 1: you know what, I'm just gonna start dressing like a 115 00:07:27,400 --> 00:07:32,280 Speaker 1: man and it totally worked. And it's funny because there 116 00:07:32,280 --> 00:07:34,840 Speaker 1: were writings at the time when Barry was in Africa 117 00:07:34,920 --> 00:07:38,000 Speaker 1: doing all this work from people who commented on how 118 00:07:38,480 --> 00:07:41,920 Speaker 1: uh this This doctor had a certain effeminiscy. He was 119 00:07:41,960 --> 00:07:45,440 Speaker 1: always trying to hide and he actually became embroiled in 120 00:07:45,560 --> 00:07:49,520 Speaker 1: this steamy love affair with a married aristocrat in Africa 121 00:07:49,600 --> 00:07:53,760 Speaker 1: as well, who gave Barry a dog named Psyche that 122 00:07:53,800 --> 00:07:57,360 Speaker 1: the doctor took around everywhere and Dr Barry for Canadian listeners. 123 00:07:57,920 --> 00:08:02,480 Speaker 1: Dr Berry was later transferred to Canada, thus becoming Canada's 124 00:08:02,520 --> 00:08:08,800 Speaker 1: first female doctor. H look at that British empire. Indeed. Indeed, 125 00:08:09,440 --> 00:08:13,200 Speaker 1: so we think of these successful c sections, the ones 126 00:08:13,280 --> 00:08:16,800 Speaker 1: where the mother and child actually do survive the operation, 127 00:08:16,840 --> 00:08:20,600 Speaker 1: as more of a modern procedure, but nineteenth century travelers 128 00:08:20,640 --> 00:08:23,320 Speaker 1: reported seeing it performed in Uganda and Rwanda, and the 129 00:08:23,360 --> 00:08:26,960 Speaker 1: wound would be sound shut and stuffed with like banana 130 00:08:27,040 --> 00:08:29,760 Speaker 1: leaves and things. I mean, it's it's very fascinating that 131 00:08:30,000 --> 00:08:34,040 Speaker 1: there were reports of you know, local village doctors performing 132 00:08:34,040 --> 00:08:37,720 Speaker 1: this without all of the quote unquote modern nineteenth century 133 00:08:37,720 --> 00:08:41,560 Speaker 1: British technology, right, but of course, as technologies such as 134 00:08:41,600 --> 00:08:46,400 Speaker 1: crucial elements like anesthesia become more readily available, and as 135 00:08:46,400 --> 00:08:52,040 Speaker 1: births start moving from homes into hospitals, new obstetrical and 136 00:08:52,040 --> 00:08:56,000 Speaker 1: surgical skills begin to be developed as well, and c 137 00:08:56,240 --> 00:09:00,000 Speaker 1: sections become a little safer and a little more common, 138 00:09:00,040 --> 00:09:02,320 Speaker 1: even though they're still considered for a very very very 139 00:09:02,320 --> 00:09:06,319 Speaker 1: long time to be last resorts. Yeah, and this is 140 00:09:06,360 --> 00:09:09,000 Speaker 1: around the time too, that doctors started advocating for that 141 00:09:09,120 --> 00:09:12,280 Speaker 1: low cervical C section, which reduced infection rates as opposed 142 00:09:12,280 --> 00:09:16,960 Speaker 1: to that uh more drastic vertical cut. Now, this is 143 00:09:17,000 --> 00:09:21,400 Speaker 1: a bit of a gory detail, but this technological development 144 00:09:21,520 --> 00:09:25,000 Speaker 1: of c sections is also a really good thing because 145 00:09:25,040 --> 00:09:29,240 Speaker 1: it replaced something called a craniotomy, in which if the 146 00:09:29,280 --> 00:09:32,640 Speaker 1: baby had to be delivered by emergency, since they didn't 147 00:09:32,679 --> 00:09:36,800 Speaker 1: know how to um surgically get inside of the womb 148 00:09:37,600 --> 00:09:41,520 Speaker 1: through a c section, they actually had to go into 149 00:09:41,800 --> 00:09:45,439 Speaker 1: the vaginal canal and and break the fetal skull and 150 00:09:45,480 --> 00:09:50,720 Speaker 1: pull the baby out that way. Yeah, so c sections 151 00:09:51,640 --> 00:09:56,520 Speaker 1: definitely a positive development, and its urbanization continues. One of 152 00:09:56,559 --> 00:10:00,480 Speaker 1: the other reasons why we see C section rates rises 153 00:10:00,559 --> 00:10:02,920 Speaker 1: not just because more women are trying to go to 154 00:10:02,960 --> 00:10:05,840 Speaker 1: the hospital to have their babies, but also because kids 155 00:10:05,880 --> 00:10:10,200 Speaker 1: are developing rickets, which is a nutritional deficiency that leads 156 00:10:10,240 --> 00:10:13,200 Speaker 1: to the softening of the bones, and all these women 157 00:10:13,240 --> 00:10:16,520 Speaker 1: were growing up with it and had malformed pelvis. Is 158 00:10:16,840 --> 00:10:20,480 Speaker 1: that prevented normal delivery? Now this was also addressed once 159 00:10:20,520 --> 00:10:24,880 Speaker 1: safe milk became more available. Um, but yeah, I had 160 00:10:24,920 --> 00:10:27,960 Speaker 1: no idea that rickets and c sections in the US 161 00:10:28,040 --> 00:10:31,200 Speaker 1: for somehow connected, no idea. And so you know, after 162 00:10:31,400 --> 00:10:34,680 Speaker 1: safe milk was available, kids are healthier, they have better nutrition. 163 00:10:35,000 --> 00:10:37,520 Speaker 1: But doctors were slow to respond to the reduced need 164 00:10:37,600 --> 00:10:39,880 Speaker 1: for c sections and kept doing them pretty much at 165 00:10:39,880 --> 00:10:43,440 Speaker 1: the same pace. And after World War Two, c section 166 00:10:43,520 --> 00:10:46,520 Speaker 1: rates never dropped back to where they were before rickets 167 00:10:46,559 --> 00:10:50,040 Speaker 1: became widespread, and today C section rates have reached an 168 00:10:50,040 --> 00:10:54,679 Speaker 1: all time high. And we'll get into reasons why that is. 169 00:10:54,840 --> 00:10:59,600 Speaker 1: But jumping forward to modern cesareans, let's talk about health 170 00:10:59,640 --> 00:11:03,960 Speaker 1: and say fifty and start off with risks to the baby, 171 00:11:04,040 --> 00:11:07,680 Speaker 1: because there are some risk associated, of course, with babies 172 00:11:07,720 --> 00:11:10,840 Speaker 1: delivered by c section. They are, for instance, more likely 173 00:11:11,280 --> 00:11:15,360 Speaker 1: to develop transient hipnia, which is a problem marked by 174 00:11:15,400 --> 00:11:18,800 Speaker 1: abnormally fast breathing during the first few days after birth. 175 00:11:18,840 --> 00:11:20,760 Speaker 1: And I have a feeling Carolina's related to that issue 176 00:11:20,760 --> 00:11:24,280 Speaker 1: of lung development that you mentioned earlier. C sections done 177 00:11:24,320 --> 00:11:27,840 Speaker 1: before thirty nine weeks or without proof of lung maturity 178 00:11:27,880 --> 00:11:31,680 Speaker 1: could also increase that risk of other breathing problems such 179 00:11:31,679 --> 00:11:36,400 Speaker 1: as respiratory distress syndrome. And there are some smaller risks 180 00:11:36,440 --> 00:11:40,880 Speaker 1: of surgical incidents, such as UH surgical nicks to the baby, 181 00:11:40,920 --> 00:11:44,559 Speaker 1: but that's very rare. Yeah. Um. There are more numerous 182 00:11:44,720 --> 00:11:48,120 Speaker 1: risks for the mother, although some of these are also rare. UH. 183 00:11:48,160 --> 00:11:51,320 Speaker 1: There's endometritis, which is the inflammation or infection of the 184 00:11:51,400 --> 00:11:55,240 Speaker 1: membrane lining the uterus that can cause fever, foul smelling, 185 00:11:55,280 --> 00:12:00,000 Speaker 1: vaginal discharge, and uterine pain. Increase risk during future pregnant 186 00:12:00,000 --> 00:12:02,680 Speaker 1: and see such as bleeding, problems with the placenta and 187 00:12:02,800 --> 00:12:07,439 Speaker 1: uterine rupture, and also increased bleeding more so than with 188 00:12:07,520 --> 00:12:11,920 Speaker 1: vaginal birth, reactions to anesthesia, blood clots, wound infection, injury 189 00:12:11,920 --> 00:12:14,240 Speaker 1: to other organs. So there are a couple that are 190 00:12:14,280 --> 00:12:18,439 Speaker 1: specific to C section in particular, but also just general 191 00:12:18,520 --> 00:12:22,000 Speaker 1: risks that you would face with most surgeries. Yeah, and um. 192 00:12:22,080 --> 00:12:26,080 Speaker 1: When it comes to emergency c sections, UH, complications that 193 00:12:26,160 --> 00:12:29,560 Speaker 1: tend to arise from those are on the upside, at 194 00:12:29,640 --> 00:12:33,960 Speaker 1: least more commonly linked to whatever medical condition prompted that 195 00:12:34,040 --> 00:12:38,360 Speaker 1: emergency delivery rather than the C sections. So while there 196 00:12:38,360 --> 00:12:41,839 Speaker 1: are definitely some more unique risks that are associated with 197 00:12:41,920 --> 00:12:45,000 Speaker 1: cesarean delivery, a lot of times those complications might be 198 00:12:45,720 --> 00:12:50,360 Speaker 1: more associated with a condition that a woman already came 199 00:12:50,400 --> 00:12:54,280 Speaker 1: to the hospital with. Now, one thing that moms and 200 00:12:54,400 --> 00:12:57,280 Speaker 1: doctors have been concerned with over the years is is 201 00:12:57,320 --> 00:13:01,240 Speaker 1: it okay uh to have vaginal childbirth after you have 202 00:13:01,320 --> 00:13:03,680 Speaker 1: had a C section? Are you only supposed to stick 203 00:13:03,720 --> 00:13:06,559 Speaker 1: with C sections once you've had one? And a two 204 00:13:06,559 --> 00:13:08,760 Speaker 1: thousand four study in the New England Journal of Medicine 205 00:13:08,800 --> 00:13:13,800 Speaker 1: said that serious complications are possible, but the absolute risk 206 00:13:13,920 --> 00:13:16,839 Speaker 1: is very small when you have a vaginal childbirth after 207 00:13:16,880 --> 00:13:19,880 Speaker 1: C section, which is abbreviated in these journals as v 208 00:13:19,960 --> 00:13:21,960 Speaker 1: B A C which I did not know it has 209 00:13:21,960 --> 00:13:25,440 Speaker 1: its own little abbreviation. So that said that the risk 210 00:13:25,520 --> 00:13:30,320 Speaker 1: being small, it is worth pointing out that when compared 211 00:13:30,400 --> 00:13:34,120 Speaker 1: to elective repeat C section, women attempting vaginal birth after 212 00:13:34,240 --> 00:13:37,800 Speaker 1: C section are at a somewhat increased risk of serious 213 00:13:37,800 --> 00:13:41,520 Speaker 1: obstectric complications, and that drives with a recent Australian study 214 00:13:41,559 --> 00:13:45,880 Speaker 1: that came out in which found that repeat C sections 215 00:13:45,960 --> 00:13:48,720 Speaker 1: might be a safer option. Um It found that among 216 00:13:48,760 --> 00:13:53,040 Speaker 1: babies born by a planned cesarean point nine percent and 217 00:13:53,080 --> 00:13:56,120 Speaker 1: died or had serious complications, compared with two point four 218 00:13:56,160 --> 00:14:00,199 Speaker 1: percent of babies born by v back and point eight 219 00:14:00,200 --> 00:14:03,880 Speaker 1: percent of moms who had repeat C sections experienced severe bleeding, 220 00:14:04,080 --> 00:14:07,160 Speaker 1: while two point three percent of those who gave birth 221 00:14:07,280 --> 00:14:09,640 Speaker 1: vaginally did. And the thing is that these risks might 222 00:14:09,679 --> 00:14:12,200 Speaker 1: sound very small. We're talking about like point eight percent. 223 00:14:12,280 --> 00:14:14,960 Speaker 1: That might not sound like a lot, but the differences 224 00:14:15,040 --> 00:14:20,360 Speaker 1: are statistically significant and things for moms to have serious 225 00:14:20,400 --> 00:14:23,680 Speaker 1: conversations with their doctors about as they're deciding the kind 226 00:14:23,720 --> 00:14:27,320 Speaker 1: of birthing method that is best for them. So, all 227 00:14:27,360 --> 00:14:29,960 Speaker 1: that being said, how many C sections are safe for 228 00:14:30,040 --> 00:14:33,640 Speaker 1: a woman to have? Dr Roger harms his name is 229 00:14:33,720 --> 00:14:37,560 Speaker 1: Dr harms Over at Mayo Clinics said that while there's 230 00:14:37,600 --> 00:14:40,520 Speaker 1: not a ton of research out there about this, most 231 00:14:40,600 --> 00:14:44,000 Speaker 1: women can safely have up to three C sections, although 232 00:14:44,600 --> 00:14:48,360 Speaker 1: each repeat C section is generally more complicated than the last. 233 00:14:48,400 --> 00:14:50,400 Speaker 1: I mean, think about it. Let's let's put it in 234 00:14:50,480 --> 00:14:53,400 Speaker 1: terms of any surgery you keep having the same surgery 235 00:14:53,880 --> 00:14:57,680 Speaker 1: and complications could arise. And so the primary concern when 236 00:14:57,680 --> 00:15:01,520 Speaker 1: you're having repeat c sections is weaken uterine wall, problems 237 00:15:01,560 --> 00:15:04,680 Speaker 1: with the placenta, such as implanting too deeply in the 238 00:15:04,760 --> 00:15:08,640 Speaker 1: uterine wall or covering the cervical opening which is placenta previa. 239 00:15:08,800 --> 00:15:12,640 Speaker 1: There's also a risk of bladder injuries and heavy bleeding. Now, 240 00:15:12,680 --> 00:15:14,800 Speaker 1: when I feel like a lot of times when we 241 00:15:14,880 --> 00:15:17,840 Speaker 1: think about or hear about C sections, a lot of 242 00:15:17,840 --> 00:15:21,840 Speaker 1: times it is with all of these warnings and concerns 243 00:15:22,040 --> 00:15:25,280 Speaker 1: over whether or not it is good for the mother 244 00:15:25,400 --> 00:15:27,200 Speaker 1: and the baby we we I think we still tend 245 00:15:27,240 --> 00:15:29,360 Speaker 1: to frame it in our minds as this kind of 246 00:15:29,400 --> 00:15:34,360 Speaker 1: emergency procedure. But in developing nations, some research has found 247 00:15:34,400 --> 00:15:38,280 Speaker 1: that it could really improve maternal health outcomes. There is 248 00:15:38,320 --> 00:15:40,040 Speaker 1: an article that came out in the New York Times 249 00:15:40,080 --> 00:15:43,760 Speaker 1: in May of twelve which talked about how performing C 250 00:15:43,960 --> 00:15:48,960 Speaker 1: section deliveries extensively and forty nine poorer nations could save 251 00:15:49,080 --> 00:15:54,359 Speaker 1: almost seventeen thousand mothers lives each year and prevent many fistulas, 252 00:15:54,400 --> 00:15:59,200 Speaker 1: which are internal tearings happen during prolonged labor, and in 253 00:15:59,280 --> 00:16:02,320 Speaker 1: most country the operation would save two to six times 254 00:16:02,640 --> 00:16:05,440 Speaker 1: the cost and income created by mothers who would otherwise 255 00:16:05,640 --> 00:16:09,440 Speaker 1: have died or would have been disabled. So as c 256 00:16:09,640 --> 00:16:13,400 Speaker 1: sections maybe on the rise in more developing nations, as 257 00:16:13,480 --> 00:16:19,080 Speaker 1: some NGOs and nonprofits look into giving doctors local doctors 258 00:16:19,080 --> 00:16:22,040 Speaker 1: the resources to do that, it's sort of mirroring a 259 00:16:22,080 --> 00:16:25,200 Speaker 1: pattern that's going on in the United States and the 260 00:16:25,240 --> 00:16:28,600 Speaker 1: Western world of c sections being on the rise. But 261 00:16:28,720 --> 00:16:32,080 Speaker 1: there is all this debate around these rising numbers as 262 00:16:32,120 --> 00:16:36,960 Speaker 1: to whether or not this is cause for concern because 263 00:16:37,640 --> 00:16:39,320 Speaker 1: a lot of it has to do with the fact 264 00:16:39,360 --> 00:16:44,240 Speaker 1: that women are outright asking for c sections once they, 265 00:16:44,280 --> 00:16:46,760 Speaker 1: you know, learn that they're pregnant and everything. They're saying, oh, 266 00:16:46,800 --> 00:16:50,000 Speaker 1: you know what, we're gonna go ahead and schedule this delivery. 267 00:16:50,040 --> 00:16:53,760 Speaker 1: But first, um, let's talk more about the how much 268 00:16:53,800 --> 00:16:57,120 Speaker 1: that rate has risen. So c sections are actually the 269 00:16:57,160 --> 00:17:00,000 Speaker 1: most common procedure done in operating rooms now and between 270 00:17:00,960 --> 00:17:07,200 Speaker 1: two thousand seven the rate jump from tot of all births. 271 00:17:07,200 --> 00:17:09,359 Speaker 1: That's coming from a US News and World Report article 272 00:17:09,400 --> 00:17:14,000 Speaker 1: in September, And what's surprising to a lot of researchers 273 00:17:14,119 --> 00:17:16,720 Speaker 1: is that the C section rate is actually very high 274 00:17:17,160 --> 00:17:20,360 Speaker 1: for first time mothers. That's one of every three new 275 00:17:20,400 --> 00:17:24,560 Speaker 1: moms getting one. Yeah, and some gynecologists are are really 276 00:17:24,600 --> 00:17:28,080 Speaker 1: concerned about this. For instance, Robert Barbiera, who's the chief 277 00:17:28,080 --> 00:17:32,760 Speaker 1: of obstetrics and gynecology at Brigham Women's Hospital, says that 278 00:17:32,840 --> 00:17:36,960 Speaker 1: the rate should be more in the range. And those 279 00:17:36,960 --> 00:17:41,199 Speaker 1: concerns are stemming from whether or not these women are 280 00:17:41,280 --> 00:17:47,560 Speaker 1: undergoing unnecessary major medical procedures. Because a C section is 281 00:17:47,600 --> 00:17:51,920 Speaker 1: a surgery. You undergo anesthesia and incisions are made. We've 282 00:17:51,920 --> 00:17:55,560 Speaker 1: described the process, and so some doctors are concerned that 283 00:17:56,240 --> 00:17:59,879 Speaker 1: we are almost doing too much in that regard. Okay, 284 00:17:59,880 --> 00:18:03,040 Speaker 1: so why why this increase? A Time article in August 285 00:18:03,040 --> 00:18:07,520 Speaker 1: of looked at possible reasons, and some of those include 286 00:18:07,800 --> 00:18:11,920 Speaker 1: the rising rate of multiple births, more obesity in pregnant women, 287 00:18:12,040 --> 00:18:15,560 Speaker 1: the older age of mothers urging women some doctors are 288 00:18:15,640 --> 00:18:19,800 Speaker 1: urging women to undergo repeat c sections, and an increase 289 00:18:19,840 --> 00:18:22,840 Speaker 1: in induced labor up from ten percent of deliveries in 290 00:18:22,920 --> 00:18:26,359 Speaker 1: nineteen nine to more than two in two thousand and six. 291 00:18:26,720 --> 00:18:29,200 Speaker 1: And going into this research, I didn't think induced labor 292 00:18:29,240 --> 00:18:32,600 Speaker 1: had anything to do with C sections, but it sure does. 293 00:18:33,080 --> 00:18:36,240 Speaker 1: Doctor Debrah Arenthal did a study of induced labor and 294 00:18:36,240 --> 00:18:41,000 Speaker 1: found that nearly forty of cases of induced labor were elective, 295 00:18:41,359 --> 00:18:44,840 Speaker 1: and she says that reducing elective labor induction could lower 296 00:18:44,920 --> 00:18:47,280 Speaker 1: the C section rate in the US by as much 297 00:18:47,320 --> 00:18:51,480 Speaker 1: as twenty Yeah. And one of the ways that the 298 00:18:51,520 --> 00:18:56,479 Speaker 1: American College of Obstetricians and Gynecologists, for instance, is looking 299 00:18:56,560 --> 00:18:59,960 Speaker 1: at lowering the C section rate is by urging doctor 300 00:19:00,160 --> 00:19:03,760 Speaker 1: is to attempt what's called a trial of labor. Essentially, 301 00:19:03,800 --> 00:19:06,919 Speaker 1: a woman comes into the hospital to have a baby, 302 00:19:07,000 --> 00:19:10,119 Speaker 1: and the plan is, Okay, we're gonna try for a 303 00:19:10,200 --> 00:19:13,919 Speaker 1: vaginal birth, but we're gonna have everything in place for 304 00:19:14,000 --> 00:19:17,160 Speaker 1: a C section if necessary. So you're gonna really, really 305 00:19:17,160 --> 00:19:20,720 Speaker 1: really really try, but we'll do a C section if 306 00:19:20,760 --> 00:19:24,720 Speaker 1: it comes to that. Thus, at least giving it I 307 00:19:24,720 --> 00:19:26,920 Speaker 1: don't know, I guess giving it a college try, giving 308 00:19:26,920 --> 00:19:31,000 Speaker 1: it the old college try. Um. One other interesting thing 309 00:19:31,040 --> 00:19:33,320 Speaker 1: about the rates of c section is that they do 310 00:19:33,520 --> 00:19:37,639 Speaker 1: differ so widely between hospitals, and part of that is 311 00:19:37,680 --> 00:19:42,159 Speaker 1: just different doctors are encouraging different things. Um. This is 312 00:19:42,240 --> 00:19:45,119 Speaker 1: coming from a study in Health Affairs in March of 313 00:19:45,160 --> 00:19:48,000 Speaker 1: this year. C section rates range from as low as 314 00:19:48,080 --> 00:19:51,600 Speaker 1: seven percent in some hospitals to as high as seventy percent, 315 00:19:51,680 --> 00:19:55,560 Speaker 1: and other u S hospitals, and even among low risk pregnancies, 316 00:19:55,600 --> 00:19:59,400 Speaker 1: those rates varied. They the study authors right, vast differences 317 00:19:59,440 --> 00:20:02,440 Speaker 1: in practice patterns are likely to be driving the costly 318 00:20:02,680 --> 00:20:06,680 Speaker 1: overuse of cesarean delivery in many US hospitals. And now 319 00:20:06,760 --> 00:20:09,160 Speaker 1: here's why. Because I was like, Okay, well, what's what's 320 00:20:09,200 --> 00:20:11,280 Speaker 1: really the concern? I mean, yes, obviously we have a 321 00:20:11,320 --> 00:20:14,400 Speaker 1: health concern with women undergoing unnecessary procedures, but they point 322 00:20:14,400 --> 00:20:18,880 Speaker 1: out because Medicaid pays for nearly half of US births, 323 00:20:19,080 --> 00:20:25,240 Speaker 1: government efforts to decrease variation are warranted. M m uh. Well, 324 00:20:25,600 --> 00:20:28,600 Speaker 1: the newest wrinkle to arise and all of this, as 325 00:20:28,920 --> 00:20:32,240 Speaker 1: I have now mentioned a few times on the podcast, 326 00:20:32,520 --> 00:20:36,760 Speaker 1: is this whole elective factor of women taking a bit 327 00:20:36,800 --> 00:20:40,920 Speaker 1: more ownership over the whole childbirth process in terms of saying, hey, 328 00:20:40,960 --> 00:20:42,760 Speaker 1: you know what, I want to sign up for a 329 00:20:42,840 --> 00:20:45,960 Speaker 1: C section. And the funny thing is, I feel like 330 00:20:46,000 --> 00:20:50,200 Speaker 1: it's getting a lot more press in the past few years, 331 00:20:50,400 --> 00:20:53,960 Speaker 1: and uh as being this new medical trend. But we 332 00:20:54,080 --> 00:20:57,879 Speaker 1: found a two thousand one USA Today article reporting on 333 00:20:57,920 --> 00:21:02,800 Speaker 1: the quote unquote whole new trend of patient choice cesareans, 334 00:21:02,920 --> 00:21:05,000 Speaker 1: but I mean it's definitely something that is picked up, 335 00:21:05,240 --> 00:21:07,520 Speaker 1: and when those numbers were first starting to pick up 336 00:21:07,560 --> 00:21:11,679 Speaker 1: in the early two thousand's, physicians were very reluctant to 337 00:21:11,800 --> 00:21:15,080 Speaker 1: agree to it. There was an article in the journal 338 00:21:15,240 --> 00:21:18,040 Speaker 1: Birth from two thousand four I talked about how without 339 00:21:18,040 --> 00:21:22,440 Speaker 1: a clear medical indication, most practitioners who were surveyed wouldn't 340 00:21:22,440 --> 00:21:24,399 Speaker 1: perform a C section, and that was based on a 341 00:21:24,440 --> 00:21:28,479 Speaker 1: survey of one hundred and seventy physicians. But there was 342 00:21:28,600 --> 00:21:32,760 Speaker 1: an interesting difference among who gave a thumbs up or 343 00:21:32,920 --> 00:21:38,640 Speaker 1: thumbs down to elective c sections. Physicians who were men 344 00:21:39,119 --> 00:21:43,720 Speaker 1: and had patients with higher socio economic statuses were more 345 00:21:43,920 --> 00:21:47,720 Speaker 1: likely to give the thumbs up to an elective C section. 346 00:21:47,760 --> 00:21:50,359 Speaker 1: And I feel like that links to this whole stereotype 347 00:21:50,400 --> 00:21:53,760 Speaker 1: of as our UK listeners might have her being too 348 00:21:53,800 --> 00:21:57,640 Speaker 1: posh to push that is this thing that oh, well, 349 00:21:57,680 --> 00:22:00,639 Speaker 1: you know, ladies who lunch just want to pencil in 350 00:22:00,960 --> 00:22:03,840 Speaker 1: fitting in the birth between a manny and a penny. Yeah. Well, 351 00:22:03,880 --> 00:22:08,160 Speaker 1: and also thinking about the whole Marissa Meyer, CEO of Yahoo, 352 00:22:08,240 --> 00:22:11,400 Speaker 1: who literally like scheduled her birth with a very limited 353 00:22:11,920 --> 00:22:15,000 Speaker 1: maternity leave and was back at work, I mean the 354 00:22:15,000 --> 00:22:17,240 Speaker 1: whole kind of you know, let's put it on our 355 00:22:17,400 --> 00:22:21,160 Speaker 1: Google calendar and go, well, so, what does the American 356 00:22:21,160 --> 00:22:24,560 Speaker 1: College of Obstetrics and Gynecology say about this? What? You know? 357 00:22:24,760 --> 00:22:28,240 Speaker 1: What were they weighing in on? And they said that, look, 358 00:22:28,280 --> 00:22:31,720 Speaker 1: if the woman is informed and gives adequate informed consent, 359 00:22:31,880 --> 00:22:34,760 Speaker 1: and the doctor believes the C section promotes overall health 360 00:22:34,760 --> 00:22:40,040 Speaker 1: and wellness, then the surgery is ethically justified. But doctors 361 00:22:40,040 --> 00:22:42,280 Speaker 1: are saying should we even do it? There was a 362 00:22:42,320 --> 00:22:45,720 Speaker 1: discussion on the Royal College of Obstetricians and Gynecologist site 363 00:22:46,440 --> 00:22:50,480 Speaker 1: and the UK's National Institute for Health and Clinical Excellence 364 00:22:51,080 --> 00:22:55,040 Speaker 1: abbreviated NICE UH in two thousand four said that when 365 00:22:55,080 --> 00:22:57,639 Speaker 1: a woman requests a C section because she has a 366 00:22:57,680 --> 00:23:01,080 Speaker 1: fear of childbirth, she should be offered counseling such as 367 00:23:01,080 --> 00:23:05,240 Speaker 1: cognitive behavioral therapy to help her address those fears. But 368 00:23:05,840 --> 00:23:11,000 Speaker 1: in NICE turns around and gives new guidelines that say, 369 00:23:11,040 --> 00:23:14,600 Speaker 1: for all women requesting a C section, if after discussion 370 00:23:14,680 --> 00:23:17,199 Speaker 1: and offer of support of vaginal birth is still not 371 00:23:17,320 --> 00:23:21,880 Speaker 1: an acceptable option, offer a planned cesarean section. And that's 372 00:23:21,920 --> 00:23:25,920 Speaker 1: a definite change from when they said previously. Maternal request 373 00:23:26,119 --> 00:23:29,639 Speaker 1: is not on its own an indication for cesarian section, 374 00:23:29,960 --> 00:23:34,040 Speaker 1: and that seems like a positive development. I mean, I 375 00:23:34,119 --> 00:23:36,639 Speaker 1: feel like these are issues where obviously you and I 376 00:23:36,680 --> 00:23:39,879 Speaker 1: can't speak from first person experience, but the thought of 377 00:23:40,760 --> 00:23:46,720 Speaker 1: having a child and not having that much ownership over yeah, 378 00:23:46,800 --> 00:23:50,280 Speaker 1: how I do it would make me uneasy. And I 379 00:23:50,320 --> 00:23:54,040 Speaker 1: can understand how doctors might say, Okay, you're you know, 380 00:23:54,160 --> 00:23:57,320 Speaker 1: you're clearly just terrified of the pain of childbirth. Lets 381 00:23:57,480 --> 00:24:01,080 Speaker 1: you know, educate you into what actually goes into all 382 00:24:01,119 --> 00:24:04,800 Speaker 1: of this. Maybe a C section isn't really you know, 383 00:24:04,840 --> 00:24:07,120 Speaker 1: what what you think it is, but it does seem 384 00:24:07,160 --> 00:24:10,239 Speaker 1: like they're there. The fact that elective c sections are 385 00:24:10,280 --> 00:24:14,560 Speaker 1: becoming more accepted medically and socially is a positive thing 386 00:24:14,800 --> 00:24:21,520 Speaker 1: for women, although Veronica Vergeron in the journal Bioethics in 387 00:24:21,520 --> 00:24:24,679 Speaker 1: two thousand seven would argue the opposite, and from a 388 00:24:24,840 --> 00:24:29,199 Speaker 1: feminist standpoint. Now, when you send me the link to 389 00:24:29,760 --> 00:24:34,360 Speaker 1: her paper in Bioethics talking about how elective c sections 390 00:24:34,359 --> 00:24:37,600 Speaker 1: are actually bad for women, um, I was surprised because 391 00:24:37,600 --> 00:24:41,359 Speaker 1: I would assume that the feminist standpoint on you know, 392 00:24:41,480 --> 00:24:44,600 Speaker 1: childbirth would be choice, choice, choice, you know, whether I 393 00:24:44,640 --> 00:24:46,919 Speaker 1: want to be at home with a dula, in a 394 00:24:47,000 --> 00:24:50,359 Speaker 1: hot tub, having my baby underwater, or in a highly 395 00:24:50,400 --> 00:24:55,320 Speaker 1: medicalized environment in the hospital, scheduling that baby and getting 396 00:24:55,320 --> 00:24:59,680 Speaker 1: out of there. No Vergeron says that the medical it's 397 00:24:59,720 --> 00:25:03,639 Speaker 1: just medicalization of childbirth that is terrible. She says it 398 00:25:03,640 --> 00:25:07,400 Speaker 1: reflects a sexist bias with regard to conceptions of the body. 399 00:25:07,800 --> 00:25:10,280 Speaker 1: And you know, we mentioned informed consent earlier that a 400 00:25:10,400 --> 00:25:12,959 Speaker 1: Cox said, Hey, you know, as long as there's informed consent, 401 00:25:13,040 --> 00:25:16,520 Speaker 1: go ahead. She said that that can't be meaningfully exercised 402 00:25:16,600 --> 00:25:20,399 Speaker 1: unless women are made aware of the sexist underpinnings of 403 00:25:20,440 --> 00:25:25,280 Speaker 1: the medical model of childbirth, which she explains as the 404 00:25:25,400 --> 00:25:30,720 Speaker 1: exclusively feminine attributes of child bearing make it particularly vulnerable 405 00:25:30,840 --> 00:25:35,000 Speaker 1: to appropriation by a male dominated medical profession and a 406 00:25:35,119 --> 00:25:39,560 Speaker 1: patriarchal culture. Well, I mean, she has a point if 407 00:25:39,600 --> 00:25:43,440 Speaker 1: we go back to say when James Miranda Stewart Berry 408 00:25:43,800 --> 00:25:47,400 Speaker 1: was cross dressing in order to get into medical school 409 00:25:47,440 --> 00:25:50,240 Speaker 1: because women were not allowed in medical school in eighteen 410 00:25:50,240 --> 00:25:53,680 Speaker 1: o nine. And uh, I mean, and it has been 411 00:25:53,720 --> 00:25:56,320 Speaker 1: it's only been in you know, the past fifty years 412 00:25:56,320 --> 00:25:59,520 Speaker 1: really that women have been catching up to men numbers wise, 413 00:26:00,040 --> 00:26:05,520 Speaker 1: in medicine. But it's it's almost looking maybe too too 414 00:26:05,560 --> 00:26:09,560 Speaker 1: deeply into what's going on when we were talking about 415 00:26:09,560 --> 00:26:15,040 Speaker 1: like our health and our body, is um a patriarchal 416 00:26:15,160 --> 00:26:20,480 Speaker 1: past worth dismissing the present if that makes sense. Yeah, 417 00:26:20,600 --> 00:26:23,800 Speaker 1: I agree with you. This whole conversation though, too, about 418 00:26:23,800 --> 00:26:27,240 Speaker 1: this medicalization of childbirth, which to meet in the back 419 00:26:27,320 --> 00:26:30,280 Speaker 1: of the whole paper was you know, you should be 420 00:26:30,320 --> 00:26:34,399 Speaker 1: having a natural childbirth. People what to do? That's what 421 00:26:34,440 --> 00:26:38,560 Speaker 1: I'm saying. It's such a chopper, becomes such a complicated issue, 422 00:26:38,760 --> 00:26:41,199 Speaker 1: and we're not even gonna get into breastfeeding in that 423 00:26:41,240 --> 00:26:44,160 Speaker 1: whole debate. You know, it's like I would think that 424 00:26:44,200 --> 00:26:49,000 Speaker 1: we should embrace as women, we should be embracing the 425 00:26:49,119 --> 00:26:52,879 Speaker 1: choice of elective c sections. Because there was also the 426 00:26:53,000 --> 00:26:55,480 Speaker 1: Salon essay that I felt like stood in such sharp 427 00:26:55,560 --> 00:26:59,800 Speaker 1: contrast to bergeron Um. It was by Page Parker not 428 00:27:00,000 --> 00:27:03,320 Speaker 1: too long ago, about her planned C section and what 429 00:27:03,440 --> 00:27:06,800 Speaker 1: relief that she felt when she kind of allowed herself 430 00:27:06,880 --> 00:27:08,800 Speaker 1: to say, you know what, I don't want to have 431 00:27:08,840 --> 00:27:11,439 Speaker 1: a vaginal delivery. She was hoping actually that her baby 432 00:27:11,520 --> 00:27:14,600 Speaker 1: was breached with the feet down so that the doctor 433 00:27:14,800 --> 00:27:19,840 Speaker 1: would have to do perform a C section, and that 434 00:27:20,000 --> 00:27:21,919 Speaker 1: you know, she felt a lot of guilt at first 435 00:27:22,560 --> 00:27:26,320 Speaker 1: for wanting that right, but was so relieved, was so relieved, 436 00:27:26,440 --> 00:27:28,800 Speaker 1: although she did follow up at the end by saying 437 00:27:29,320 --> 00:27:34,400 Speaker 1: it was insanely painful recovery and because friends of hers 438 00:27:34,400 --> 00:27:36,639 Speaker 1: had warned her that she was crazy for wanting a 439 00:27:36,680 --> 00:27:41,119 Speaker 1: C section because the recovery is a bit more intensive sometimes. Um. 440 00:27:41,200 --> 00:27:44,520 Speaker 1: But just even having that choice leading up to the 441 00:27:44,560 --> 00:27:47,480 Speaker 1: delivery and the childbirth UM seemed to make a big difference. 442 00:27:47,520 --> 00:27:49,040 Speaker 1: And again, I mean, this is also one of those 443 00:27:49,040 --> 00:27:52,359 Speaker 1: conversations where every woman's situation is going to be different. 444 00:27:52,800 --> 00:27:55,480 Speaker 1: You know, we don't want a blanket thing of saying, 445 00:27:55,520 --> 00:27:58,640 Speaker 1: you know, only c sections, only vaginal births, only hot 446 00:27:58,680 --> 00:28:04,600 Speaker 1: tubs and sensual music in the background. Apparently it really 447 00:28:04,640 --> 00:28:08,800 Speaker 1: I've been thinking clearly about about baby having. I don't know. 448 00:28:08,840 --> 00:28:12,400 Speaker 1: I just the whole time I was reading Burton's essay, 449 00:28:12,640 --> 00:28:15,359 Speaker 1: I I pictured her with like one hand on a hip, 450 00:28:15,400 --> 00:28:18,440 Speaker 1: in the other hand like pointing accusingly at me. Right, 451 00:28:19,560 --> 00:28:22,080 Speaker 1: which is the opposite? I'm sure of what she's actually 452 00:28:22,600 --> 00:28:25,840 Speaker 1: advocating for. Right, I would I would hope, Well, we'd 453 00:28:25,840 --> 00:28:29,040 Speaker 1: hope because I certainly would not want someone using the 454 00:28:29,200 --> 00:28:34,159 Speaker 1: guys of feminism to tell women what to do. That 455 00:28:34,160 --> 00:28:39,000 Speaker 1: that's ah, that wouldn't be good. Yeah. Well. One instance 456 00:28:39,040 --> 00:28:41,600 Speaker 1: of when someone is going to tell you what to do, Kristen, 457 00:28:42,280 --> 00:28:44,680 Speaker 1: is when you have to have an emergency or an 458 00:28:44,760 --> 00:28:48,600 Speaker 1: unplanned c section. The doctor is going to be like, listen, lady, 459 00:28:49,000 --> 00:28:53,800 Speaker 1: this baby's coming out. So what circumstances are we in 460 00:28:53,960 --> 00:28:56,480 Speaker 1: when we have to have an emergency c section? The 461 00:28:56,560 --> 00:28:59,320 Speaker 1: most common reason is that a woman's labor is not 462 00:28:59,360 --> 00:29:01,440 Speaker 1: progressing and so they have to get the baby out. 463 00:29:01,960 --> 00:29:04,600 Speaker 1: Other reasons include the baby not getting enough oxygen, the 464 00:29:04,600 --> 00:29:07,960 Speaker 1: baby being in that abnormal position, breach the feet or 465 00:29:08,000 --> 00:29:11,160 Speaker 1: the buttocks being first in the birth canal or transverse, 466 00:29:11,680 --> 00:29:14,880 Speaker 1: and that baby is a little you know, like football player, 467 00:29:14,920 --> 00:29:17,840 Speaker 1: and he's trying to like go out sideways through his shoulder. 468 00:29:17,920 --> 00:29:20,760 Speaker 1: I don't know, I don't know if that baby is doing. 469 00:29:21,840 --> 00:29:24,760 Speaker 1: Another reason could be that you're carrying multiples, because it's 470 00:29:24,800 --> 00:29:28,200 Speaker 1: common for one to be in an abnormal position, although 471 00:29:28,960 --> 00:29:31,880 Speaker 1: you don't actually have to have a c section when 472 00:29:31,920 --> 00:29:35,760 Speaker 1: you're having multiples. A New York Times reported in February 473 00:29:36,160 --> 00:29:38,800 Speaker 1: that there was no difference in outcomes between vaginal and 474 00:29:38,840 --> 00:29:42,560 Speaker 1: C section deliveries for mothers of multiples, and that the 475 00:29:42,600 --> 00:29:47,040 Speaker 1: serious medical problems were completely even between births like they 476 00:29:47,080 --> 00:29:49,760 Speaker 1: were just there were thirty six serious medical problems for 477 00:29:49,800 --> 00:29:52,680 Speaker 1: C section babies and thirty five for vaginal birth deliveries. 478 00:29:52,720 --> 00:29:55,360 Speaker 1: So yeah, and that's a pretty significant development because the 479 00:29:55,400 --> 00:29:58,040 Speaker 1: thinking had been for a long time that with multiples 480 00:29:58,480 --> 00:30:03,000 Speaker 1: probably gonna go with the C section precisely. So other 481 00:30:03,040 --> 00:30:04,840 Speaker 1: times you're going to have to have an unplanned or 482 00:30:04,960 --> 00:30:08,240 Speaker 1: emergency c section, include like we mentioned earlier, there's a 483 00:30:08,240 --> 00:30:12,400 Speaker 1: problem with your placenta, either placental abruption or that placenta previa. 484 00:30:12,760 --> 00:30:15,160 Speaker 1: There could be a problem with the umbilical cord, or 485 00:30:15,200 --> 00:30:18,000 Speaker 1: you or your baby has a health condition or concern, 486 00:30:18,760 --> 00:30:21,719 Speaker 1: And I would be curious to know though, which is 487 00:30:22,440 --> 00:30:28,480 Speaker 1: more common for doctors to tell, you know, expecting mothers 488 00:30:28,520 --> 00:30:30,640 Speaker 1: say you're going to have a C section even though 489 00:30:30,840 --> 00:30:34,080 Speaker 1: you want you've requested a vaginal delivery for X, Y 490 00:30:34,120 --> 00:30:37,800 Speaker 1: and Z, Or for a doctor to say, no, we're 491 00:30:37,800 --> 00:30:41,920 Speaker 1: gonna try for a vaginal delivery even though you've requested 492 00:30:42,080 --> 00:30:44,960 Speaker 1: a C section. Yeah, I wonder. I'm really curious to 493 00:30:45,000 --> 00:30:48,480 Speaker 1: hear from listeners about that issue of you know, whether 494 00:30:48,880 --> 00:30:52,400 Speaker 1: how how much I guess negotiating power you really have 495 00:30:52,960 --> 00:30:56,120 Speaker 1: with the doctor in terms of what which kind of 496 00:30:56,160 --> 00:30:58,840 Speaker 1: delivery method you go for. Yeah, and I'd be interested 497 00:30:58,880 --> 00:31:01,479 Speaker 1: to hear from the moms out there. Did you go 498 00:31:01,560 --> 00:31:04,600 Speaker 1: into the hospital expecting one thing and you got the other? Oh, 499 00:31:04,600 --> 00:31:07,320 Speaker 1: I'm sure. Yeah, I would imagine that the number would 500 00:31:07,360 --> 00:31:11,520 Speaker 1: be pretty high because with the trial of labor situation, 501 00:31:11,840 --> 00:31:14,080 Speaker 1: when you go into the hospital intending to give the 502 00:31:14,120 --> 00:31:17,640 Speaker 1: old college try to a vaginal birth and then they 503 00:31:17,640 --> 00:31:20,600 Speaker 1: have to do a C section, it's a double digit percentage, 504 00:31:21,040 --> 00:31:24,040 Speaker 1: I'm pretty sure. So now is the time, though, we 505 00:31:24,080 --> 00:31:27,640 Speaker 1: need to hear from listeners out there who can speak 506 00:31:27,680 --> 00:31:32,680 Speaker 1: first person to the C section scenario and also to 507 00:31:32,800 --> 00:31:36,160 Speaker 1: the women who have written in though asking for you know, 508 00:31:36,240 --> 00:31:38,840 Speaker 1: more info on c sections. We hope this has helped. 509 00:31:39,240 --> 00:31:41,880 Speaker 1: It is a pretty in depth topic, but we tried 510 00:31:41,920 --> 00:31:44,360 Speaker 1: to touch on as much stuff as we could and 511 00:31:44,440 --> 00:31:49,000 Speaker 1: for etymology nerds, correct everyone about the old Julius Caesar 512 00:31:49,120 --> 00:31:53,640 Speaker 1: myth not true. So yeah, send us your letters, mom 513 00:31:53,720 --> 00:31:56,840 Speaker 1: stuff at Discovery dot com is where you can send them. 514 00:31:57,200 --> 00:31:59,360 Speaker 1: You can also message us on Facebook or if you 515 00:31:59,400 --> 00:32:02,480 Speaker 1: have a quick quip. You can tweet us at Mom's 516 00:32:02,480 --> 00:32:07,240 Speaker 1: Stuff podcast. And now back to our letters. Yeah, here's 517 00:32:07,360 --> 00:32:13,400 Speaker 1: one from Sean about our women's basketball Coaches episode. My 518 00:32:13,440 --> 00:32:16,920 Speaker 1: thoughts were along the lines of youth coaching, he says, 519 00:32:16,960 --> 00:32:20,880 Speaker 1: in the division of household labor, You've mentioned on several 520 00:32:20,920 --> 00:32:23,880 Speaker 1: previous podcasts that the division of household chores is becoming 521 00:32:24,000 --> 00:32:26,640 Speaker 1: more equitable, but that it's still not even close to 522 00:32:26,760 --> 00:32:29,720 Speaker 1: even I wonder if this leaves dads with more to 523 00:32:29,840 --> 00:32:33,520 Speaker 1: volunteer as youth coaches. That, along with the preconceived notion 524 00:32:33,560 --> 00:32:36,800 Speaker 1: that guys know more about sports than girls, something I 525 00:32:36,840 --> 00:32:39,680 Speaker 1: know my younger sister hates, means that women aren't going 526 00:32:39,720 --> 00:32:41,880 Speaker 1: to get the fake till you make it benefit of 527 00:32:41,920 --> 00:32:44,760 Speaker 1: the doubt that men would. Because, let's face it, many 528 00:32:44,800 --> 00:32:50,400 Speaker 1: youth coaches are far from experts ps. Shawan says, pat 529 00:32:50,440 --> 00:32:52,480 Speaker 1: some it is truly amazing and belongs on the mount 530 00:32:52,520 --> 00:32:56,840 Speaker 1: Rushmore of American coaches, not women's coaches, are basketball coaches, 531 00:32:56,920 --> 00:33:00,920 Speaker 1: but all time, any sport, any gender coaches. So thanks 532 00:33:00,960 --> 00:33:03,160 Speaker 1: for your thanks for input shown that's interesting. I hadn't 533 00:33:03,160 --> 00:33:05,640 Speaker 1: thought about the division of labor thing. Well, I've got 534 00:33:05,680 --> 00:33:10,400 Speaker 1: one here from Carmen, who played women's soccer in college, 535 00:33:11,000 --> 00:33:13,120 Speaker 1: and she writes, I dealt with many of the issues 536 00:33:13,160 --> 00:33:16,280 Speaker 1: you described regarding the male versus female coaches. I had 537 00:33:16,320 --> 00:33:19,280 Speaker 1: a female coach for the first two years, who was, unfortunately, 538 00:33:19,320 --> 00:33:21,800 Speaker 1: one of the worst coaches I've ever dealt with. This 539 00:33:21,880 --> 00:33:24,640 Speaker 1: prompted one of my teammates to write a public blog 540 00:33:24,680 --> 00:33:27,760 Speaker 1: post about how women's teams ought to have male coaches 541 00:33:28,120 --> 00:33:31,080 Speaker 1: because men are less prone to being overemotional or engaged 542 00:33:31,080 --> 00:33:33,720 Speaker 1: in petty fights with the players. This is a shocking 543 00:33:33,840 --> 00:33:36,000 Speaker 1: statement to me, since I have had many good and 544 00:33:36,120 --> 00:33:39,640 Speaker 1: bad coaches of both genders during my lifetime, and in 545 00:33:39,680 --> 00:33:41,600 Speaker 1: two thousand nine when this happened, we ought to have 546 00:33:41,640 --> 00:33:44,680 Speaker 1: progressed past the idea that women can't be coaches. Luckily, 547 00:33:44,760 --> 00:33:46,800 Speaker 1: my school had a female athletic director who had been 548 00:33:46,800 --> 00:33:49,120 Speaker 1: a coach herself for many years, and after discovering the 549 00:33:49,160 --> 00:33:52,120 Speaker 1: blog post, she gave my team quite a speech about 550 00:33:52,160 --> 00:33:54,680 Speaker 1: how hurt she was that the blog post has missed 551 00:33:54,680 --> 00:33:57,000 Speaker 1: all of her hard work as a coach and promoted 552 00:33:57,040 --> 00:34:00,480 Speaker 1: the idea that women are inherently incapable of leading a team. 553 00:34:00,480 --> 00:34:02,680 Speaker 1: Looking back, I think the most important thing I took 554 00:34:02,720 --> 00:34:05,160 Speaker 1: away from that experience is that women are often the 555 00:34:05,200 --> 00:34:08,880 Speaker 1: ones holding themselves back from achieving more. My female teammate 556 00:34:08,960 --> 00:34:12,040 Speaker 1: publicly wrote about how my female coach was a bad 557 00:34:12,080 --> 00:34:15,560 Speaker 1: coach because she was female. But women need to support 558 00:34:15,560 --> 00:34:18,759 Speaker 1: each other and not promote those kinds of stereotypes. So 559 00:34:18,800 --> 00:34:21,000 Speaker 1: thanks so much for this podcast and all the other 560 00:34:21,000 --> 00:34:25,239 Speaker 1: ones you do. That's true. Ladies helping ladies and men 561 00:34:26,120 --> 00:34:28,600 Speaker 1: and men can help lads do. Let's all just help 562 00:34:28,640 --> 00:34:31,720 Speaker 1: each other. Let's all hold hands around the globe, except 563 00:34:31,719 --> 00:34:35,200 Speaker 1: around the ocean pots. So you can send your letters again, 564 00:34:35,280 --> 00:34:37,680 Speaker 1: do mom stuff at Discovery dot com. You can find 565 00:34:37,719 --> 00:34:41,359 Speaker 1: us on Facebook, follow us on Twitter at mom Stuff Podcasts, 566 00:34:41,360 --> 00:34:43,920 Speaker 1: and find us on Tumbler at stuff Mom Never Told 567 00:34:43,920 --> 00:34:46,839 Speaker 1: You dot tumbler dot com. Be sure to check out 568 00:34:46,840 --> 00:34:51,760 Speaker 1: our brand spanking new YouTube channel and YouTube dot com 569 00:34:51,840 --> 00:34:55,400 Speaker 1: slash stuff Mom Never Told You. And if that's not 570 00:34:55,640 --> 00:34:57,839 Speaker 1: enough for you to do during the week, you can 571 00:34:57,840 --> 00:35:05,920 Speaker 1: head to our website It's how stuff works dot com 572 00:35:05,960 --> 00:35:08,400 Speaker 1: for more on this and thousands of other topics. Is 573 00:35:08,400 --> 00:35:17,760 Speaker 1: it how stuff works dot com.