At Home Births

[Fudgie]

OG, CS loves you and is attracted to you and seeing your vagina during labor isn't going to change how he sees you. even a little poop won't matter, I'm sure!

 

I've seen B through some pretty gnarly gastrointestinal problems as a result of his colon problems (messes, messes!) and I still think he's the sexiest thing alive. Even if he got a colostomy bag (very real possibility for him), he'd still be hot to me.

[OptomisticGirl]

I know, but it's still one of those things I'd like to avoid if I can. Same reason there won't be anyone but is in the delivery room and NO VIDEO. No one else is seeing my who ha!

[sweetpea03]

No, he probably won't but I would still like for him to be attracted to me after I give birth to his child. I'm sure seeing the babies head stretch me beyond believe is NOT going to sex me up in his eyes. Also, there is the chance you can poop yourself. I would just rather not know if I do or not and I KNOW he would say something as per an inside joke of ours.

 

LOL, yea, the pooping thing is very real and happens often. I've seen it happen a number of times when volunteering in the womens center at the hospital and had a couple cousins poop during delivery, too. I think you can laugh about it later, but at the time, might not be so funny. I figure I want my future husband to be there and it wouldn't matter if he looked or not. He's already had to help me after a surgery I had and needed help walking for about 2 weeks. I feel like it helped us bond more than anything, didn't make him think any different of me.

[OptomisticGirl]

LOL, yea, the pooping thing is very real and happens often. I've seen it happen a number of times when volunteering in the womens center at the hospital and had a couple cousins poop during delivery, too. I think you can laugh about it later, but at the time, might not be so funny. I figure I want my future husband to be there and it wouldn't matter if he looked or not. He's already had to help me after a surgery I had and needed help walking for about 2 weeks. I feel like it helped us bond more than anything, didn't make him think any different of me.

 

OH yes, CS will be right there with me holding my hand. I told him if he looks down though, I will pull out what is left of his hair, lol.

 

CS has taken care of me before when I got sick. In the end no matter hwat I know I can laugh anything that happens off butttt still.

[sweetpea03]

OH yes, CS will be right there with me holding my hand. I told him if he looks down though, I will pull out what is left of his hair, lol.

 

CS has taken care of me before when I got sick. In the end no matter hwat I know I can laugh anything that happens off butttt still.

 

I highly doubt he'll care if he sees you poo or anything, he loves you and that's what matters. Though I do hope he doesn't faint..

 

I watched my cousin's husband faint after he kept saying he would be fine. poor guy.

[OptomisticGirl]

I highly doubt he'll care if he sees you poo or anything, he loves you and that's what matters. Though I do hope he doesn't faint..

 

I watched my cousin's husband faint after he kept saying he would be fine. poor guy.

 

Oh he won't mind. I will. He'll just make an inside joke to me which I won't find funny since I have just shoved a child out of me.

 

I think he'll be fine. He doesn't get squimish.

[Fudgie]

I would be a terrible husband, I'm too curious for my own good. I've seen births and I always have a rush of awe/surprise/fear/gross (not because I find it gross, but because of my own feelings about ME giving birth). It's a very natural thing. I'm glad I'm not a husband because I'd be down there at the feet with open hands saying "OMG OMG here it comes! oh man! oh god! look! oh man! Oh crap!"

[sweetpea03]

I would be a terrible husband, I'm too curious for my own good. I've seen births and I always have a rush of awe/surprise/fear/gross (not because I find it gross, but because of my own feelings about ME giving birth). It's a very natural thing. I'm glad I'm not a husband because I'd be down there at the feet with open hands saying "OMG OMG here it comes! oh man! oh god! look! oh man! Oh crap!"

 

LOL. oh wow, I can see me like that too... I am easily amused and think many things are just fascinating. I'd want to be where the action is at. Look, there is the head!!

[Seraphim]

My husband thought seeing his son be born was an intensely awesome experience. He did not faint or feel queasy or anything. He did however say..."hey honey did you see those scissors?" Uh not what I wanted to hear but what can you do.

[sweetpea03]

My husband thought seeing his son be born was an intensely awesome experience. He did not faint or feel queasy or anything. He did however say..."hey honey did you see those scissors?" Uh not what I wanted to hear but what can you do.

 

LOL. I can see my boyfriend saying something like that. I know he doesn't get faint or queasy either and likes to be involved in what ever is happening. I am glad he is like that though, though I hope he pays attention to his thoughts and doesn't tell me things I don't want to hear.

[Hope75]

I will find a more reliable source tonight. But I guarantee that America, despite have an excellent medical education system, has a very high rate of infant mortality and death of the mother during the delivery. I don't think that this is about obesity, as much as medical procedures being performed on the mother during delivery. Many doctors are afraid to let the mother delivery vaginally because they are afraid of being sued for malpractice.

 

Annie is absolutely correct, the U.S. has a frighteningly high infant and mother mortality rate for a developed country. I can certainly understand not wanting to birth at home for fear of something going wrong but studies have shown that in most instances home birth is actually SAFER than a hospital birth, due to less intervening by doctors who want to get a baby out under a certain time frame either because of unfounded assumptions that something will go wrong if a baby takes more than 24 hours to come out, or their convenience/scheduling.

 

3 great books with good sources to read up on this are "Pushed" by Jennifer Block, "Spiritual Midwifery" and "Ina May's Guide to Childbirth" both by Ina May Gaskin.

 

If you did some research you would be surprised at how many birth/labor 'complications' are actually caused by the interventions that doctors do in the hospital, such as pitocin inductions, use of cervical ripening agents to speed effacement and dilation such as Cytotec, which is known to cause uterine rupture and is not FDA approved for induction/enhancement of labor, and the manufacturer even released a statement to the medical community telling them NOT to use it for induction/enhancement and yet it is STILL routinely used. (it was offered to me for my induction with my daughter and I refused it and was given rolled eyes and a petulant, 'why not?' by the OB who chose to induce me.)

 

Other problem causing interventions are stripping of the membranes, amniotomy (artificial rupture of the membranes), pitocin, not allowing a laboring mother to get up and move around and change position, either due to epidural, connection to IV's, oxygen, fetal monitoring etc. Risking infections by AROM too early, IV's, epidurals, also putting a forced time clock on labor by AROM, forcing women to maintain positions that are not conducive to the baby coming down/opening the vaginal canal, pushing c-sections for 'failure to progress' when often it is just the doctor isn't willing to allow the woman's body to progress natural when the baby is in no danger whatsoever.

 

Studies show that most breech births are actually safe and successfully delivered vaginally without difficulty if not intervened with.

 

Also you will find an alarming amount of doctors who induce for mothers being 'overdue' who are not yet 42+ weeks (38-42 weeks is considered term) with NO medical reason, and thus setting the mother up for a cascade of complications as her body was not ready to go into labor which usually means a long painful, failed induction ending with a c-section. These days it is very easy to monitor babies who are 'late' (past 42 weeks) using dopplers, ultrasound and biophysical profiling to avoid unnecessary inductions but doctors schedule inductions for convenience.

 

Anyway, some interesting reading.

[Seraphim]

I agree with you there Hope. My brother's wife had their last 2 daughters at home with no intervention at all. Her last daughter was actually at 42 weeks when she was born. My sister in law wanted no medical intervention and she was sure the baby would come on it's own. She did, right when her body and the baby were ready. In 2 hours of labour she had her beautiful baby girl who was perfect and no issues whatsoever. Her eldest daughter was born at the hospital and supposedly she had "breathing troubles" and what not........that was a joke. I saw that baby she was as healthy as a horse and weighed over 9 pounds. Everyone who saw her in the NICU wondered why she was there. There was zip wrong with her. After that experience they had their kids at home.

I think my own labour was slowed down by the fact I asked for the epidural. I was already over 7 cm when I asked. I should have just finished it out and it would have been faster. Once I had the epidural I was on my back and my labour slowed significantly. What I wanted to do and what was working was walking. I wanted to keep pacing the hall but they wanted me out of the way and in a bed. While I was walking I could take the pain. Once in a bed I had nothing to concentrate on so the pain became unbareable. I will say however my OB wanted me to work at doing the labour almost entirely intervention free. He could have hurried it along and done the episiotomy earlier as I was pushing over 3 hours and could not move that boy's head. He really felt I could do it. Had my son's head been normal size most likely I could. My son was born perfectly healthy with no issues at all. It was myself that risked death. If I did not have the risk of death I would have a baby entirely at home and intervention free.

I agree drs want to move things along too fast because of schedules to keep. My mother had me entirely natural at the hospital with no intervention and it took over 36 hours but I am here alive and well and my mother is still alive too.

 

BTW....I am praying all goes well with your pregnancy Hope.

[sweetpea03]

I wrote earlier about some reasons for why the US has a higher infant mortality rate. ("The US has a very diverse cultural population, along with that comes the possibility for different medical complications. Certain races are predisposed to certain complications. The differences between races/income levels and the treatment they receive is pretty wide. Also, the biggest factor for infant mortality in the US is because of preterm birth, which is preventable by the mothers in most cases if she gets medical care regularly. There are a high number of women who do not get prenatal care. Obesity can cause preterm labor, so that is part of the problem and we do have an obesity epidemic.")

 

Also, if you don't want a doctor to do something, you just need to speak up. You have to be your own advocate. Doctors are human and make mistakes, so watch what they are doing and if you are not comfortable, then say something. I wouldn't go so far as to say it is "safer" to have a baby at home. If something goes wrong when you are at home, you miss precious time in order to fix a problem. The hospital has everything on hand, ready in a moments notice to do life-saving procedures. Babies go down hill very quickly when something goes wrong and I've seen it first hand many times. Even low-risk pregnancies can end badly. My mother was "low-risk" with me, but had me in a hospital. I was rushed to the NICU as I was not breathing when I was born because of a tumor crushing my airway.

 

I don't see how having an IV and other wires would cause someone to be stuck in a bed. They can easily be maneuvered and you can walk around. If a pregnant woman wants to get up and walk, she can and should. If the woman doesn't want intervention, than she won't get it. I've volunteered in the womens' center at the hospital for a couple years and see women who give births according to their plan. The doctors and medical personnel will not force a woman to do something she is not comfortable with, though they may suggest what they think is best for her.

 

Hope your pregnancy goes well!!

[Hope75]

You would be surprised at how many people think doctors are the end all be all when it comes to medical knowledge and making the right decisions for them and their baby, and just follow what they say and allow interventions that are not medically necessary because they either don't have the medical knowledge to know better and question it, or just don't have the courage to speak up to a doctor, or if they do, they are bullied into it with statements like, "don't you want what's best for your baby?" or "x,y,z increases the risk of a.b. & c to your baby so it's best you do h,i & j.". As a nurse I see this almost every day in my practice and part of my job is to encourage patients to advocate for themselves and speak up and question doctors and I certainly don't see many patients who are comfortable or informed enough to speak up.

 

Having an IV, being hooked up to O2, having fetal monitors on, (esp. if the EFM is internal) all make it more difficult for a woman to get up and move around and limit how far she can go (specifically EFM unless the hospital carries telemetry units and the major city hospitals where I live (Boston, known for it's top hospitals) do not carry them and in my research I have not found many that do), and often times if mothers ask to get up they are told they cannot because of their connections and because EFM typically comes loose and stops reading well when you are up and moving around and although studies show continuous EFM shows no improvement in fetal outcomes vs. intermittent EFM many hospitals continue to make continuous EFM part of their protocol, which gives mothers a leash of a few feet from the machine next to her bed. With an epidural a woman is grounded to the bed, and you can include a foley catheter to her connections in that scenario too. Basically with IV's, O2, etc is more about the convenience of the medical staff having to adjust wires and tubes and move them around than it being physically impossible to do so. I've seen this in my practice all too often too.

 

As far as being safer at home vs. a hospital, though there are absolutely certain scenarios when a pregnancy is too high risk to be delivered at home, (placenta previa, PIH, pre E. & complications from GD come to mind, as well as babies with known birth defects in utero), with a low risk pregnancy studies show there is no additional risk to birthing at home and in fact outcomes tend to be better than hospital births with a lower mortality and morbidity rate.

 

Licensed midwives are trained and able to initiate emergency medical procedures at home in the case of something going wrong (IV's, O2, CPR, Aspiration/suction, warming, glucose administration, medications) and in most cases when something isn't looking right the midwife knows well before the baby is ready to born though fetal monitoring and monitoring of the mother at home and is able to transport her and baby to the hospital in plenty of time for intervention before birth if need be. It is rare that a precipitous birth occurs in which there are complications and little time to get mother and baby to the hospital.

 

Of course ALL of this is contingent on the mother and baby being low risk to begin with (high risk moms and babies are risked out for home births by qualified midwives ) and having a qualified and licensed professional midwife to assist in the birth).

 

Here are some interesting links to review:

 

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[sweetpea03]

I find it sad that people will not speak up and hope more people learn to question things that don't seem right. If they don't like something they should ask questions, or if they are really having problems, then they should go for a second opinion to a new doctor. I would not stay with a doctor who had the "God syndrome" type of air about him or her and would find someone else. Though I have been around many doctors and have rarely come accross those types.

 

Yes, it is easier to have a patient lay in bed than moving around, not just for practicality of not messing with wires, but also because of the risk for being sued. If she falls, she can easily sue the hospital. People sue for anything, so it's something they have to try to control. Though with the hospital I have been at in the LA area, I've seen many pregnant women allowed to move around. They aren't restricted to their beds.

 

Some things can be missed when considering what is a high risk vs low risk pregnancy. My mother's pregnancy with me was "low risk", and I was seen to have no complications in utero. No one knew I would have a tumor in my neck that crushed my airway. They ended up doing emergency surgery as soon as I was born. If I was not born in a hospital, I doubt I would have made it. Not all medical complications can be foreseen and even with the best doctors claiming the mother to be "low risk", that may not be the case. Medical technology is getting better and better, but not all cases of complications will be detected. I would never risk my own life or my child's by having a home birth. There are precious moments that allow a baby's life to be saved and if not done quickly, there will be consequences. A licensed midwife can only do so much with what she has. I have a friend who is a midwife and she's great at what she does. I'm not against them in any way. Though midwives do not have all of the medical equipment at hand, like there would be at a hospital. I'm all for women who want to have unassisted births. It is their choice and they can do that, but I don't think risking so much is worth it. I know for myself, I won't even have the option, not that I would take it, but it's something I would choose anyways, to be in a hospital. I know I can easily do my own birth plan and go as I want to, and also have that security to know that if anything goes wrong, we will get immediate medical care and not wait for an ambulance.

[OptomisticGirl]

Actually in my OP which links to the article I read, it said that (I think) only 20 some odd States legally allow midwives to deliver at home. If a midwife were to deliver a child at home and someone fuond out, the midwife could be prosecuted for impersonating a doctor. There are some States that are trying to get a law passes were midwife can deliver at home without fear of the law.

[Hope75]

I agree that it is very sad that this day and age people are afraid to speak up and question what feels wrong to them. In many cases it is a case of them just not knowing enough, or thinking they know something but not as much as the doctor caring for them. I can't tell you how many times I have been with a patient while a doctor talks to them about a procedure or diagnosis and the patient nods as though in understanding, says no when asked if there are any questions, and then when the doctor leaves the patient says, "What did he say?" or, "What does that mean?"

 

Not sure how things operate where you are but here typically you are followed by an OB or midwife during pregnancy, and most are part of a practice of several doctors and/or midwives, and you may see some or all of them during your pregnancy or choose to be followed by just one primary caregiver, and there is no guarantee that your primary OB or MW will be the one delivering you, in most cases it is whomever is on call at the time of your labor, surgery or induction so many times the laboring mom is faced with a doctor she has never met, and has not established a trusting relationship with (if she has with her primary OB.), and that contributes to that feeling of being unsure of herself, or intimidated as well.

 

And you are right that many times limiting a laboring mother's mobility is touted in the name of 'safety' by the hospital staff because there is less risk in nailing the patient to the bed than letting her get up and labor with so many connections, and not enough staffing for a staff member to accompany the mother and her equipment to ambulate and change position.

 

I am not sure how old you are, but I do know that medical technology has come a LONG way in the last 20-30 years and things that weren't discovered in utero when we were born are often found now, esp. with the advent of genetic markers, AFP testing, nuccal chord screening, level II, & 4D ultrasound technology, CVS, amniocentesis, even intrauterine biopsy. In fact, there have been more and more instances of fetuses being operated on while still in the womb. It's really quite amazing.

 

Of course safety of home birth also depends on education and compliance of mothers-to-be, who need to be evaluated for risk and if they are risked out-- who cooperate and do go to the hospital for birth despite it not being what they wanted for their experience. And as the above poster mentioned, having a licensed practitioner (who should have a hospital liason on standby as part of their birth protocol) which means being in a state that insures and certifies midwives for home birth. So it doesn't work for everyone.

 

As far as what certified midwives can do at home while waiting for EMS in the event of the rare emergency, with the exception of intubation and surgery, they can do almost everything else in terms of emergency measures and the need for immediate intubation and/or surgery combined with no prior knowledge of a problem during labor despite monitoring and a precipitous birth that does not allow time for transfer in the event of a problem is very, very rare, vs. the interventions doctors and hospitals routinely use on laboring mothers and babies that cause intolerance to labor, infection, fetal distress, etc, which are very, very common. It's definitely worth looking into.

 

Of course there will always be exceptions. But if you read the studies, you will see that they are very few and very far between, and in fact more neonatal and post natal deaths occur in the hospital and following hospital births than during or after home births. Most of the studies I have followed show that home birth sees less than half of the neonatal deaths or complications that hospital births see, and that to me is very compelling, because most people equate hospital birth with safety when in fact it seems to be riskier to mom and baby in many cases vs. home birth.

 

I think people simply fear the unknown. I know before I did my research and talked to many moms about this I definitely thought home birth was very risky and unsafe and would never have considered it. Unfortunately with both my previous pregnancy with my daughter and with this pregnancy I am risked out for home birth, but I would absolutely have seriously considered it had I not been.

[sweetpea03]

I've seen a couple operations in person done on fetuses in the womb, really amazing and fascinating stuff there...

 

Of course there will be more neonatal and post natal deaths at a hospital because they handle all of the high risk pregnancies, so it is hard to compare the 2 equally. Home births only deal with low risk pregnancies and won't touch any thing over that. Hospitals have to deal with what ever comes their way. There are a very high number of pregnant women who have not ever had prenatal care, which leads to a much higher rate of neonatal and post natal deaths. That's the biggest problem for the US. I like to see studies from opposing sides, since so many of them are very biased. The ones you gave definitely lean to that side of wanting women to have a home birth. I've seen studies in the class I'm in now about many problems the US faces considering health care for pregnant women, about prenatal care and also delivery options. Those studies would give different information that the ones you showed, and they are scholarly, peer-reviewed articles.

[annie24]

Something to consider:

 

Why should we treat birth - a normal human event that has been going on for thousands of years - as a medical emergency requiring surgery 30% of the time? If I am young, healthy and have had good prenatal care and a low risk pregnancy, I would feel comfortable giving birth at home. It also helps that I am 10 minutes away from several hospitals. I don't live out in the boonies.

 

And many people, like hope said, are not informed, they don't have the confidence or the knowledge to ask for different medical opinions. and if they question their doctor, he/she can say, 'Oh, so where did YOU go to medical school?' one person is a doctor, one person is not and that is intimidating. Like hope said, they leave the room and turn to the nurse and ask her to 'translate'.

[BellaStranger]

I'm a bit confused? If doctors are so worried about getting sued- why would they do something MORE risky to get the baby out quicker if they didn't have to? Is that not a contradiction? I trust medical professionals and I trust that they know more than I do, even if I researched like crazy for 9 months (which I'm sure I will do anyway)! I'm sure there was a time when more than 30% of women died in childbirth- because a natural process it may be but it has always been and always will be a risky one! I was born by ceserean and without it, I would probably have died- I can't bring myself to throw that back in the face of the medical profession- they do a great job...we might not all agree with them, but I believe they are doing their best!

[annie24]

I think we are far past the days of 30% of women dying in childbirth. I don't think that the rate was ever that high. I'm not saying that ALL cesareans are unnecessary, but I think a lot are. The cesarean rate is 31% in the US, while it is 22.5% in Canada. And why the discrepancy??

 

some docs want to go home by 5. yeah. they don't want to be stuck all night at the hospital, especially if they are an OB and that is their job. Do you want to work 24 hours a day waiting for the kid to be born? miss dinner or your kid's recital waiting for a baby to come out? i really don't know how the insurance and malpractice works, but i know that OB/GYNs have the highest costs of malpractice insurance in the US, some up to $200,000 a year!

[sweetpea03]

Something to consider:

 

Why should we treat birth - a normal human event that has been going on for thousands of years - as a medical emergency requiring surgery 30% of the time? If I am young, healthy and have had good prenatal care and a low risk pregnancy, I would feel comfortable giving birth at home. It also helps that I am 10 minutes away from several hospitals. I don't live out in the boonies.

 

And many people, like hope said, are not informed, they don't have the confidence or the knowledge to ask for different medical opinions. and if they question their doctor, he/she can say, 'Oh, so where did YOU go to medical school?' one person is a doctor, one person is not and that is intimidating. Like hope said, they leave the room and turn to the nurse and ask her to 'translate'.

 

You have to look at the population they are treating, along with the specifics of the conditions that go along with "unhealthy" pregnant women. Teen moms who don't have 'hips' yet, don't do well with natural delivery and many have c-sections. That's just one population. Obese, heavily overweight pregnant women tend to get c-sections as well because of all of the complications involved. Women who have multiples also have c-sections. There are more as well... You can't assume just because a number is somewhat high, that it is automatically "wrong" to do. Yes, some may over do it a little, but for the most part a c-section is done when medically necessary. If you feel like your doctor is pushing you for a c-section that you don't want, then ask them as to why they think you should get one and decide for yourself. Also, if a doctor treats you like that, then ask for another one. You don't have to stay with that doctor, as no one is forcing you. I've only met one doctor like that, and I enjoyed questioning him to really get to why he thought he knew it all. You have to be your own advocate and follow your gut. Though if you trust your doctor, then you know they aren't going to do something that will put you in harms way. They will do what is best for your unique case, as everyone is different. I trust my specialist with my life and his decisions have never let me down.

[Seraphim]

In Canada there has been a push by the medical community it's self to stop doing procedures that are not medically necessary. As our health care is provincially funded there is only so much it will pay for. They are cutting down more and more on things they no longer deem necessary. That might account for the discrepancy in the numbers. There you pay for your own health care from whatever insurance company and you get what you want with whatever they pay for or you pay for it yourself. Our system does not work that way. Here yes you can have private insurance AND public insurance. However that does not mean you are going to get medically not necessary procedures done.Our provincial plan where I am cuts more and more things from the payment plan every year.

 

I do not think it is cause Canada has less obese people or less teenagers or less people in poor situations or less immigrants or whatever. It is the focus of the medical community forced by the government telling them they are not paying for certain things anymore that has lowered the numbers.

[Hope75]

I suspected you would say that but actually the studies I am referring to (see the links I posted above) are showing labor and birth of low risk mothers and infants, both in the same class and risk category, and not talking about the high risk births. These studies were done specifically looking at low risk births both in home and in hospital so the data would be accurate and not skewed by the high risk population. If you add the high risk deliveries to the hospital stats the mortality/morbidity rate is actually much, much higher than twice the deaths and complications of home birth. What I'm talking about are things like respiratory distress/ ARDS caused from unnecessary c-sections (both those that are elective and those that are pushed on mothers for 'failure to progress' when the fetus is in no distress but the doctor is in distress because they want to leave or have other obligations), nosocomial (hospital acquired) infections for both mother and baby, (studies show this is one of the biggest risks), injuries from interventions like forceps, vacuum extractors, internal fetal scalp electrode use during labor, foley catheter infections in mothers, epidural site infections and complications, episiotomy site infections, c-section site dehiscence and infections, fetal distress and intolerance to the powerful contractions of induced labor, postpartum hemorrhage following surgery or induction, uterine rupture from the use of cervical ripening agents such as Cytotec, DVT's, PE and CVA (blood clots in the legs, lungs and brain which can cause permanent injury or death) from pelvic surgery to the mother following a c-section.... there are more but you get the idea. These are all following low risk births that were intervened with unnecessarily in a hospital setting.

 

Here is a link that talks about a study done in Canada on the same risk category:

 

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this article talks about 2 different studies published in the BMJ (scholarly article):

 

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and at the bottom of this article there are references to 6 or 7 studies with bulleted points comparing like data from both hospital and home birth which are all scholarly articles from well known medical journals (Brit. J Obstetrics and Gynaecology, American Journal of Public Health, Brit. Medical Journal, Medical Journal of Australia, as well as nursing journals and midwifery journals.)

 

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[Hope75]

If you do a little more research you will find that almost every teen teen given the chance can give birth successfully without c-section and that cephalopelvic disproportion (pelvis being too small to pass a baby) is a very small minority. The pelvis is comprised of several bones attached by ligaments. During pregnancy a hormone called relaxin is released that softens and stretches those ligaments and opens and widens the pelvis by up to 30% or more. It is a rare case indeed that by the time a woman is sexually mature enough to get pregnant that her pelvis will not be able to accommodate a baby's passage, even young teens. In addition to this, a baby's skull in utero is comprised of several plates with a soft center and during delivery those plates overlap to make the head smaller and more streamlined to facilitate delivery. That is why newborns have those two soft spots you feel, one if front and one in back that don't fuse and harden until roughly 3 & 18 months, respectively.

 

In addition, changing position during labor (i.e., squatting, using a birth ball, sitting on the toilet or a birthing chair) also opens up the pelvic inlet by up to 30%. You will find that most cases of 'CPD' are diagnosed in women lying flat on their back (often because of an epidural) and 'failure to progress' when a change of position could be all that woman needed to deliver the baby.

 

I have seen some tiny women pass some monster babies, and even I have been surprised because looking at the woman's frame you'd never guess she'd pass a 12+ pound baby naturally! The female body is very accommodating and is designed to give birth vaginally.

 

Here is an article that states that CPD occurs in less than 0.5% of pregnancies and even that is on presumptive diagnosis due to 'failure to progress' which can be related to many factors and often is not true CPD, that it usually occurs only in a first pregnancy, which is telling in itself since first babies tend to be the smallest and subsequent babies tend to be larger- so what does that tell you?

 

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This article talks about risk factors for CPD, most having to do with congenital birth defects of the pelvis, or prior injury to the pelvis, or 'macrosomia' (large baby, typically over 9lbs) which in itself is a questionable and unreliable diagnosis, and no where does it mention being a teen or young mother:

 

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Interestingly when macrosomia is the reason given for CPD, in most instances the 'estimate' of baby's size in utero is off by more than a pound, both when using ultrasonic diagnosis and by palpation. This is another cause for early induction that usually isn't necessary.

 

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Obesity and multiples are not reasons by themselves to have a c-section although many doctors routinely schedule them. The number of elective c-sections is climbing as well. Also, the majority of doctors require that a woman who has already had a c-section with a first birth have repeat c-sections with all subsequent deliveries 'due to the risk of uterine rupture', despite studies showing that the actual risk of uterine rupture with a low transverse incision (which is done in almost all sections except for a select few true emergent sections) with one prior c-section is 0.1 % and with 2 prior c-sections is around 0.5%. Interestingly when scheduling a repeat c-section the risks of surgical infection, wound dehiscence, hemorrhage and subsequent hysterectomy, and other post op complications are higher than the risk of uterine rupture, for those who are granted a 'trial of labor' (indicating the doctor's belief that it will fail since it is only a trial) often an induction is planned, and induction itself increases the risk of uterine rupture. Interestingly all of the above mentioned reasons for c-section do not fall under the category of medically necessary without any additional risk factors and yet are routinely the reason given for a c-section.

 

As mentioned in my prior post you can certainly change doctors but if your doctor shares hospital privileges with other members of the same practice you are not likely to get your primary doctor at time of delivery, and you may find through shopping for other doctors that many have a similar policy regarding c-sections- though I do advise shopping around if you are being pushed into a c-section.