meself, being d’mothers firstborn, was a c-section (i went into distress or somesuch, and the docs recommended it and me ma naturally agreed), and then 1 year, 1 month, and 1 day later (creepy, huh) me lil bro was born the usual way.

at no stage leading up to the brothers birth did the docs raise an issue with a normal birth after the c-section.

oh and to top it off, me ma woke up mid c-section, which naturally scared the living shit out of her. They had to go light on the anesthetic cos of meself.

now granted this was all mid-80s irish health system, which wasn’t awesome, so…….

It may be on the whole that, given the demands of medical school and the importance of keeping obstetricians trained to a high enough level, it’s simpler and thus more reliable to expect doctors to master a smaller number of techniques. There’s a cost in training doctors in a wider variety of techniques. You have a fixed number of weeks that someone is in med school, internship, and residency–where are you going to take the time to bring them up to expertise in one more birthing procedure? Should doctors have less training in c-sections, thus making c-sections less safe when they are medically necessary, or do you give them more training in c-sections with the tradeoff that c-sections become dramatically safer but also more widely used (and restricting choice)? Maybe you’re right, and med schools should allocate training differently than they are. I don’t know.

I don’t doubt that VBAC doesn’t warrant widespread prohibition, but having a prior c-section may be a contributing factor to a set of complications in one particular case that necessitate a c-section.

Something I can speak more authoritatively about, having been in the position to need to research it, is breech birth. Full-term breech births are no more risky than vertex births when attended by a skilled attendant. Why, then, are doctors no longer learning those skills and instead defaulting to a major surgical procedure? Why did the state of Idaho just ban midwives from attending breech births at home, so women don’t have an alternative AND midwives lose the ability to legally pass on the tradeskill of breech attendance?

The only time breech becomes less safe is when choice is taken away… And by that removal of choice they create a self-fulfilling prophecy.

I’m still curious to hear your thoughts on my kidney scenario. I’d also like to know if you think a court would ever actually rule to compel paternal sacrifice like that. I think not – I think there is a deep-rooted belief in our society that, because women carry children, our bodies become a sort of public property and the sacrifice of bodily integrity or even life is acceptable. But there I go flying my feminist flag again. :)

If there’s a 5% chance that a baby will die during vaginal birth but a significantly lower (say 1% chance) the baby will die during a c-section, I think it’s morally defensible for the court to order that we cut our losses and give that baby 1 in 100 rather than 1 in 20 odds of life, yes. Likewise, if somehow your jumping out of a plane could potentially save someone’s life–quintuple their chances of survival–then my opinion would be the same. Of course, your argument is stupid because jumping out of a perfectly good airplane does not affect anyone’s survival but the jumper.

I think I’d have to know a lot more about obstetrics to intelligently comment beyond that. It might be that VBAC is excessively dangerous, risky, or tricky, and that there are good medical reasons why it’s not done very much. There’s a very large grey area around the issue of informed consent when it comes to life-threatening situations, especially when it’s medically necessary to consider two lives rather than just one.

It’d be one thing to argue “the person facing the peril retains the right to protect their own hide” if c-sections were a particularly life-threatening surgery, but they’re not.

Is a pretty brazen statement from someone who will never be faced with having one.

But, since I can’t hold your lack of a uterus against you, let me put it this way: Imagine your wife was bullied into an unnecessary c-section. (Happens every. single. day.) It made it really hard for her to breastfeed, she had a horrible recovery, and it all contributed to a nasty bout of post-partum depression. She joined ICAN and started reading about her options, and decided she wanted to attempt a VBAC. So, she went her OB/GYN at the start of her next pregnancy, and declared her desire to VBAC – only to learn no hospitals in the area will allow it. The nearest hospitals that will are an hour and a half away, which is entirely too far to travel by car. Scheduling an induction at one of the VBAC hospitals is more or less out of the question, because pitocin-induced labor can be dangerous for a scarred uterus.

Assuming you were on board with your wife’s VBAC plans, how do you think you’d feel about her birth choice being taken away by liability insurance policies and government dictate? If you think you’d just shrug your shoulders and say “Meh, just have another c-section, woman, it’s no big deal!” then… you haven’t been around a determined pregnant woman before. :)

Now, imagine watching the wife you adore, laboring through one of the most difficult trials a woman ever goes through, hauled off to the hospital operating room in physical restraints because the doctors know best and the courts backed them up.

I don’t know what you’d do. I have a feeling The Inconvenience would be in jail for assault.

There has to be some point in law where the government is allowed to protect the rights of the child over the rights of the parent.

I have struggled with this question when it comes to things like religion and medical care. If someone literally believes their child will go to the wrong sorta afterlife if they have [insert medical procedure here], and thus their mortal soul is on the line, is it the prerogative of the court to insist upon [medical procedure]? I honestly don’t know. It would seem that the child’s right to life trumps the parent’s right to religious freedom, yes.

But, when you get into the domain of bodily integrity, or right to life vs. right to life, I don’t know that it should ever be the prerogative of the court to make that decision for someone.

Furthermore, if a c-section can be ordered…

If a child is in late-stage kidney failure and can only be saved by a transplant, and the only match that can be found is the child’s father, do you support the idea of the courts compelling him to be a living donor and give up one of his kidneys? A quick Google search tells me outcome for living donors in mortality, morbidity and overall quality of life is superior to living kidney donors than c-section delivering women.

36 women per 100,000 receiving c-sections die during the surgery — this does not include complications later.

By contrast, about 35 skydivers die per 3.5 million jumps — and about 10% of those deaths are attributed to suicide, since the jumpers didn’t make any attempt to release their ‘chutes, or even removed them before jumping.

Would you consider it morally defensible for the court to order someone to jump out of a plane, if he/she had committed no crime?

All surgery carries the risk of death, from many possible sources.

The rate of maternal death in childbirth has increased, not decreased, in the US. The source? C-sections.

There has to be some point in law where the government is allowed to protect the rights of the child over the rights of the parent. The only reason Roe comes into play is that Roe says that point can occur in the third trimester depending upon state law. At that point, the law also generally recognizes that the parent has a positive obligation of care towards the child, perhaps barring any life-threatening risk to the parent. It’d be one thing to argue “the person facing the peril retains the right to protect their own hide” if c-sections were a particularly life-threatening surgery, but they’re not.

As a matter of fact, there’s even laws against someone *endangering* their child, and while those aren’t usually determined by any sort of objective measure of risk, there might be pre-existing conditions severe enough that refusing a c-section would constitute endangerment.

As you may recall me mentioning earlier this year, there are no doctors on the Palouse who will attend vaginal breech births, and the Idaho midwifery licensing scheme banned attending at home, too. I don’t think I should be forced into unnecessary surgery by government dictate and lazy medicine.

But, let’s pretend the situation is truly dire. I cannot imagine refusing a c-section if I had reason to believe it would cost my child his or her life. Most people don’t invest 40 hard weeks of pregnancy in someone to just go all “meh” about it at the end.

But, let’s pretend further and imagine a mother did say that. Isn’t it a violation of basic human dignity to say it’s okay to cut into someone’s body for the sake of another person? Surgery is not without risks and complications… I just can’t accept the idea a court should force a woman into the operating room to save a baby any more than I can imagine a court order compelling someone to donate a kidney or bone marrow to save a family member’s life.

When helping someone (even if the help comes in the form of bringing them into the world) carries with it a measure of peril, I figure the person facing the peril retains the right to protect their own hide, first.

I mean, sheesh – the SCOTUS rules cops have no duty to risk their necks to protect citizens, and yet we can slice open a VBAC mom against her will because of a hospital policy?