Natural birth vs C-section

[rws85]

Hi, my partner is currently 38weeks pregnant and yet to start having any contractions. We are due to see her dr again next week where the doctor is going to check the weight of the baby. The Dr has told my partner if the baby is over 3.5kgs that she will recommend a C-section. If she is under 3.5kgs they might look at inducing her if her cervix hasn't started to dilate.

I'm wondering if this is normal procedure or a matter of convenience?

It isn't me that has to give birth so I am happy to let my partner decide what she wants to do, I am just concerned for her.

[Morakot]

Procedures for giving birth vary highly from country to country. In France, for example, epidural analgesia during childbirth is the norm, where as in the Netherlands woman tend not to opt for it.

In Thailand, Caesarian sections are commonly recommended by physicians and routinely requested by women.

There is a range of factors where delivery by C-section is required. Weight of the baby is one factor but on its own a meaningless assessment.

Edited October 28, 2015 by Morakot

[Morakot]

Background:

Hospital-based childbirth in Thailand is usually not a domain of midwifery and primarily done by obstetricians or gynaecologists (medial doctors). In many Western countries this is not that case and midwives are in charge of normal (low-risk) birth. Midwifery in Thailand is seen as outdated and merely remains in rural places. Physicians' approaches to delivery tend to more invasive and hence C-sections are very common.

Edited October 28, 2015 by Morakot

[Boo]

From a recovery point of view a vaginal birth is always better. A c-section is a major operation & the mother, unless very lucky, will be in pain & have restricted capabilities for several weeks to 3 months. After a vaginal birth she will be up & moving around within hours. A bit sore but nothing unmanageable.

As mentioned, when midwives aren't present, medical doctors prefer to go the quickest & easiest route for them, not the mother.

But it is your gf's choice so just be supportive & question what the doctor says carefully to ensure their recommendation is in mum & babies best interests. I have heard horror stories of women being told to have C-section cause their surgeon has a game of golf to get to.

[rws85]

This is what I am worried about but now the doctor has told her it might be to big for natural birth she seems 100% committed to having a c-section. Seems to be excited about being able to pick a good day/date for our girl to be born.

[Bangkokhatter]

My wife gave birth 3 months ago so can give you some recent experience.

We both decided we wanted a natural birth and our doctor was made aware of this very early on in the pregnancy and confirmed it would be no problem, provided all was well, and was something the doctor also supported.

We went for a check up on the due date ( no contractions ) and were informed that the wife was in labour so everything was prepared and we sat in the delivery suite waiting. The nurses came in every 20 mins or so to check the dialation and make sure everything was ok. After about 4 hours with the wife in some discomfort ( not very painful, she said ) the doctor comes and informs us she is not dialated enough and we may have to consider a c-section. At this point i mentioned we wanted a natural birth and reminded the Doctor that she had agreed to this. She said we could give it another hour and check again.

The hour passes with the wife in a bit more pain and the Doctor comes back to measure. This time she say's we must have a c-section because they were worried about a natural delivery and the baby being harmed because it had not turned. At this point i felt pressured to agree as the wife was in pain and the Doctor was talking about a few other dangers so off we went for the surgery.

Luckily all turned out ok , baby daughter was fine and the wife recovered pretty quickly considering. I was though left disappointed with the whole affair, considering the labour was only 5 hours long before they wanted to operate and they would not let me attend. I should add this happened on a Saturday evening and did think maybe the Doc had a pressing engagement that night.

Having said all this the Hospital stay was very good and the nurses and staff gave us a good service, should think so considering the cost

[rws85]

Glad to hear your wife recovered quickly. Guess it is understandable that your can't go in the operating room during a surgery but think I also would feel like you have missed out on something. Especially being my first child, I would like to see her born, maybe this is selfish feeling this way?

I will go with what ever my partner ends up deciding on and just hope there isn't any problems for her or our daughter. I just hope she understands the risks involved and also what it means if we have more kids in the future.

[Bangkokhatter]

Glad to hear your wife recovered quickly. Guess it is understandable that your can't go in the operating room during a surgery but think I also would feel like you have missed out on something. Especially being my first child, I would like to see her born, maybe this is selfish feeling this way?

I will go with what ever my partner ends up deciding on and just hope there isn't any problems for her or our daughter. I just hope she understands the risks involved and also what it means if we have more kids in the future.

It was our first child also, so we were both a bit green about it, I don't think wanting to be at the birth is selfish really, it's an event that mum and dad should be able to share

Previously i was told by the doctor that should a c-section be required i could attend no problem, when it all started i was told it's after 7 pm so they did not have the staff to look after me.

Just try not to be pressurised into something both of you don;t want but it's not easy when your partner is screaming and the Doc has some other appointment.

Congratulations on your upcoming birth and am sure whatever you decide mother and baby will be fine.

[rws85]

Thanks mate and thanks for the advice also! [emoji106]

[MaeJoMTB]

Government hospital = natural by nurse

Private hospital = C-section by doctor

It's all about the money in Thailand.

My tiny wife gave birth to a huge one naturally in a Government hospital.

Edited October 28, 2015 by MaeJoMTB

[rws85]

We have been going to a private hospital and there is about a ฿20,000 difference. So I kind of felt it could be a reason they'd prefer a c-section. Also the convince of being able to schedule a time to do it.

[rws85]

Hoping I am worrying about nothing.

[Patsycat]

I'm sure everything will go hunky dorey!! Good luck and congrats.

[Boo]

Ha, 5 hrs and they are pushing c section? I was induced at 4pm Thursday & my son popped out naturally at 10am Friday. Labour, the word itself tells you what it will be like, these thai doctors are more interested in time than process. This is why midwives are essential imo

But I'm glad your wife & daughter are ok, a healthy mum & baby are the main & only really relevant thing at the end of the day

[Sheryl]

A weight over 3.5 kg at 38 weeks is NOT an indication for C-section. And lack of dilation ate 38 weeks is NOT an indication for induction!!

International guidelines are to consider induction at 39 weeks if the weight is over 4.0 gm, since that may reduce the need for C-section, but to in any case allow a trial of labor, as large size by itself is not an indication. It is the diameter of the head relative to the pelvis that matters so if one were to go by anything it would be by the head diameter not the weight. And even that cannot be determined for sure without a trial of labor, though the larger the head the more chance it will prove necessary.

Otherwise if weight not over 4.0 gm international practice is to not think about induction until it hits 41 weeks. There is no reason on earth to think of inducing someone because no dilitation at 38 weeks, it is not expected that soon.

Really sounds like the doctor is trying to arrange matters for his own convenience. But if your partner is already sold on the idea there may not be much you can do.

[rws85]

Thanks for the advice! We are due to see the doctor on Thursday, will see what she tells us then. I also got the feeling that it seems to be more convenient for the doctor to just book a time for a c-section.

Edited November 3, 2015 by rws85

[Chuckles78]

My Thai wife gave birth to our son 2yrs ago of 4.1kg naturally and although it was very tough on her she did well and recovered quickly afterwards.

Last month my wife gave birth to identical twin girls in switzerland and the doctors said c-section was the only option.

On the day in surgery i was amazed at the amount of doctors and nurses present during the procedure... Maybe 8-10 all doing their bit.

Operation went very well and very quick! but recovery took much longer with c-section with more pain and discomfort after op.

All the best!

Edited November 5, 2015 by Dieter78

[rws85]

Thanks for your reply.

After a visit to the doctor today, she has estimated the baby is between 3.3 - 4.2kg. Apparently the baby is to big and her should is preventing her from turning so head hasn't come down. Not sure how true this is but she has convinced my partner and we are booked in for a c-section.

Doctor hardly spoke to me today, only spoke in Thai to my partner and her mum. Can't say I am very happy with everything today.

Will be nice once our daughter is out and I can't stop worrying about it. Just hope everything goes ok for my partner and our daughter.

[Sheryl]

If the baby is in a transversr lie (sideways in the womb rather than head or butt down) then indeed a c-section is necessary. I can't tell from the description if that is the case though.

[rws85]

Well all went well, both mum and baby are doing well.

[Patsycat]

YAY!! Congratulations!! What's her name?

[rws85]

Zoe

Edited November 9, 2015 by rws85

[Chuckles78]

Congratulation!

[rws85]

Thank you