Top Ten Signs Your Doctor Is Planning To Perform an Unnecessary Cesarean Section on You

1. Arrives to L&D immediately after office hours and says, “I just don’t think this baby is going to fit.”

2. Third Trimester, Routine Office Visit, “I think this is going to be a big baby. You should just have a C/S”– Did you know?  ACOG has very specific guidelines for when it is appropriate to offer a patient an elective C/S for MACROSOMIA (fancy word for large baby).  ‘Prophylactic (elective) cesarean delivery may be considered for suspected fetal macrosomia with estimated fetal weights greater than 5,000 gms (11 pounds) in women without diabetes and greater than 4,500 gms (9.9 pounds) in women with diabetes.

3. “We should induce at 39 weeks because your baby is getting too big” – Did you know that, according to ACOG:

‘Induction of labor at least doubles the risk of cesarean delivery without reducing shoulder dystocia (rare situation where baby’s shoulder can get stuck at delivery) or newborn morbidity(complications).  Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.’

4. Performs routine ultrasounds at end of pregnancy to see how big your baby is. Did you know that ultrasounds at the end of the pregnancy can be 1-2 pounds off?  Ask some VBAC patients who were talked into a C/S for this, then had a vaginal delivery of a bigger baby the next time.

5. “You have a positive herpes titer (or history of herpes); the baby will get it if you deliver vaginally.” Try some Valtrex for the last month of the pregnancy that is pretty much standard of care now.  It prevents outbreaks and allows for a normal vaginal delivery.

6. “Your baby is breech. You need to have a C/S” Ever heard of or performed an External Cephalic Version (process by which a breech baby is turned to the proper position)?  It really does work.

7. “You have pushed for 2 hours” (with an epidural that prevents you from feeling anything so you are probably not pushing effectively; this is evident on exam because the baby’s head is still perfectly round, but you do not need to know that) “It’s just not going to come out”

8. “I scheduled you for an induction at 39 weeks. It is just soooo… much more convenient for you!” (and so much higher risk of ending in a C/S, especially if you are not dilated when you start the induction).  At least 80% of my VBAC patients were induced the previous pregnancy.  For whose convenience was the induction?

9. First Visit (7 weeks), “Congratulations you are having twins.  I will go ahead and schedule your C/S at 38 weeks, but don’t worry if you go in to labor early I will cut you right away!” Translation, “I am scared out of my mind for you to deliver your babies vaginally because I am not trained on what to do when the second baby is coming, plus it pays more to cut you open.  Oh yeah, I don’t have that great a rapport with you because I only spend 2 minutes (fundal height, heart beat and ‘I’ll see you next time’) with you each visit, so I am afraid I will be sued for trying to do the right thing.”

10. First Pelvic Exam in Office (7 weeks), “Hmm, your pelvis is pretty narrow”.

Bonus Tip:

11. 38-week visit, “Your blood pressure is a little high today. You are probably developing preeclampsia or toxemia.  That can cause you to have a SEIZURE!  The treatment is to deliver the baby.  You need a Cesarean Section, as this is the quickest way to resolve it.  Let’s get you up to L&D NOW!” Translation – Preeclampsia or Pregnancy Induced High Blood Pressure is a pain in the butt.  If I induce you, it could take 24 hours or more and then I would have to manage your blood pressure, and put you on Magnesium.  This is way too inconvenient.  Do not worry you can try to have the baby vaginally next time.  Yeah right!

Well, I hope you future moms find use for these tidbits of info.  If anyone wants to add anything, please feel free.  Your experience may help other women in the future. Remember, there are only a few emergent reasons for a C/S such as fetal distress, unexplained heavy vaginal bleeding, etc.  It is okay to ask your doctor questions.  We are not supposed to bite.

Jonathan Weinstein, MD, FACOG

Obstetrician/Gynecologist

Husband to a Labor and Delivery Nurse with 27-years’ experience

Father to two beautiful children, Zoe and Ashton

We only have a few birth days!  Our bodies are born as girls and mature into women with the ability to give birth.  We only give birth a few times in our lives.  Therefore, we need to focus on birth as a unique, valued time in a woman’s live where we celebrate the miracle and blessing of birth. A BIRTH day is a day of life, celebration and family!

Choosing the best setting for your birth day is very important.  Due to incredible marketing, hospitals rank as the number one birth option for women and their families to use to give birth.  Out of hospital births are not as common but on a rapid rise, they are like on of our best kept secrets.  There are a myriad of reasons  one might  choose an out of hospital birth as opposed to a hospital birth.  Primarily men and women are now leaning towards more affordable birth options while reducing the risks to mothers and babies.

Sadly the number on risk to a woman in labor is surgical intervention.  Failed induction, adverse response to induction and fear are the number one reasons that surgical births are occurring.   Surgical births is also very expensive and increases the risks for women and their babies after delivery with infection, respiratory illness, blood clots, prolonged hospitalization, undue pain etc., etc. etc.

CHOOSING THE BEST SETTING FOR YOU IS VERY IMPORTANT.  ONE OF THE

BIGGEST DETERRENTS TO MAKING YOUR CHOICE MAY BE YOUR INSURANCE COMPANY.

Lets talk a little about how you can choose your birth setting.

• Check out your options, visit local birth centers, take a tour, ask them how they handle safety.
• Talk to the midwives, ask about their philosophy of birth, how they handle emergencies, when are they present for you birth.
• Talk to the doctors, ask about their philosophy of birth, how they handle emergencies, when are they present for your birth.
• ASK EVERYONE ABOUT COSTS.  Remember the costs of the hospital are called facility fees, asked about other fees too!  Like the costs of the pediatrician, the medicines, the doctor or midwife, the room, anesthesia, there are a lot of “hidden costs” get it all in writing.

1. Did you know that the “average” cost for a natural vaginal birth in the hospital here in Kansas City is $12,500.00.
2. Did you know that the “average” cost for a natural vaginal birth at a birth center in the Kansas City area is $4500…and this cost INCLUDES the fee for your midwife, your baby, any medications used during birth or immediately after birth, all NB screening, aromatherapy, nutrition, water birth, staff, and much more.
3. Did you know that birth center staff must be certified like hospital staff in Cardio-pulmonary resuscitation and Neonatal resuscitation?
4. Did you know that birth centers have available medications for you if you need an IV, treatment for infection such as GBS, treatment for hemorrhage and many other concerns of  delivery?
5. Did you know that our states both Kansas and Missouri license free standing birth centers (and I am talking about those who are NOT part of a hospital)?
6. Did you know that government based health care insurance plans credential birth centers.  In other words reimburse them for services they offer?
7. Did you know that birth centers do work with hospitals and OB/GYNs if you need more help getting your baby born or need to transfer your care?  They are prepared in emergencies and are ready if and when one may happen.

So, if you are considering choosing an out of hospital birth setting, and your insurance company is telling you to “pick a hospital”, let them know the 7 statements I wrote above.    You are the consumer of the insurance plan you carry—ask them to consider saving MORE money by adding  a birth center to their listing of birth options.  They will save money and you will have an incredible birth day!

Let me know your thoughts!  There is SO much to talk about and I have just touched the tip of a BIG ICEBERG here!

Ciao!

I just wanted to take a moment to share my excitement and hopefully encourage other women who are possibly going through the same struggles with their insurance company.  When I first heard of the New Birth Company opening I thought there was no way it’d be possible to birth with them since my husband’s insurance was a private pay deal and they had a specific “no midwives” policy.  I called the company who manages our insurance benefits and asked who it was that I needed to talk to about making an exception to their rule.  I was told it was impossible to have that kind of exception made and the only way I could possibly work around it was to take on the cost of the birth and then hope that they would later approve it in an appeal.  This answer was unacceptable to me.  I pressed on further and asked who it was that made the decisions for the exceptions and was reluctantly told that it was a Board of Trustees type decision and I should mail them a
letter.  Again – this seemed a little too passive to me as mail can get lost- but at least I knew where to turn to next.  I contacted Kendra at the New Birth Company and she was a wealth of help.  She helped me draft a letter to the Board of Trustees to request they make an exception to their rule and allow me to help them save money by birthing at a licensed birthing center vs. a standard hospital birth.  I thought for sure this wouldn’t work, but what was the worst they could do, say “no”? I then called my husband’s company and asked who specifically I needed to talk to on the Board. Thankfully the gentleman that I was placed into contact with was very nice, personable and willing to take this request to the Board to see if it would even be considered as an option.  To my surprise, it passed their “should we consider this” stage, their cost  analysis stage and was eventually voted on and passed by the Health and Welfare committee.   I am thrilled that I faced my fears and took on the “giant” that really was a lot more gentle and tame than I had thought it would be.  I’m even more thrilled that I get to have the birth I want in a low pressure setting AND insurance is going to pick up the tab for it (what could be better than that!).  Thanks New Birth Company in all of your help, encouragement and support through this process.  I couldn’t have done it without you!  I’m looking forward to sharing my
special birthing day with you all in August!

Warmly,
Morgan