My shocking revelation when I moved to Indiana is that its not just Mormons who are believers in unorthodox medical practices. Its endemic. Maybe the percentages are higher among Mormons? I don’t have the data, but it could be.

page 2 Safety Concerns.

My history: 3 babies, 3 c/s: first for breech, second after an attempted home VBAC (relucant hospital transport after 1 1/2 days of labor–the baby didn’t fit–no major urgency), third a repeat c/s after that baby was also showing signs of not fitting. I guess my experiences are a good example of natural versus conventional medicine. I was a true believer in what midwife types say about VBACs, especially that CPD (the baby’s head too big to fit) doesn’t ever happen. Well, I was proven wrong and my son and I are still here today because of that c/s. I’m very grateful that the hospital was there for us. Still, the midwife does good work (for other, normally built people), she knew when to insist that we transport to the hospital, and she knew how to handle other emergencies.

About the rest of alternative medicine–there are a lot of quacks out there (especially MLM related), but conventional medicine doesn’t have all the answers, and it’s hard to know what’s right and wrong. I respect science and appreciate a good study, but I sympathize with someone who looks at alternative treatments for diseases that conventional medicine doesn’t do a good job with. Like someone mentioned above, the best alternative medicine has to offer is in maintaining good health. I look at my great-grandparents who lived into their 80s and 90s without any degenerative conditions and wonder what their descendants are doing wrong.

http://content.nejm.org/cgi/content/abstract/351/25/2581

Maternal morbidity associated with cesarean delivery without labor compared with spontaneous onset of labor at term. Obstet Gynecol. 2003 Sep;102(3):477-82.

Ethical dimensions of elective primary cesarean delivery. Obstet Gynecol. 2004 Feb;103(2):387-92. Review.

Obstetric events leading to anal sphincter damage. Obstet Gynecol. 1998 Dec;92(6):955-61.

(Sorry, no URL for these.)

I think that this is some good evidence; there are also other studies supporting the same conclusion. The risks of immediate and long term complications of cesarean versus vag delivery in the United States, when performed by experienced surgeons and anesthetists, are essentially same.

Claire,

The correlational data that you supply for difficulties with regard to breastfeeding after a CS delivery looks pretty good; I wonder, though, what the percentages are. If a baby born by CS is, say, 10% less likely to be successfully breastfed, that represents a statistically significant difference; but what does it mean in real-world terms? The studies on psychosocial well-being in CS babies are thought provoking, but it seems that they are correlational; I don’t have them available to me to see how they arrived at their conclusions, but I’d be interested in knowing more.

With regard to VBAC, your references cite relatively old data; newer data shows lower maternal and fetal risk with repeat CS. And the risks for CS versus vag birth as stated on the pregnancy-info.net page are either just plain wrong, or they do some pretty heavy qualifying to arrive at those numbers. They sure do make it sound alarming.

And I really should note, I *am* (for the time being) an advocate of vag birth over CS.

http://www.plus-size-pregnancy.org/CSANDVBAC/bfaftercesarean.htm

http://www.thebabycorner.com/page/1137/

http://pregnancy.about.com/cs/cesareansection/l/blicanresponse.htm

http://parenting.ivillage.com/pregnancy/plabor/0,,qjs8,00.html

http://www.pregnancy-info.net/c-section_complications.html

lots more out there…

I’m not disagreeing that you could assert that your “burden of proof” construct can be helpful. I just find it amusing (and sometimes bothersome) that many of us tend to project our professional training into our everyday discussions. An economist could assert that every decision-making discussion with your spouse involves a cost-benefit analysis. As a statistician, I could assert that there is an underlying null hypothesis and an underlying alternative hypothesis, and (like burden of proof) frame the issue such that my spouse needs to “prove the alternative hypothesis” in order to disprove the null. Of course, I wouldn’t discuss things that way with my spouse.

I much prefer discussing, “What’s best for our child? Let’s consider the potential benefits, the risks… could it be counterproductive or harmful… etc. What evidence is available for each of these possibilities?” But, I suppose we actually are in agreement, because perhaps you prefer this kind of discussion as well. It seems that your bringing up the “burden of proof” is appropriately limited to those times when the disagreement is sharp, and the two parties are unlikely to be persuaded to reconsider.

LOL about the organic sheets. But it sounds like most of the peopel commenting on this thread who had a midwife attended hospital or birth center birth had a good experience, and I’v heard of some homebirths that were transferred to the hospital where they turned into c-sections, so I still say do your research, educate your self, plan your birth the way you want it, and be happy knowing you did what you thought was best for you and your family even if it doesn’t turn out how you’d like. Too many women just turn them selves over to the ‘authorities’ on this one and complain later- I think we have some responsibilities to examine our feelings and experiences and the options (as you obviously did!)

I do agree with you about the (fake) emergency c-section being a bad thing. (I have actually thought that if you want medical model, you should go whole hog and have a section and if you want natural, you should do it at home on your organic cotton sheets, and anything in between is probably going to cause more problems than it solves.)