Sep 27

Posted by My OB said WHAT?!?.

“All Roads Lead To A Cesarean Section.”

“All roads lead to a cesarean section.” – Midwife’s informed consent information prior to an induction.

59 people dislike these words.

There are 21 comments to this post.

ourlittlefamily had this to say, Sep 27, 2011 @ 3:02 pm (Quote)

not if I dont want it to!! on second thought… maybe I dont want the pit then, thanks…

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Lynn had this to say, Sep 27, 2011 @ 3:04 pm (Quote)

Then I’d better not drive anywhere. Good thing there’s home birth!

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Sarah Reply:
September 27th, 2011 at 5:32 pm Sarah(Quote)

this

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Layla19 Reply:
September 28th, 2011 at 3:23 pm Layla19(Quote)

*Applause*

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Judith had this to say, Sep 27, 2011 @ 3:48 pm (Quote)

true if you hold a scalpel in your hand! are you really a midwife?!

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Aron had this to say, Sep 27, 2011 @ 4:00 pm (Quote)

“….with me as your birth attendant.”

Considering that midwives (yes, that includes nurse-midwives) are specifically trained to help preserve the normalcy of birth and reduce the need for surgical interventions, this particular birth attendant is admitting to a pretty high level of ineptitude.

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Sheva had this to say, Sep 27, 2011 @ 4:20 pm (Quote)

Yeesh, then get off the road!!!

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nicki had this to say, Sep 27, 2011 @ 4:58 pm (Quote)

only with you….I’ll just find another provider thanks….(but I learned my lesson the hard way)

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Kate, Ren's Mama had this to say, Sep 27, 2011 @ 5:01 pm (Quote)

I’m confused. What dos this even mean? I’m guessing that she’s not actually saying that 100% of her patients end up with a c-section, or even that 100% of her induction patients do. Maybe she means that in the “this isn’t working, what’s our next best option?” chain of events, a c-section is the last thing in the chain? Whatever she meant, it’s really poorly worded and does NOT inspire confidence.

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LG Reply:
September 27th, 2011 at 7:47 pm LG(Quote)

MTE. Was it supposed to be an “inductions suck and legitimately increase the risk of a c-section even if we’re really careful, so just FYI, go into this with your eyes open” kind of thing? If so, seriously poor wording. If not, it gets a big ol’ WTF.

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Rosa had this to say, Sep 27, 2011 @ 5:26 pm (Quote)

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Becca had this to say, Sep 27, 2011 @ 5:38 pm (Quote)

Call me crazy, but I don’t see what’s so wrong with this one. I mean, let’s assume for a moment that the induction is medically necessary. The midwife sits down with mom and goes over the risks- and she has to tell the mom that induction raises the risk of having a c-section. It’s not always something the provider can control. You can induce and do everything right, like turn down/off the Pitocin, or get mom upright, or support a low intervention labor, or whatever- but you can’t say that there’s always a way out of a c-section. Ultimately, start the road at any intervention and you can always follow it out to a c-section. It doesn’t mean that the road will end in a c-section, just that it can.

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Jade Reply:
September 27th, 2011 at 7:07 pm Jade(Quote)

I read it this way too. I guess when we see the pink link it might make more sense.

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Mama Wrench Reply:
September 28th, 2011 at 2:46 am Mama Wrench(Quote)

It’s the “all roads lead to” part that’s so off-color. It makes it sound as though, no matter what you do, if you get induced you WILL get cut. It makes me think of the Wikipedia philosophy game, where you pick a random post and click the first link till you get back to the Philosophy entry. It doesn’t matter where you start, you will ALWAYS end up at Philosophy, even if there are detours along the way.

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Details Reply:
September 28th, 2011 at 4:33 am Details(Quote)

Philosophy Or the Kevin Bacon game.

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Jade Reply:
September 28th, 2011 at 6:07 am Jade(Quote)

I have never heard of either of these games but find both of them extremely inriguing.

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Kristin had this to say, Sep 28, 2011 @ 3:17 am (Quote)

Then I’m glad you aren’t the one driving.
We can just pull over here and have my baby without surgery, thanks.

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Merideth Geers, CNM, MSN, LM had this to say, Sep 28, 2011 @ 4:28 am (Quote)

As the originator of this submission, I will explain further. Whenever the women who were scheduled for inductions came in to the hospital on the evenings this particular midwife was in house, she was charged with initiating the procedure and, of course, giving informed consent. She invariably ended her informed consent monologue with this particular line.

The first time I heard it, I nearly fell on the floor. It ALWAYS bothered me. I believe that it is important to give full informed consent, which is what she was trying to do. But, there is informed consent done tactfully and there is a way to promote shared decision making by giving the woman and her partner a DECISION AID. This could be either a discussion or a document that spells out all of the risks/benefits/alternatives including doing NOTHING AT ALL. Followed by, giving the women and their partners ample time to mull it all over (perhaps get a second opinion) before proceeding with the clients’ decision. My feeling is that if it is done properly, more women would be opting to let labor begin on its own.

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Details Reply:
September 28th, 2011 at 12:57 pm Details(Quote)

So do any of the moms who hear this line get up and leave because they suddenly realise that they are increasing their chances of c-section by 40% by inducing? Does she give them ample time to mull it over? Or does she say this as she is starting the procedure? Is it her contention that waiting for labor to start naturally can also lead to c-section? Does she emphasize the 40% increase risk? Please tell me your hospital doesn’t have 100% c-section rate.

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Merideth Geers Reply:
September 28th, 2011 at 5:02 pm Merideth Geers(Quote)

I never saw a single woman change the induction plan. Obviously, they were ok with the information given and were ok with the induction. The “informed consent” was usually given just before the insertion of cervidil. No, it did not have a 100% C/S rate… more like the nat’l norm of 34 – 35%.

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