Atul Gawand, an assistant professor of surgery at Harvard Medical School, said in an article in The New Yorker Magazine ( Assessment: how did the birth go into industrial .10 / 9/2006): “And yet there is something alarming due to the fact that labor is still surgical. Some hospitals already have a caesarean section in more than half of the children's supplies ... We are losing touch with another natural process of life, the medical mainstream, it will soon be lost. ” During the first third of the 20th century, a revolution in medicine occurred in medicine, which anticipated all this. While most urban women delivered babies at home with the help of a midwife, by about 1933 most urban babies were delivered by doctors in hospitals. However, hospital care did not bring any benefits to mothers or newborns. In fact, newborn mortality from birth injuries has increased during the previous two decades! The author cites "incompetence" as the most consistent factor.
As he noted, medical practitioners must do something to standardize the process of childbirth (make it easier to work like an ABC!), And improve their number, or they will lose confidence. Even without advanced tools and techniques, midwives showed more consistently good results! A cesarean section in this, at the time, was like an emergency surgical procedure last stop. Historically, it almost always killed a mother through blood loss and infection. However, over the course of a quarter of a century, all of this has really changed. The turning point occurred in 1953 in the form of a standardized scale for assessing a newborn, which was rated "Apgar". At about the same time, surgical methods and antiseptics became independent. Evaluation has become a beacon on which could be statistical studies. The immediate health and long-term prognosis of the infant have become measurable, reflecting the ability of institutions and their practitioners to improve the effectiveness of their approaches and procedures. But, if the two procedures are equivalent in efficiency (when the staff is properly trained), how do you determine which approval and at what convenience?
A caesarean section is a procedure. Using forceps on delivery is a skill. Gawande repeats this as art. Here is a great example of where the path of least resistance takes precedence over a jolt to increase the skill level of practitioners. Because of this, mothers can suffer unnecessarily.
Due to statistics that confirm that the C-section is a viable option, studies on the long-term effects on women who have suffered from this were insignificant and had little impact on the direction that obstetrics is leading. Gawande cites tongs as a completely revolutionized childbirth. Their use is sharp reduced infant mortality. The problem with forceps is that it is believed that too many doctors cannot master instruments and equipment well enough to make them effective. Doctors who are located however, they are well trained in methods, but have success rates that are equal to a cesarean section in difficult labor.
Working with a tool for safely guiding an infant through an unchanged birth canal is significantly different and more complex than cutting through the tissue, stopping bleeding, digging up the baby and then stitching the injured tissue. One of them is to promote a natural, not always predictable process. The other is the removal at the edges.
You might think that the C-sections will only be used in severe emergency situations. They are not. Nowadays, they are being offered more and more often as special on the delivery menu!
Apgar is focused on newborns, which means that the goal is the production of live and healthy deliveries. It is also designed to catch the endangered infant and intervene in medicine before it is too late. The fact that it is not intended is to give equal attention to the health and future well-being of the mother AFTER she leaves the delivery room.
A caesarean section is the most representative of the procedures that were integrated into typical delivery. Today, it is more routine than not to include IV, fetal cardiac monitoring, pitocin (to “drive contractions”), and anesthesia of the spinal block during labor. Many of them in the process of delivery are chosen so as to beat the odds and smooth out rough edges; almost the same as saying: "We will make it convenient for both of us today ... and we will not talk about tomorrow." Of course, this is the mother and family who pay for all this, but how many contracts?
What was once a miracle of labor was a technical procedure. It depends on its distribution on the industrial assembly line, in the hospital system with a predominance of men, which still does not understand, not to mention the signs, subtleties of a woman. The role of women in delivering a healthy indicator of Apgar? Gavande says: "Against assessment for a newborn baby, the pain of the mother and blood loss and the duration of the recovery seem to mean little." Could he give a study that shows statistics for women's experience? No, this is what “seems” to be considered small. Caesarean treatment is much more cruel to the mother than using forceps. Recovery will continue. Healthy tissue is damaged. The feeling of dissociation from the natural process of birth, when you give birth to a newborn (as opposed to going through the procedure to remove growth!). Very well can lead to traumatic undertakings in connection with the mother and child. Of course, this is just an extrapolation on my part, made from conversations with women who have undergone it. But what do I know; I have no statistics to support me.
Maybe someone should ask.
