EVEN BETTER – AFTER ALL THESE YEARS!

With my latest couple of posts talking about some of the more silly (and sometimes stupid) things that people think or say – I would like to shift things up a bit and tell you about some of the remarkably good things that I’ve seen or heard.

I find it stunningly remarkable that in just 100 years we have made cesareans go from something that we do on dead mothers to try to save their babies – to something that is so routine that 1 out of every 3 pregnancies in this country will end in a cesarean and USUALLY has a healthy mom and baby to show for it! I have an old obstetrical text at my office that says, “to date 5 cesareans have been performed in the United States on mothers that survived! And in Europe that number is 12.” (I am not looking at the book so that quote is from memory and may not be word-for-word – but definitely close enough) Now, as much as we stomp and yell that the cesarean rate is too high (and it is!) and that it is putting women/babies at a higher risk because they are done too casually and too often (and they are!) – think about everyone that you know in your life. Think about their births. Eliminate the ‘questionable’ ones….and think about the people you know who have had a transverse lie baby (laying sideways), or placenta previa, or a prolapsed cord….surely you’ve known someone who was pregnant with a baby who was presenting brow/asyclitic that precluded a vaginal birth but who is holding a healthy baby right now. I can say with an almost certainty that you probably know someone who would not have their baby in their arms if it had been 100 years ago.

To that I say WOW! And that we take that so much for granted….after such a short amount of time! I was born in 1969 when the C-sec rate was 2.6%. I was born via cesarean – my mother attended a support group for mothers who had cesareans. Yes, for the sake of this post I am revealing my age…but I want you to really really think about this! PLEASE!! In 40 years we have gone from a Cesarean being something you pray you will survive…to something that they have been able to make safe enough that so many people consider it routine.

This is not to say that it is without risk – it is giving credence to the fact that we have been able to REDUCE the risk THAT MUCH…and in such a short amount of time!!

In Arizona, in 1950 (not that long ago folks!), the neonatal mortality rate was 25.7:1000. In 2002 (still in Arizona) the neonatal mortality rate had dropped to 4.1:1000. This means that every year, because of medical advances, for every 100 babies born, 2 of them are going home with mommy that would have otherwise have been buried. That’s…amazing!! And that’s just in the last 60 years!

40 years ago, when I was born, the age of viability of a premature baby was 28-30 weeks. Prior to that stage of the pregnancy, there was almost no hope for the baby. Today there have been babies born as early as 21 weeks (from conception) and survived!! The ‘age of viability’ is currently 24 weeks – with GOOD outcomes at 25-26 weeks! Again let me stress, this is not that long ago! The introduction of Surfactant (the substance given to extremely premature babies so that their lungs can function with less chance of collapsing and sticking closed) – seems routine to those that use it, yet it was only introduced into obstetrics in the 1980’s.

Medical advancements have been no less than miraculous and amazing to me. I bow to the brave physicians that hone their skills every day trying to save people’s lives – knowing that they will not always succeed, and putting their hearts on the line knowing that they will have to live with the memories of everyone that they were unable to save. I think that we (myself included) should stop once in a while and yell, “THANK YOU” to the physicians that truly do spend their life trying to improve the outcomes for generations to come. I am grateful not only for myself (yes, I have had a cesarean) but for my clients who I know are much better off because of medical advancements. My life and my outcomes for some of my clients would be very very different without them – and I think we should all be grateful and not lose sight of that.

4 Comments

  1. Kelli wrote:

    It seems like we shared a brain today. I was just thinking that I wish I could thank the team that treated my family after our car accident. My mom was 30weeks with my brother and because their heartbeats were mixed up(one was 90, the other 120)and she had no notable symptoms, she spent 6hours with a torn placenta before it was caught. After her c-section(her 3rd but first emergency)which counting the c-sections was her 11th pelvic surgery, the surgeon(OB) came in and said “I’m so so sorry, I gave you a terrible scar, I’ve never shaken like that in surgery but I was so startled by this, I was so scared to lose your baby, please forgive me.” My mom let her know she’d given up bikinis a couple of surgeries ago. My brother did pass the next day but I can never forget way my mom talks about that woman connecting with her and caring deeply even though she was a stranger in another state. I am grateful my mom is still with us and grateful my brother had a chance to be with us for a short while. I’m grateful that you are with us too. I love a life saving c-section, esp. when the family is treated with emotional dignity. It should only be like that.

    Friday, March 5, 2010 at 7:15 pm | Permalink
  2. Shari wrote:

    Here, here! My husband was born at 27 weeks gestation, 33 years ago, and I, for one, am soooo grateful he is here :o)

    Friday, March 5, 2010 at 11:16 pm | Permalink
  3. Kolleen wrote:

    The comments were as moving to me as the article!! I think that the medical advances and neccesity get overshadowed quite often by the way we take things for granted..so many scheduled, unneccesary c-sections can make even the necessary ones seem frivolous (sp?). It is good to hear about the good stuff 🙂

    Saturday, March 6, 2010 at 4:14 pm | Permalink
  4. Shari wrote:

    I forgot to add that my husband was born by c-section for complete placenta previa, heavy bleeding is the reason he was taken early. He has a scar on his back all the way along his left shoulder blade where they cut him open right there in the room he was born, immediately after birth (without anesthetic, mind you!) to sew shut the PDA in his heart. All this and he has no lasting effects from being born 13 weeks early, his vision is even better than mine 😀

    Sunday, March 7, 2010 at 11:17 am | Permalink

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