Choosing Date for C-section.

In addition to the convenience factor, it is preferred to have a scheduled c-section as opposed to an emergency one. Is there a reason this is being planned as a c-section rather than vaginal? It is my understanding that just because you had one c-section does not mean the next one has to be. I do realize there could be a medical reason to have a c-section but it isn't always a given.

If there is a medical reason, that could be a reason to schedule (certain conditions like placenta previa would be to avoid complications). Talk to you doctor and then plan accordingly.

I would erge you to consider a vback. I have a few friends who had one csection and then doctors just schedule the next. they opted for a vback and said it was much easier. My sil had a long labor then a csection. Next baby she had placenta previa so scheduled csection. This baby they just set the date and I don't know why they don't try to see what how it goes. Good luck to you

Personally, I didn't WANT my Dr. to be preforming a major surgery at midnight, or rushing from an event, or groggy, or over-scheduled, or unavailable. That is ALWAYS a concern. That they simply can't do a c-section for you, when you need it. And, every labor can be totally different. If your labor is not slow, the Dr. may not have time to be there.

However, if this is something you REALLY want to do, then just tell your Dr. He's there to listen to you. You could also consider scheduling your c-section closer to your due date.

8Kids- The average time for women in the hospital after c-sections is 2-4 days. 7-10 days is 100% false. Also, the rate of c-sections, is not 46%. Things have changes, as well. Women are having baby later, more and more women are having multiples, more women are having high risk pregnancies, more women suffer from fertility and have to use scientific means to conceive (many of those pregnancies being high risk,) People are heavier and more morbidly obese women are having children (which leads to complications), people in America are less healthy and have more health complications. Are there doctors who just want to schedule and get the money? Sure! However, there are more medical reasons women are having c-sections, as well.

Hi RJ! Tell your doctor what you would like, he will honor your wishes.

Not all doctor's prefer to schedule for their own convenience. My OB's office has 5 doctors and they share on call duties. My OB wasn't able to make it to the birth of my daughter, but I knew that I could trust any of her associates. None of them are the butchers that people make doctors out to be.

Oh my word, 8kidsdad, you might want to check your facts before you post about birth again! :) My sister had a c-section and was out of the hospital in 24 hours. I had a natural birth and was in the hospital for 5 days. I should have had a c-section, but my doctor was trying to honor my wishes- not squeeze more money out of me.
Good grief!

Generally doctors want to schedule c-sections 1 week before your due date to give to keep you from going into labor. In my case, my water broke 1 week before both of my scheduled c-sections. I was very concerned about getting to the hospital in time.

There are many reasons why the c-section rate has increased so much. A main reason is that c-sections are so much safer than they used to be. My husbands mother delivered 3 breech babies vaginally, because at the time c-sections carried so many risks. Now, the risk during a c-section is much smaller than the risk of having issues vaginally delivering a breech baby. Plus most of the risk with a c-section is on the mother, whereas delivering a breech baby the risk is to the baby.

Also, most ob's have a set rate that includes all of your visits, the delivery and the hospital visits. One rate for vaginal and one rate for c-section. Yes, the c-section rate is higher, but not to the degree that I think the doctor would choose a c-section just to make money.

Is the c-section elective, or medically necessary? If medically necessary, why would you risk going into labor when you already know that you need a c-section. All 3 of my babies have been c-sections. 1st was emergency, 2nd was emergency after a failed induced vbac, 3rd was scheduled. The 3rd was, by far, the easiest & most calming for me. With the 2nd I was scared, having labored for 12 hours and not progressing at all.

Yes, you can request it of your doctors, and they can't FORCE you to schedule the c-section in advance, but you are increasing your risk.

ETA: The article that Mallory cited does not even apply to your situation: " The differences were small, but the study found that more kids born at 37 or 38 weeks did poorly compared with children born even a week or two later. " Your doctor is NOT asking you to schedule for 37 or 38 weeks. He asked you to schedule at 39 weeks. There is no indication that delivering at 39 versus 40 weeks makes any difference.

Ignore fear mongering, I really want to say to you. The idea that there are doctors who will only deliver babies by c-section is just a made-up fantasy.

Women who don't ever have to have c-sections are lucky. Because we have better and safer methods to handle at risk deliveries and immediate problems, babies and mothers who would have died in the old days live. Thank goodness for this.

There will always be doctors who are greedy. There will always be moms who want to have an easier time of it. The point I want to make is that if you have to have a section, then it's your choice to a degree if you want to experience labor. There are some reasons to do it, but you don't have to go through the pain if you don't want to. I wouldn't worry so much about the convenience of the doctor.

Just because interns go days without sleep doesn't mean that the system is right. That whole thing is one of those "I had to do it, so everyone else has to, too." It's dangerous for the patients. And most of our ob's are older now and older people can't and shouldn't go without sleep. Making a comparison with younger interns and older doctors is not helpful.

Dawn

My second c section was scheduled at 39 weeks and 5 days so I made sure it was as close to my due date as possible. My dr wasn't working that weekend. I agree that it should be as close to the due date to give baby as much time as needed.
At 8kids I'm not sure what kind of botched surgery the women in your family had but I was out of the hospital the day after my last c section. That's right I had her the 9th and was released the 10th. And standard time is only 4 days, not 7-10.

My wife didn't have any c-sections. My daughters have had several. My son is a doctor of pharmacy. I said c-sections are much more common today than they were when i was first married and in large part it was because the doctors and hospitals were greedy and the doctors would rather schedule a c-section than have to come in for a delivery when the baby felt like coming. Too many unschuduled deliveries have cost the doctors their favorite T-times or have interrupted a good night's sleep.

My son, the doctor, said I was wrong. Ok, he has the education. But, my wife never had a c-section. I have daughters or DIL that had c-sections and some of those were unnecessary in my opinion. I learned that some of the doctors that my kids went to won't deliver a baby unless its by c-section.

Why do they (docors and hospitals) prefer c-sections? Money ! ! ! A natural delivery gets a mom in and out of the hospital in two days. A c-section gets a mom in and out of a hospital in 7 to 10 days. A c-section yields several visits by the doctor, sometimes two to 4 times a day. (And he bills for a visit, even if it was for only a couple of minutes long.) A natural birth gets them two visits, maybe three. A natural birth interrupts his life. A c-section is scheduled and usually M-F, no weekends. The hospital bills for a nurses visit. Many more times for a c-section than for a natural birth.

Women's bodies have NOT changed that much over the last 3 decades. But c-sections are up 46%. (From a study done by the british) Money is the reason. A c-section is much more invasive and subjects the mom to a lot more germs. But the doctors are not worried about germs as much as they are they are about their bank accounts.

A c-section is NOT necessary in all cases. Medical people even have a name for it, VBAC. (Vaginal Birth After C-section)

ETA: For those that worry about how much sleep a doctor gets, do research on how many hours interns work and they do it day after day and week after week. They get paid very poorly and work some shifts that run 20 or more (yes! More) hours per day. I've read where some are assigned 36 hour shifts. How effective and alert do you think they are if they see you after they have been on duty for 30 hours with no sleep?

Good luck to you and yours.

Be realistic here. Doctors have to have sleep too. If you wait until you go into labor, it could be the middle of the night or a weekend, and you run the risk of having some on-call obstetrician performing your c-section instead of YOUR doctor that YOU chose. In addition to that, going into labor can complicate c-sections and even make them more risky for you AND for baby. Labor can make baby's vitals unstable. I've had two c-sections, both scheduled, and will have my third in December. I choose, with the advice of my doctor, to do what is absolutely best for me and my baby. Going into labor doesn't mean baby is ready, it means your body is ready. No reason to do that if you're going to have a c-section anyway, in my opinion. Having a c-section 1 week early poses no threat to your baby, he/she is fully developed. I had my 2nd daughter almost 3 weeks early via c-section and she was 8 lbs, 2 oz, and very healthy, still is.

Scheduling a c-section is less about convenience for the doctor and more about the safety of you and your child. I understand that you want the baby in there for as long as possible, but at 39 weeks the baby is safe to come out and be part of the world. I agree with most of what Everley said, there are probably other factors. I would discuss it at length with your doctor before you have your heart set on another method.

I had to have a scheduled c-section with my son because he was breech. I also wanted him to come into this world when he was ready but honestly, no offense, that is kinda a silly reason to make such a fuss. If you want to move up the date of the c-section (and v-bac is not an option for you), then discuss that with the doctor. My c-section date was 4 days before my due date and guess what...I went into labor that morning. I can tell you it was not fun. There are much higher risks associated with getting a c-section when in labor than when not and I was also not given any pain medication (even though I asked) until it was time for the c-section. Also, since it is surgery, your stomach should be empty or you may get very ill and throw up during or after if you have not planned to have the c-section. If you are concerned that your baby is not gestationally ready to be born, then certainly discuss that with your doctor. But if it's so the baby can choose his or her birthday, it is not that big of a deal.

You should also find out the rules of the hospital. Not every hospital follows the same rules when it comes to c-sections.
I tried a v-bac once with a backup c-section scheduled. I rescheduled a couple times. I started pre-labor and went to the hospital. The doctor was urging me at one point to go ahead with the c-section because the surgical room was free at a certain time and because she was going out of town that day. I was totally annoyed that my choice was not the most important thing. My husband helped me calm down so that I could speak with the doctor with less emotion and tell her that even if it ended in a c-section eventually, the v-bac was really important to me. The doctor listened and took a few moments to think about it. She remembered that the amniotic fluid level had dropped too quickly with my first baby so she sent me for a second ultrasound as an indication of how much longer we could wait for the c-section. It was the right choice because the same thing was happening again and we needed to move quickly. Even though the doctor was right-- that I did need to get into that 7am surgical time-- it wasn't for the right reasons at first and I was so glad she gave me every possible chance at the v-bac.

It all depends on the reason for your C-section. If you have medical reason, perhaps the doctor doesn't want you to go into labor. There are certainly some conditions where that would be a really bad idea. Or, he might be scheduling it simply to save the time in case you all decide you want to use that date. And finally, a lot of research has shown that semi-emergency C-sections in the middle of the night have worse outcomes than scheduled day time ones (less NICU time, quicker recovery, etc.).

Just talk to your doctor. Tell him you'd like to go into labor and then have a C-section and see what he says. I completely don't agree with the posters who say that you should simply insist on what you want because you're paying for this. You're also paying for medical advice. Ask for it!

I think it totally depends on why you are having a planned C Section, as others have mentioned. Discuss with your Dr.

I had a scheduled C section almost 18 years ago. They would not let me go more than a week ahead. I chose the day I did for 2 reasons. I got to have the Dr I wanted from the large practice I went to, and I would eventually get to choose if my daughter went to kindergarten or not! (Her birthday is August 31st, and Sept 1st is the cut off date for kindy here in our area! I was thinking way ahead! But mostly I wanted my Dr to do it). I was due Sept 4th.

My daughter was a Frank Breech presentation. They already tried to turn her several weeks before, with no success. It was a bit dangerous for me to deliver her as is. One foot dangling down, the other foot, and an arm all in pretzel formation up high. She actually has a slightly malformed foot as a result of her uterine position that causes pain if she runs or is on her feet too long.

Dad-- you are totally wrong on the time in the hospital for a C section. Maybe a REALLY long time ago, but as I said, I delivered almost 18 years ago. I delivered Wed morning and left before lunch on Saturday!

Bottom line, talk to your doctor to find out how much control you can have with this and still be safe for you and your child.

Best of luck and CONGRATS!

I think you should definitely have the discussion that you want - it never hurts to ask and see what the doctor has to say.

And, the longer babies stay "in", the healthier they are, in general. So I think it is reasonable for you to use this reasoning to ask your Dr. to wait a little longer and maybe schedule just a day or two before your due date. My dr scheduled mine for 5 days before my due date. Of course, I went into labor 2 days before the scheduled day, so my baby picked his birthday anyway. So you never know, even if you do have to pick a date.

If there is a medical reason for the c-section (e.g., placental previa), then you should get it before going into labor. Frankly, with previa, you should have your c-section well before it's likely you'll go into labor.

If there is not a medical reason, why are you getting one? If you wait until you go into labor, you might have to have an emergency c-section. I've heard those are more difficult recoveries. Ask your doc in these words, "Can I wait until I go into labor?" and "What are the potential complications/risks of waiting until I go into labor vs a scheduled c-section?"

ETA: And as has been noted already several times, 8kidsdad is apparently not well-informed regarding c-sections or general hospital/medical practices (and probably motives, as well). Generally, one might stay 2 or 3 days in the hospital with a c-section. And hospitals don't want you to stay for long. With my first, the nurse was trying to kick me out after 2 nights (less than 48 hours). My insurance covered 72 hours, and I was having trouble breastfeeding and was exhausted, so I had my doc make it clear to the nurse/hospital that I should stay another night. With my second I stayed 2 nights. Both were c-sections.

I agree there are too many c-sections these days. But some are still prudent. And what doc in their right mind would _want_ to do a c-section at midnight? If someone is going to cut me open, and I have the choice, I'd prefer it be during the day when our body's natural clock says we should be awake and alert.

Here is an article that i just read where they say that a longer time in the womb increases intelligence. It specifically mentions how this should affect elective c-sections that are scheduled early because of convenience.

I would not wait until you go into labor though because that will make your procedure riskier. I would schedule on the due date or a day after/before. Send your doc this article if necessary.

http://triblive.com/usworld/2135419-74/born-weeks-percent...

You need to consider why you are having a C-section. It might be a bad idea for you to go into labor at all. Emergency C-sections should not be planned. Any C-section taking place after you go into labor would be an *emergency* C-section, because once you go into labor, all bets are off.

Talk to your doctor, and share your concerns. You should not have a doctor you feel uncomfortable talking to about this.

You ask this properly of the doctor by looking him in the eye and confindently discussing why you are having the c-section in the first place (if you don't already know) and discussing the concerns you laid out here. Talk to him about your wishes and if he says it's not possible to wait for labor ask him why. Have this conversation in his office with your clothing on, not in an examination room.

There is a whole lot of mis-information in these responses. Many people just don't look into the truth behind birth in America. If you truly need a c-section it can be a wonderful, life saving operation. Sadly there are MANY unnecessary c-sections being preferformed for a variety of reasons, and yes that includes doctor convenience.

I agree with ALMOST all of 8kids post, I think he's right on many points. The article below from a non-profit that's been around since 1918 lays it out pretty well. Don't we all as Mom's owe it to ourselves to do a little research into what is to be one of the most important moments of our lives?

http://www.childbirthconnection.org/article.asp?ck=10456

Just remember your doctor is not a God. He's a smart guy with a lot of education who makes a good living, nothing more nothing less. He's a human being with flaws and his own agenda just like the rest of us. Don't be intimidated, talk to him about your concerns and if you don't like his answers find another doctor. You and your baby are the customers.

This is another liability issue. Ob's are required to be "immediately available" at VBAC's in case of the rare uterine rupture. This is harder to schedule so they just go with c-sections for convenience or some hospitals won't support. If you would like to have a VBAC talk to your dr about the options at the hospital and if necessary someone else being the one "immediately available" if he/she doesn't want to put his/her schedule on hold during your labor.

If you don't mind having another csection, the idea of scheduling a week in advance is to avoid the scenario above. Also consider the idea of recovering from labor PLUS recovering from surgery. Recovering from one is easier than recovering from both. i.e. your body is less exhausted from a csection surgery that didn't have a long labor in front of it.

Talk to your dr though - you can discuss all the options on your specific situation.

It's your pregnancy, your baby - you do what you want! Tell the doc exactly what you said here. If he argues, tell him it is not up for discussion. You are paying him, he is there for you, not the other way around. You are in control of your healthcare, not the docs.

Good morning - as others have stated, if the C-section is due to medical necessity I'd go with the doctors recommendation.

However - just because you had a C-section with the first it does not mean you must have one with following pregnancies.

I had an emergency C-section with my first and when I was due with my second I opted for a scheduled C-section as I had seen two close family members who tried VBAC with near fatal complications......I've also seen many people who have had successful VBACs.

So, I think it is very realistic for you to have done what you want with your delivery however make sure your doctor knows what you want and speak to him/her about your needs medically, etc.

A long first labor does not mean that your second one will be long. My first labor was 26 hours, and my second was 45 minutes! But, I still wouldn't think it would be a problem for you to ask to schedule the c-section on or closer to the due date. Just talk to your doctor about your concerns.

I have read a lot of the responses. You will get a lot of responses based on opinions that are based on experiences, fear, and joy. I agree that you should talk to your doctor. Why are you all considering a repeat c-section? Was your first based on your body or the baby? If you feel that a c-section at 39 weeks isn't right, tell your doctor. I wanted and did deliver VBAC, when I was talking to different doctors I was told that I could but that I would have to be induced at 39 weeks. It just didn't feel right so I found a naturopathic midwife who would do a natural VBAC - that felt right. If I had gone the other other way I am sure I would have had a second c-section (something I was avoiding) and the baby would have been born 2 weeks before she was ready. Back to your question - if you don't feel like you can talk to your doctor, ask your doctor or request of your doctor, find a new doctor. Having a baby requires open communication from the doctor and the person having the baby. I agree with the person who said that when you have the conversation, be in the office with your clothes on and with your husband/baby's father. Perhaps discuss having another ultrasound at 39 weeks to see how baby is doing. In the end, I think you should go with your feeling (as long as they are from an open minded perspective). As humans we sense what is going on with our body - good or bad - and when we need someone else to help. Good Luck!

Just let your doctor know that you would like to wait until you go into labor on your own, then have the c-section upon arriving at the hospital. You most likely won't have your doctor there to perform, but there's always someone on call, so a doctor will be there to do the surgery. Good luck to you!

I am completely in favor of waiting until the last possible minute. Going into labor and then requesting the C/S seems like the best option, UNTIL you remember that in the case that you go into labor at midnight, do you really want your OB performing major abdominal surgery on you with little to no sleep?
I agree with a PP that scheduling for your due date seems the best case scenario, and then if you go into labor before that, you know your baby was ready to be born, and you just roll with the punches of the timing. OBs perform emergency C/S's all the time at night, so it isn't impossible, just not favorable if you have another option.