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Post by Deleted on Apr 14, 2019 17:41:07 GMT -5
This is a bit long but I want to provide all the details needed for a good answer. A dear friend's daughter is expecting. She's about 2 weeks out from her due date, but the baby is quite large (8 lbs which she said was big for a girl?). At her most recent visit last week the dr. sent her to the hospital for a day of monitoring b/c her blood pressure is spiking intermittently, and told her to leave her job now and go on bed rest. My friend is understandably concerned about her daughter and the baby, but she said a couple of things I'm not sure are totally accurate. I've never been pregnant and know nothing about insurance coverage and modern childbirth practices.
My friend is extremely upset because they won't induce her daughter or give her a C-section at this point but are instead advising patience and bed rest. This is a second child, she delivered the first baby vaginally without issues, and is a robustly healthy 28 year-old active woman (hiking, hunting, camping, etc.). That said, first baby was 10 years ago, this is different daddy, mother no longer smokes and better pre-natal nutrition has produced a much larger baby. My friend asserts that "Obamacare won't pay for C-sections anymore unless the mother's life is in danger" but I don't quite buy that as factual. It's my understanding that there has been a shift in thinking away from C-sections over the last few decades for a variety of reasons. And apparently the policy of this obstetrical practice is to induce only when the woman has passed her due date or for other significant medical reasons.
Can anyone tell me what modern insurance (ACA and others) provides for and what the current medical thought is?
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oped
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Post by oped on Apr 14, 2019 17:52:14 GMT -5
Yeah, I don't think so. I think you get what you need. But yeah, if the baby and mom are in relatively good health they aren't going to induce or do a c section these days. Estimates are just that. It could be 8 lb. Maybe not.
'obamacare' isn't an insurance. I use healthcare.gov. My insurance is Blue Cross. If anything what the legislation did was mandate that all insurance has to cover childbirth... didn't used to be that way...
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NoNamePerson
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Post by NoNamePerson on Apr 14, 2019 17:56:39 GMT -5
She should contact her insurance carrier and get the answers she is looking for. Only they can give her accurate information.
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justme
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Post by justme on Apr 14, 2019 18:01:28 GMT -5
While 8lbs isn't small, it certainly isn't "large enough to require c section just based on size". My tiny SIL pushed out two kids just under and just over 9lbs with no drugs.
I've never heard of ACA not covering a c section - at least one that's needed. But second the comment that doctors are starting to back away from doing c sections for every little thing.
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Post by The Walk of the Penguin Mich on Apr 14, 2019 18:05:51 GMT -5
It really doesn’t matter what other insurances do, but what the daughter’s insurance covers. As mentioned, the push has strongly gone against elective C sections over the last few decades or so. This has absolutely nothing to do with the ACA.
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NoNamePerson
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Post by NoNamePerson on Apr 14, 2019 18:10:24 GMT -5
It really doesn’t matter what other insurances do, but what the daughter’s insurance covers. As mentioned, the push has strongly gone against elective C sections over the last few decades or so. This has absolutely nothing to do with the ACA.
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Post by Deleted on Apr 14, 2019 18:19:21 GMT -5
Thank you all for sort of confirming my thoughts. I totally get my friend wanting the safest and easiest path forward for her daughter based on the science of her time and her own personal experience. I'm crying ugly right now because I just got a call that another dear friend, great pregnancy, full-term, etc. delivered last night and that sweet baby girl didn't make it. Life is so tentative and fragile that my heart goes out to every person who ever took that leap of faith to conceive
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alabamagal
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Post by alabamagal on Apr 14, 2019 18:26:41 GMT -5
If the doctor recommends a c-section the insurance will pay. That is different than a mom requesting one for convenience.
8 lbs is not that big. The main issue is the size of the baby’s head and position. Head down, chin tucked in and facing down (I think) are what is good for delivery. Also the space between the moms pelvic bones matters, but you cannot tell by how tall, waist size or athletic the mom looks.
All my babies were 9-10 pounds with big heads and delivered vaginally.
My DD had a c-section with a smaller baby because she was not positioned correctly so that the chin would tuck in.
Blood pressure spikes are nothing to mess with. If the doctor says bed rest then that is what is needed.
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Post by Deleted on Apr 14, 2019 18:27:11 GMT -5
Thank you all for sort of confirming my thoughts. I totally get my friend wanting the safest and easiest path forward for her daughter based on the science of her time and her own personal experience. I'm crying ugly right now because I just got a call that another dear friend, great pregnancy, full-term, etc. delivered last night and that sweet baby girl didn't make it. Life is so tentative and fragile that my heart goes out to every person who ever took that leap of faith to conceive I am so sorry for your friend. My DIL had to deliver a child that died before it was born. It is heart-breaking.
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NomoreDramaQ1015
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Post by NomoreDramaQ1015 on Apr 14, 2019 18:28:16 GMT -5
There has been a real push against voluntary C sections. The hospital I gave birth at requires now doctors provide a ton of paperwork to prove it's medically needed for mom or baby.
8lbs is not big it's pretty close to average nowadays. Weight has nothing to do with needing a Csection. My OB has delivered 13 lbs babies vaginally no problems and has mothers with tinier babies need intervention.
Medical advice has changed drastically when it comes to pregnancy and delivery. Especially in 10 years. It has zip to.do with the ACA.
Even if insurance covers it which they do that is not a valid reason for doctors to perform one nowadays. That's actually a case that has been made against voluntary C sections because studies show the fact they get more $$$$ compared to vaginal births is a part of why they became so popular.
As long as baby and mom are medically healthy labor will be allowed to take its course naturally.
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jelloshots4all
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Post by jelloshots4all on Apr 14, 2019 18:30:17 GMT -5
This is a bit long but I want to provide all the details needed for a good answer. A dear friend's daughter is expecting. She's about 2 weeks out from her due date, but the baby is quite large (8 lbs which she said was big for a girl?). At her most recent visit last week the dr. sent her to the hospital for a day of monitoring b/c her blood pressure is spiking intermittently, and told her to leave her job now and go on bed rest. My friend is understandably concerned about her daughter and the baby, but she said a couple of things I'm not sure are totally accurate. I've never been pregnant and know nothing about insurance coverage and modern childbirth practices. My friend is extremely upset because they won't induce her daughter or give her a C-section at this point but are instead advising patience and bed rest. This is a second child, she delivered the first baby vaginally without issues, and is a robustly healthy 28 year-old active woman (hiking, hunting, camping, etc.). That said, first baby was 10 years ago, this is different daddy, mother no longer smokes and better pre-natal nutrition has produced a much larger baby. My friend asserts that "Obamacare won't pay for C-sections anymore unless the mother's life is in danger" but I don't quite buy that as factual. It's my understanding that there has been a shift in thinking away from C-sections over the last few decades for a variety of reasons. And apparently the policy of this obstetrical practice is to induce only when the woman has passed her due date or for other significant medical reasons. Can anyone tell me what modern insurance (ACA and others) provides for and what the current medical thought is? Drs can't always predict babies weights. Both mine were predicted at 7lbs. I had an 8.9lb and 9lb baby. Both naturally but thank goodness with an epidural!! I can't answer the insurance question. Each provider is different
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TheHaitian
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Post by TheHaitian on Apr 14, 2019 18:40:52 GMT -5
My DD just turned 2 so my information is not recently accurate and we are about to start trying for #2.
From what I understand there has been a big push against c-section because Dr’s were recommending them like prescribing antibiotics ... because : A) padded their overall gross (more money) B) save time : you don’t have to wait for a baby to come... you go in, get it out, still have time to make T time. C) less headache of some sort.
Now unless the mother and/or child life is in danger they do not go the C-section route; it is a last resort. But yes if you need it, must have it: your insurance will most likely cover it.
We almost lost DD at 19 weeks, had a scare at 28-30 weeks and she came 5 weeks early at 35 weeks. And even then when we got to the hospital they kept my wife there longer trying to keep DD from coming and get closer to 40 weeks.
After 3 days we had enough and there was no way we were going to do this for days/weeks (they were planning to keep her there as close to 40 weeks as possible). So we said if the baby is fine (which they were telling us): my wife is fine and obviously DD did not want to stay in there anymore ; let her out. The Dr respected our wishes and moved DW to the birthing room, 2-3 pushes a couple of hours later DD was here.
Summary 1) C-section is now last resort 2) they will do everything they can to keep the baby cooking as close to the due date as possible 3) they only induce if past due date or putting mom/child or both at risk.
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giramomma
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Post by giramomma on Apr 14, 2019 19:10:55 GMT -5
One thing about ultrasounds is they can be off, too, in terms of weight. I would trust a Level 2 Ultrasound (often done at hospitals) a bit over ultrasounds done in a OBs office. However, a normal pregnancy wouldn't require the use of a Level 2 ultrasound.
I also don't think 8lbs is that big. One of my kids was 8lbs, one was over 8.5lbs. Two were under 8 lb, but not by much, a half pound or less. As for scheduling interventions, it depends on the OB.
My first OB wanted to schedule my induction after my 20 week ultrasound came out OK. He also told me I "HAD" to get testing that I really didn't need. He also offered that my first choice should be termination if we found out Miss M had downs in the first trimester. He was doing all these things to protect his ass rather than think of what medical care I might need. I would not wish that kind of OB on anyone.
Also-to amend Carl's #3, if a woman is younger than 40, they will let her go to 41 weeks before talking inducing. Once a woman hits 40, the risk of stillbirth goes up very slightly (think a couple hundreths of a percent), so they then like to induce between 39 and 40 weeks.
Since nothing was happening, I did end up scheduling an induction (on a weekend to make childcare easier!) a day or two before my real due date for #4. The decision wasn't made until I hit 39 weeks, though. I would be worried about PIH and preeclampsia. If the drs are decent, I'm sure they would have done their due diligence in testing for these things.
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billisonboard
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Post by billisonboard on Apr 14, 2019 19:24:17 GMT -5
This is a bit long but I want to provide all the details needed for a good answer. ... ... this is different daddy, ... I laughed when I read this.
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Post by Deleted on Apr 14, 2019 19:33:42 GMT -5
This is a bit long but I want to provide all the details needed for a good answer. ... ... this is different daddy, ... I laughed when I read this. Just the facts here. First one was little skinny dude, this hubby is taller and well-insulated.
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justme
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Post by justme on Apr 14, 2019 20:14:10 GMT -5
I laughed when I read this. Just the facts here. First one was little skinny dude, this hubby is taller and well-insulated. Bahaha all those jokes lily made on how i met your mother just popped in my head.
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Mardi Gras Audrey
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Post by Mardi Gras Audrey on Apr 14, 2019 22:24:51 GMT -5
Your friend doesn’t know what she is talking about. Insurance most definitely does cover csections. I just had my second child (in feb) and had a csection with no insurance issues. My first child (2 yrs ago) was also csection. Had blue cross blue shield first time around and united health second. The second time as a scheduled one (dr gave me a choice of vaginal or csection, I picked scheduled csection,, kid came 2 weeks earlier than scheduled cs).
I also have a coworker with kaiser who had a scheduled csections without issues.
The info on from other posters about going away from csections is spot on, though. Mine and my coworker who were scheduled were because we had already had one. Both of us had our first children 2 years ago and had emergency csections after being in labor for about 24 hours. In neither case were they scheduled for the first ones or for our convenience.
My sister in law had her first child last week. She went 2days past her due date and they still hadn’t induced her or did a csection. She is healthy and in her early 30s. I think they would have induced if she had been about a week later.
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Mardi Gras Audrey
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Post by Mardi Gras Audrey on Apr 14, 2019 23:03:56 GMT -5
I wanted to add that they will try to keep the baby in as long as it’s safe. I know when I was in labor 2 years ago, they had posters all over the labor and delivery area talking about how the baby needed all 40 weeks to develop and it wasn’t good for the baby to come early. They may be trying to get her as close to her due date so the baby has more time to develop.
Off topic: I hated those posters and found them very depressing. If u are at l&d in labor, it usually isn’t a choice at that point so u are just making women going into labor early depressed and anxious about their baby being born too early (at a time when u probably want ur patient to be as relaxed as possible). I meant to write the hospital and tell them that...
Also, the choosing a caection seems to vary by region a bit. I am in CA and my doc just let me decide for the second (he didn’t seem to have preference but did mention if I had a second caection, would need to have another for any addl kids). My cousin in Chicago had her second 2 years ago and her doc wouldn’t schedule her for one even though she had an emergency one with her first (4years ago). The doc wanted her to have a vaginal (VBAC). She ended up laboring for like 36 hrs and then having a second caection anyways. She was not happy with her doc.
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wvugurl26
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Post by wvugurl26 on Apr 15, 2019 6:35:46 GMT -5
It might depend on the area. I know two people on the east coast who had scheduled maternal choice c-sections. Their kids are 4 now.
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happyhoix
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Post by happyhoix on Apr 15, 2019 7:52:36 GMT -5
I agree about doctors getting away from doing c sections just to be able to schedule the delivery or avoid the stress of labor. Back in the dark ages (30 years ago) when I had DS, the wife of one of the hospital's doctors was having a C section, and there was a party going on in her room down the hall from me - the room was supposed to be for the 'natural birth' moms, but the doctor pulled strings (it was the nicest, largest room), invited a bunch of friends, and they were all in there drinking champagne waiting for the C section to be completed. C section was scheduled because her OBGYN was going on vacation and she wanted him to delivery the baby. Nurses were very annoyed. I remember at the time reading the statistics comparing the US to other nations, and we had a crazy number of C sections compared to everyone else. It's a good thing we've moved away from that. I was two weeks late and spent a day being induced and in labor, but when DS started having stress, we ended up with a C section ourselves - and I'm sure they would still do that. For an insurance company to insist on no C sections would be opening themselves to endless lawsuits, IMHO.
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TheHaitian
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Post by TheHaitian on Apr 15, 2019 8:13:10 GMT -5
I wanted to add that they will try to keep the baby in as long as it’s safe. I know when I was in labor 2 years ago, they had posters all over the labor and delivery area talking about how the baby needed all 40 weeks to develop and it wasn’t good for the baby to come early. They may be trying to get her as close to her due date so the baby has more time to develop. Off topic: I hated those posters and found them very depressing. If u are at l&d in labor, it usually isn’t a choice at that point so u are just making women going into labor early depressed and anxious about their baby being born too early (at a time when u probably want ur patient to be as relaxed as possible). I meant to write the hospital and tell them that... Yep they did that for us too... my wife went into labor or he water broke on a Thursday and I believe that was 34 weeks and 3 or 4 days. She was put on some drugs that would delay the labor. By Sunday we both were over it and not planning to stay 5 more weeks in the hospital. They confirmed DD was perfectly fine, DW was fine. So our question was why delay it? Just because they like them to cook longer. Ok was she viable? Yes... Having had 2 close calls (and possibility of miscarriage) we were in countdown mode since 19 weeks on; countdown first to 23 weeks increased her chance of survival. And every week afterwards up to 32 weeks was a blessing. At 35 I was like she did her part; she made it that far and she is ready to get the hell out. Also I don’t think they take the mothers “mental health” into equation. Every passing hour/day in that hospital made my wife more anxious, more miserable and more worried something was going to go wrong. And it is not like she could rest being in a teaching hospital and people coming in and out all throughout the day and night. Last the reason I called it and had enough was I felt they were playing God with my wife and daughter’s health putting it under unnecessary risk. It was like a game to them; as long as she doesn’t get worse (or the baby) let’s keep her like that. I was not willing to seat around and wait for the situation to get worse before they decided it was time for the baby to come. Our little miracle was born on 01/15/17 exactly at 35 weeks, she was perfect then and a little 2 years little she is still perfect!
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geenamercile
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Post by geenamercile on Apr 15, 2019 10:04:03 GMT -5
Carl we had something similar with YDD. I was going in for daily blood pressure checks and was just getting anxious. We were at 38 weeks and some. Over all I just had a feeling that she needed to come out, my body wasn't being a safe place anymore. We started with an induction but ended up with a c-section because she was breached too. It was covered.
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travelnut11
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Post by travelnut11 on Apr 15, 2019 12:11:43 GMT -5
I wanted to add that they will try to keep the baby in as long as it’s safe. I know when I was in labor 2 years ago, they had posters all over the labor and delivery area talking about how the baby needed all 40 weeks to develop and it wasn’t good for the baby to come early. They may be trying to get her as close to her due date so the baby has more time to develop. Off topic: I hated those posters and found them very depressing. If u are at l&d in labor, it usually isn’t a choice at that point so u are just making women going into labor early depressed and anxious about their baby being born too early (at a time when u probably want ur patient to be as relaxed as possible). I meant to write the hospital and tell them that... Also, the choosing a caection seems to vary by region a bit. I am in CA and my doc just let me decide for the second (he didn’t seem to have preference but did mention if I had a second caection, would need to have another for any addl kids). My cousin in Chicago had her second 2 years ago and her doc wouldn’t schedule her for one even though she had an emergency one with her first (4years ago). The doc wanted her to have a vaginal (VBAC). She ended up laboring for like 36 hrs and then having a second caection anyways. She was not happy with her doc. Agree on the stupid posters. There was an insert in my maternity folder with a picture of how the baby's head grows in the last few weeks of pregnancy which is just stupid because obviously the baby's head will also grow OUTSIDE as well. Stuff like this just makes the moms feel more stressed and guilty if their babies come early. Mine were early term (38+0 and 37+1) and I felt bad they didn't get to cook a couple of more weeks but why? They were totally healthy when they were born and are totally healthy now. On the other hand I know several women who've lost health full-term babies because their docs made them go overdue. So unnecessary.
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NastyWoman
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Post by NastyWoman on Apr 15, 2019 12:48:46 GMT -5
I agree about doctors getting away from doing c sections just to be able to schedule the delivery or avoid the stress of labor. Back in the dark ages (30 years ago) when I had DS, the wife of one of the hospital's doctors was having a C section, and there was a party going on in her room down the hall from me - the room was supposed to be for the 'natural birth' moms, but the doctor pulled strings (it was the nicest, largest room), invited a bunch of friends, and they were all in there drinking champagne waiting for the C section to be completed. C section was scheduled because her OBGYN was going on vacation and she wanted him to delivery the baby. Nurses were very annoyed. I remember at the time reading the statistics comparing the US to other nations, and we had a crazy number of C sections compared to everyone else. It's a good thing we've moved away from that. I was two weeks late and spent a day being induced and in labor, but when DS started having stress, we ended up with a C section ourselves - and I'm sure they would still do that. For an insurance company to insist on no C sections would be opening themselves to endless lawsuits, IMHO. Ha, at least I wasn't the only one, but it was another decade before you: DS1 was due 5/18 and I wanted him to be a few days early to have him by mother's day → he was born on the 28th and I had to wait for almost a full year to have my first mother's day. Fast forward almost 4 years: DS2 was due on 3/9 and his father (xH) wanted him to be born on 3/7 to share their birthday. Well... DS2 was even more stubborn than his brother and he was born on the 28th as well. They were just under/over 9lbs respectively and 22 inches tall. They were also both born on a Sunday so there definitely was no "I'm not working on a Sunday" going on there
Lastly: they were born on different continents so it was not a matter of "local custom" or doctor preference...
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WholeLottaNothin
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Post by WholeLottaNothin on Apr 15, 2019 13:08:27 GMT -5
I think I have the same birthday as your DS2 lol, just based on the info in your post. I mean exact same birthday.
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NastyWoman
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Post by NastyWoman on Apr 15, 2019 13:11:36 GMT -5
I think I have the same birthday as your DS2 lol, just based on the info in your post. I mean exact same birthday. I knew I liked you for a reason
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NomoreDramaQ1015
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Post by NomoreDramaQ1015 on Apr 15, 2019 13:16:23 GMT -5
So much of this seems doctor/hospital dependent too. When I gave birth to Gwen my OB would not let me go pass 40 weeks, period. Meanwhile when I had Abby at a different hospital as long as we were both healthy the midwife said it was up to me if I wanted to keep going or move things along at 40 weeks but she wouldn't let me go longer than 42. I've heard of doctors that will let you go longer than that but I'd have murdered them. Both would not stop labor if I went into it naturally at 35 weeks but were not going to move things along if it stopped either. The doctor when I had Gwen told me that they used to go ahead and scoot you along at 35 weeks but hospital policy had since changed and they risked getting in trouble if there wasn't a "medical reason" to induce at 35 weeks. Since mine stopped I was sent home and then had her at 39 weeks. Abby I went into labor at what the doctors pegged at 35 weeks and since I was already 10 cm she was coming out no matter what they did. Nature took it's course. "Medical reason" seems to be up to interpretation with some doctors going off the deep end one way or another and then there are those in the middle. Same with C-sections I assume. This is hospital policy and then the doctor has to determine how much wiggle room they have in there.
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HoneyBBQ
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Post by HoneyBBQ on Apr 15, 2019 14:16:50 GMT -5
Why does everyone think a C section is awesome?
Babies are MEANT to come out vaginally. A C section is a horrible invasive surgery that takes way longer to recover from. I hope she just lets that baby sit til it's due date and all is well.
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NomoreDramaQ1015
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Post by NomoreDramaQ1015 on Apr 15, 2019 14:25:11 GMT -5
Why does everyone think a C section is awesome? Babies are MEANT to come out vaginally. A C section is a horrible invasive surgery that takes way longer to recover from. I hope she just lets that baby sit til it's due date and all is well. Because we've been conditioned to. Especially older generations. If I had a dollar for every woman who insisted I had to have a C section due to my size I wouldn't have to work. It has nothing to do with my height and weight but try telling people that.
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alabamagal
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Post by alabamagal on Apr 15, 2019 14:37:29 GMT -5
Isn’t vaginal delivery better for baby? Something about beneficial bacteria and squeezing stuff out of lungs?
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