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An organisation dedicated to redressing the balance in caesarean research, communication and maternity care

Risk factors for neonatal hypoxic ischemic encephalopathy in Helsinki University Hospital

During the study period, 73 191 deliveries took place in four study hospitals, the average being 14 638 per year. 112 near-term and term neonates presented with moderate to severe HIE and were admitted to the NICU to receive therapeutic hypothermia. The incidence of moderate to severe HIE in the obstetric population was 1.5/1000.
Altogether, 45% of the neonates (40/88) in the study group were born vaginally, and 65% of these (26/40) were ventouse deliveries. Two neonates were born in breech position. The proportion of elective, emergency and crush cesarean sections were 1.1% (1/88), 15.9% (14/88) and 37.5% (33/88) respectively. Four emergency cesarean sections were preceded by failed trial of instrumental delivery (Figure 1). The mortality of the cooled neonates was 10.2% (9/88). There were no neonatal deaths in the control group.

Planned CDMR (c-section on maternal request) is associated with decreased risk of short-term adverse outcomes, compared to planned vaginal delivery.

”In fact, there is strong evidence that we have indeed passed the point already where planned elective cesarean as a birth plan, is a safer choice for a woman and her unborn baby, than planned vaginal delivery.

”The ideology is that we must not talk about the damage that happens to women in childbirth because it might make some people ask for an elective caesarean.”
”C-section mothers have been told that C-sections are dangerous, even though they pose less risk for babies.”
”Stop glossing over the risks of natural birth to cut caesareans: The vogue for vaginal delivery means women don’t hear enough about its risks. A landmark UK legal ruling might help turn the tide”
”C-sections have done more than any other procedure to save the lives of babies (and mothers). Indeed, it has long been known that C-sections are safer for babies than vaginal birth.”
”All maternal health care providers need to understand and hear the reasons why some women consider pre-planned caesareans the best option for them. This includes understanding the person’s values, fears and concerns”
”Seventy-five per cent of maternity units across the UK are denying women access to elective C-sections, even though it’s actually the safest type of birth there is.”
Women who have a planned caesarean section birth have the lowest mortality rate, new data has shown.

”CONCLUSIONS: All kinds of anaesthesia seem to be safe, but loco-regional blockade shows more advantages on the neonatal outcome also when a conversion is necessary.

”It is a potentially devastating indictment of the rising C-section rate. Most midwifery and “natural” childbirth websites claim that elective C-section triples the rate of neonatal mortality. Mainstream web sites like, and newspapers like The New York Times have repeated the claim. There’s just one problem. It’s not true.”
”But natural birth actually comes with risks, including tearing, haemorrhage and incontinence for the mother and injuries to the baby during labour. So why is it that the vast majority of pregnant women are only being warned about the risks of caesarean sections?”
”Australian researchers found the risk of stillbirth was lower in women who had a planned repeat C-section rather than trying for a natural labour.
Meanwhile, a UK study found the chance of womb rupture was reduced when mothers had an elective repeat section.”

CONCLUSION: Cesarean section does seem to provide survival advantages for the most immature infants delivered at 22 to 25 weeks of gestation, independent of maternal risk factors for cesarean section

”There is no question that aggressive promotion of the ideology of normal birth has led to tens if not hundreds of infant brain injuries and deaths in various hospital trusts around the UK.

”The verdict sends an important message. A healthy baby is not enough.

A woman’s wishes about her own body also count and the desire for a C-section is a woman’s reasonable attempt to prevent damage to her vagina and surrounding tissues as well as future incontinence.

It’s about time that we acknowledge the important right that women have to control their own bodies by opting for a C-section instead of a vaginal birth.”

”New research finds lowest maternal mortality rate with elective cesarean delivery”

”Some of the negative association for C-sections comes because the majority are performed in emergency situations, he said.

Research studies comparing vaginal deliveries with caesareans shouldn’t include C-sections performed only once something’s gone wrong in a natural birth, Murphy argued.

Murphy said planned C-sections in healthy pregnancies actually involve fewer and less-serious risks than vaginal births.”

”Millions are left with life-changing injuries after giving birth — yet are too ashamed to talk about it. Now, as doctors and midwives finally act, a searing exposé of childbirth’s shameful secret”

”You should be able to weigh up the risks, but you can’t if you don’t have the information“

”When people tout “natural birth” as an “empowering choice” (sound familiar?), they conveniently ignore all the women who have been harmed by these practices and for whom giving birth was (completely understandably and legitimately) one of the worst experiences of their lives.

”Women in labour are being denied epidurals by NHS hospitals, amid concern that a “cult of natural childbirth” is leaving rising numbers in agony.”

”The clinician’s role should be to provide the best evidence-based counseling possible to the pregnant woman and to respect her autonomy and decision-making capabilities when considering route of delivery.
”While midwives, and the government, advocate natural birth, many female obstetricians opt for a caesarean when they have their own children. Do they know something we don’t?”

”Planned Caesarean delivery can be the safest option for women who have had a Caesarean in the past, according to new research in PLoS Medicine.”

”Death from a modern elective caesarean in a fit healthy woman is so unusual that the risk can only be guessed at being in the region of one in 100,000 – less than a tenth of that from a road accident.
The truth is that C-sections have saved literally millions of lives and continue to save tens of thousands of mothers and babies in the US alone each and every year. Therefore, I am designating April Cesarean Appreciation Month in honor of the incredible benefits of C-sections.

”The philosophy of natural childbirth is not based on science; it is based on fundamental beliefs about the irrelevance of women’s suffering, beliefs about the ways that women “should” use their bodies, and value that natural childbirth providers place on their (the providers’) autonomy and having their own personal choices mirrored back to them.

The philosophy of natural childbirth is about glorifying and enjoying women’s agony, and that, of course, is nothing more than sadism.”

”But for too long there has been the distinct sense of ideology taking precedence over individual reality, even humanity, with people’s stories being dismissed if they don’t fit in with the happy natural birth narrative.

”Later, after I’d had my son, she told me the truth: her birth was the most horrific thing that had ever happened to her, and that she was in therapy due to the emotional and physical trauma it had left her with.”

Competently done, cesareans and regional anesthesia are the biggest medical advancements in obstetrics to date. They should be celebrated as such.
The philosophy of natural childbirth is not based on science; it is based on fundamental beliefs about the unimportance of women’s suffering. It is based on beliefs about the ways that women “should” use their bodies. And not coincidentally, it is based on the value that midwives and doulas place on their own autonomy, in addition to the satisfaction they gain from having their personal choices mirrored back to them.

”A Bucks County jury has awarded $11 million to a mother who suffered disfiguring and ongoing injuries during the birth of her second child. The lawsuit states that she had requested a cesarean delivery because of a difficult first birth.

”Now pregnant women to be told about the dangers of NATURAL births: Vast majority aren’t warned about risks such as tearing and incontinence”

”Happiest mothers — the ones who actively participate in, enjoy, and fondly remember their deliveries (instead of just praying for it to be over) were the mothers who did not have endless hours of suffering along with painful hours of pushing, and then the discomfort of a tear that had to be repaired while trying to get just the right amount of local anesthesia injected into a very sensitive area.”

 ”I wasn’t comfortable with the lottery I was expected to play when it came to birth, and spent weeks reading up on the risks of both vaginal and surgical methods.”

”It’s hard to imagine anything more disrespectful than telling a woman how she ought to give birth and ignoring what she might want (pain relief, interventions, maternal request C-section), yet this is precisely what campaigns for normal birth do. By campaigning on behalf of a process instead of for patients themselves, proponents of unmedicated vaginal birth are explicitly ignoring the needs and wishes of those patients.”

”CONCLUSION: Perinatal mortality and morbidity in the planned vaginal breech delivery were significantly higher than with planned caesarean delivery. Even taking into account the relatively low absolute risks of vaginal breech delivery, the current study substantiates the practice of individualised decision-making on the route of delivery in a term breech presentation.

”The Health Secretary Matt Hancock has promised an inquiry after an investigation revealed that women are being denied epidurals and pain relief when they request them. Six NHS Trusts were identified where women were refused pain relief when they asked for it and campaigners say some women are left so scarred that they’ve suffered PTSD or even been left too afraid to have more children.

”Cesarean section on request at 39 weeks: impact on shoulder dystocia, fetal trauma, neonatal encephalopathy, and intrauterine fetal demise.”

”The clinician’s role should be to provide the best evidence-based counseling possible to the pregnant woman and to respect her autonomy and decision-making capabilities when considering route of delivery.

”Ellie died because her brain was starved of oxygen during labour and the damage that resulted was so profound doctors said she would spend the rest of her life on a ventilator. It was damage that could, and should, have been avoided.



Tutkimustulosten perusteella ADHD-riski oli suurentunut etenkin, jos lapsella oli vastasyntyneen hengitysoireyhtymä, syntymänaikainen hapenpuute tai hänen äitinsä oli kärsinyt raskausmyrkytyksestä.

”Esimerkiksi syntymäasfyksiaa pitäisi akatemiaprofessori Kai Kailan mukaan tutkia. Maailmassa siihen kuolee vuosittain noin miljoona lasta ja kymmenet miljoonat lapset kärsivät sen seurauksista elämässään.

”Tutkijat havaitsivat, että useammalla kuin yhdelläkymmenestä vaginaalisesti synnyttäneellä naisella oli vammoja lihaksissa, jotka kannattelevat sisäelimiä.

”Synnytys aiheuttaa lähes jokaiselle synnyttäjälle jonkinlaisia repeytymiä.”

”Peräaukon sulkijalihakset voivat synnytyksen yhteydessä revetä, mikä voi johtaa ilman karkailuun, kiireisiin vessajuoksuihin tai jopa housuun kakkaamiseen. Edes leikkaus ei aina auta.

”Havaitsimme, että piileviä sulkijalihasvaurioita esiintyi 23%:lla alatiesynnyttäjistä ja heistä puolella esiintyi anaali-inkontinenssi -oireita. Oireet olivat enimmäkseen lieviä. Keisarileikkausryhmässä piileviä vaurioita ei tullut esiin.”

”Alatiesynnytykseen liittyviä komplikaatioita on tutkittu vähemmän kuin keisarileikkauksen komplikaatioita, ja spontaaniin alatiesynnytykseen liittyvien spontaanien repeämien esiintyvyydestä, paranemistuloksista ja pitkäaikaishaitoista ei ole tuoreita tutkimuksia.”

”Alatiesynnytyksen jälkeen häpyhermon toimintahäiriötä on kuvattu esiintyvän jopa 30 – 80 %:lla synnyttäneistä”

”Albers, Garcia, Renfrew, McCandlish ja Elbourne (1999) ovat tehneet tutkimuksen, jonka mukaan 5 404 Iso-Britanniassa synnyttäneestä naisesta vain 15 % ei saanut jonkinasteista synnytysvauriota.”

”31 % Lontoon naisgynekologeista ilmoitti haluavansa synnyttää lapsensa mieluummin sektiolla kuin alatietä.”

”Synnytyksen yhteydessä naiselle voi syntyä repeämiä, jotka vaikuttavat virtsan- tai ulosteenpidätykseen. Myös lihaksisto on raskauden ja synnytyksen jälkeen usein huonossa kunnossa.
”Saunasynnytys oli hengenvaarallista niin äidille kuin lapselle. Tilastojen mukaan vuosina 1816–1865 lähes yksi sadasta äidistä menehtyi synnytykseen. Vielä 1900-luvun alussa 350 äitiä kuoli 100 000:ta synnytystä kohden.
Tietoa potilaan oikeuksista valita hoitopaikkansa ja oikeudesta hyvään hoitoon:
Choosing Cesarean -kirjan kirjoittaneen gynekologin haastattelu: (Englanniksi, video) (Englanniksi, lyhennetty teksti)
”Toisaalta tiedetään, että alatiesynnytyksessä lapsen kuoleman ja aivovaurion riskit ovat selvästi suurempia kuin keisarileikkauksessa. Lasketun ajan ohituttua nämä riskit suurenevat vielä nopeasti.”
”Leikkaustulokset ovat hyviä ja leikkaukseen liittyvät jälkiseuraamukset ovat harvinaisia.”
”Moni äiti kertoi kaunistelemattoman totuuden kivuista ja muutoksista, joita vartalo joutuu kohtamaan synnytksen jälkeen.”
”Synnytyssalissa on supistusten aiheuttaman kivun ja siitä aiheutuvan huudon vuoksi välillä niin kova meteli, että kätilön tekisi mieli pidellä korviaan.
”Synnytystä on voitu pelätä aiemminkin, mutta siitä ei ole uskallettu puhua. Silloin on vain menty hysteerisinä synnytyssaliin.”
”Lääkärin vastaanotolla potilas voi mennä aivan lukkoon, jos lääkärin käytös on tylyä.”
”Synnytys oli kuitenkin rehellisesti sanottuna yhtä helvettiä. Synnytys jätti syviä arpia mieleeni. Epäonnistuneesta alatiesynnytyksestä jäi kovia traumoja. Traumoja joista en uskaltanut puhua ääneen, koska saimmehan täydellisen pojan ja selvisimme hengissä.
”Moni nainen pelkää, että synnytys vaurioittaa kehoa ja vaikuttaa parisuhteeseen sekä seksielämään.”

”Naiset oli jaettu 40 raskausviikon jälkeen kahteen ryhmään. Toisen ryhmän synnytykset käynnistettiin tarvittaessa 41 raskausviikon täytyttyä ja toisen ryhmän 42 viikon täytyttyä. 

Kaikki menehtyneet vauvat kuuluivat ryhmään, joiden synnytys oli päätetty käynnistää vasta raskausviikon 42 alkamisen jälkeen.”

”Aina kaikki ei kuitenkaan suju suunnitellusti ja synnytyksessä ilmenee ongelmia. Iltalehti pyysi lukijoilta kertomuksia siitä, miten synnytykset voivat mennä pieleen.”

Traumaattiseen synnytykseen liittyy usein tunteita kaoottisuudesta, hallinnan menettämisestä, kauhua ja pelkoa sekä avuttomuuden tunnetta. Synnyttävälle äidille tämä voi tarkoittaa esimerkiksi niin hänen itseensä kuin syntyvän lapseenkin kohdistuvaa pelkoa vammautumisesta tai jopa hengenvaarasta.ämäntilanteet/synnytyskokemus-voi-olla-traumaattinen

”Winnie Øverdalin synnytys ei sujunut suunnitelmien mukaan. Hän repesi täysin ja menetti pidätyskykynsä. Ja sitten iski paha infektio.
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