I’ve been mulling a post for the past few days after hearing a report on WBUR about changes in how elective C-sections and inductions are scheduled in Massachusetts. However, I’ve been reluctant to write it because the subject skirts dangerously close to questions that arise in the abortion debate, and I’d really like to avoid sticking my foot in that particular viper’s nest. The Internet gods have been awfully kind to me of late, and I’d like to enjoy a few more days of goodwill before lousing things up.
But fortune favors the bold, and what’s the point of having convictions if you’re not willing to say anything about them? So here goes…
First, the policy in question:
Many of us know a mom who chose to have her baby before its due date. There are lots of reasons why one might choose to do this: the health of the mom or the baby, her doctor’s schedule, the demands of her husband’s work, or even to hit a specific birthday. But if that perfect day falls before the 39th week of pregnancy, and there’s no medical reason for an early delivery, many hospitals in Massachusetts are saying no, you have to wait.
The number of early deliveries, from induced labor or C-sections, has been on the rise across the country for more than a decade now, including in Massachusetts. One reason is that we’ve come to expect that babies born “a little bit early” will be fine.
“Before the benefit of the neonatal intensive care unit, people were very conservative and would not induce or do repeat C-sections before 39 weeks,” says Dr. Glenn Markenson, the director of maternal and fetal medicine at Bay State Medical Center in Springfield. “But as they saw how well babies were doing with pediatric care, and they were getting pressured by patients because of social situations, there was a creep down from 39 weeks to 38 weeks, sometimes 37 weeks.”
[snip]
“Early-term infants have higher rates of respiratory distress. There are also issues with feeding,” says Dr. Lauren Smith, medical director at the Department of Public Health. “The most recent evidence shows that babies born before 39 weeks may also have developmental issues, so when you add up the increased risks and you weigh that against a situation when it’s purely elective, then you really can’t justify it.”
A growing number of hospitals in Massachusetts, and across the country, are saying no to elective inductions and C-sections before 39 weeks. The change is happening quietly and some new mothers don’t like it.
And now the part that got my blood pressure up:
Lisa Coulouris sits on her hardwood kitchen floor with the Moms Club of Reading baby playgroup.
“The bottom line is women should have 99 percent of the say in what happens with their pregnancy and their bodies,” says Coulouris, who delivered twins eight months ago after complications that led to an emergency C-section. She does not like the idea of hospitals telling women they must carry to at least 39 weeks.
“You’re already out of control of your body, so at least to know if you go to your doctor’s office and say, ‘Look, we’re at 37 weeks, and I feel like I’m ready,’ ” Coulouris says, imagining a case in which a mom would not want to wait. “To know that I would have that choice would just make me feel better. But to take it away from me just adds to the pressure of being pregnant.”
I have no idea how widespread Coulouris’s attitude is. For all I know, she’s just one woman with an opinion, and perhaps she doesn’t speak for any new mothers except herself. That said, I find her comments incredibly selfish and the attitude behind them appalling. The risks to a baby born at 37 weeks are measurably higher than for one born at 39, and I really can’t understand how a woman would elect to expose her newborn to those risks based solely on the notion that it’s her body and thus her choice alone. Feeling like one is ready is not sufficient justification, and certainly by the time of near-term delivery there is another person’s welfare at stake in that decision. The policy of stopping elective inductions or scheduled C-sections before 39 weeks is eminently reasonable.
Since I’ve gone this far, I may as well push ahead and express my greatest qualm with the pro-choice movement. The argument almost always seems to boil down to women wanting to have control of their own bodies, which is a sentiment I agree with wholeheartedly. But saying “my body, my choice” is the most blatant and egregious example of question-begging I can think of in contemporary rhetoric. If everyone agreed that it was just about women’s bodies, I don’t think there’d be much room for debate. But not everyone agrees! Many people believe that a developing fetus is an entity separate from (but inextricably linked with) the woman’s body, and that it has its own moral weight.
One can weigh both of these considerations and still favor the right of women to abort their pregnancies. I do, for the most part. But in order for there to be an honest conversation, there must be an acknowledgment that there is more than just the health of women at play when considering it.
Let me conclude with a request, which may prove redundant when nobody reads this post, much less bothers to comment. But if you did read it (thank you), and if you do choose to comment, please keep in mind that there are people of virtue, intelligence and goodwill on both sides of this debate, and keep your comments respectful. I will have a low threshold for removing comments that do not comply.
When I teach my students what question-begging is, I use two examples: “It’s a child, not a choice” and “My body, my choice.”
There simply is not a morally relevant cognitive difference between a 37 week old infant in the womb and a newborn. The only difference is that it is outside its mothers body. So one could say that the mother is not obligated to carry the child for one second longer than she has to, if you’re willing to say one is never obligated to use one’s body to help anyone else. Barely plausible, but at least possible. But when you think of the discomfort undergone by a mom at the end of the pregnancy (and I am currently 34 weeks pregnant with my third, so I know rather vividly of what I speak), compared to the severity of the health risks to the infant, it really does take a certain moral blindness to decide that back pain and difficulty getting around trump consideration of the infant’s interests in health.
A view that says it’s permissible to completely disregard the interests of athe 37 week old fetus while (it is hoped) acknowledging the interests of a newborn has some further ‘splainin to do. Because again, what is the morally relevant difference? A mother is obligated to use her body in some way to aid her newborn (even if its leaving her at a fire station instead of neglecting it). For what it’s worth, I think finding a morally relevant difference can’t be done. Either bite the bullet and say it’s permissible and therefore disregarding the interests of the newborn is permissible, or find a plausible point earlier in pregnancy for saying that the infant is not worthy of moral consideration.
So, in short, I agree 🙂
Personally, I draw the absolute, Kantian line at about two years of age. Before that it is entirely incumbent on the parent to decide based on the interests of the infant — but I’ll allow that there might be times that the interests of the infant are best served by death.
Now if I was to be a bloodless libertarian (RonPaul), I’d draw the line at three years, because then the kid’s a worker.
But Kantian autonomy doesn’t work for a two-year-old. They don’t have the requirements for Kantian morality (I.e., rationality). If my 4-year-old wants to eat only candy or doesn’t want to get a shot, beneficence should trump his consent.
By the same token, you do think the kid’s interests should be taken into account before two….so it isn’t entirely the parent’s choice (I’m assuming you don’t think it’s okay for a parent to leave a one year old in the house alone to go on vacation).
not kantian autonomy, kantian morality — White and Black. Sorry, didnt’ realize it would be unclear.
Yes, of course the kid’s interests should be taken into account! But it’s still the parent’s decision.
Well now I know why I love you!! Okay, knock it off Bozo–seriously, I loved you last post, especially coming from a mom to be at 34 weeks. Elizabeth, I wish you and your baby all the best of health and happiness. I think my mom was trying to see if there was a legal precedent to abort a 15 year-old child for her own sanity. Bye.
Mr. Saunders,
I agree with almost everything in your post. (I’m mulling over the early inducement of pregnancy….not that I disagree, but I just haven’t thought about it, and what you say seems to make sense.)
You stated my (pro-choice) position almost completely when you wrote:
That’s Dr. Saunders, Pierre. You have to work very, very hard in this country to earn that degree and Dr. Saunders has certainly earned the respect to be addressed with that title. He’s sincerely humble and might not even care, but it’s just common courtesy. While he and I certainly have our disagreements I hope I’ve always been respectful in discussing them.
Pierre, I don’t mean to suggest you’ve ever been disrespectful toward Dr. Saunders–I just pointed out medical doctors in the United States should always be properly and politely addressed as Dr.
On the one hand, I regret if anyone is offended.
But on the other hand, I aspire to live in a world where I call people with whom I am not close friends or at least friendly acquaintances by “Mr.” or “Ms.” I confess that doing this makes my forms of address rather stilted and even cloying, and I also confess that I don’t always observe this in practice. But I try to keep this as an ideal. If Mr. Saunders really prefers to be called “Dr.,” then I would have to decide to start calling him “Dr.” or simply refrain from commenting, and I’m not sure, now, which I would choose.
And I don’t deny that one has to work very hard to become and remain a doctor, especially a talented, caring doctor, as the author of this post appears to be.
Oh for mercy’s sake, Pierre. I couldn’t possibly care less what you call me. I would consider this site impoverished if you refrained from commenting. If I turn into the sort of unalloyed asshat who expects people to call me by a specified title, especially on a blog where I don’t even use my real name, then I would be heartily undeserving of thoughtful readers such as yourself.
I didn’t mess with Bozo’s comment because I try to leave well enough alone when I can, but I would sincerely regret doing so if it caused hard feelings on your part.
You know that Bozo is Heidegger/whoever-he-is-now, right?
I know. I tend to delete so many of his comments that I’m trying to be more charitable and let them slide if they’re not flagrantly incoherent or offensive. I’d hate to think letting this one stand cost me a commenter, though.
First, thanks for the kind comment.
Second, I apologize for engaging someone who I knew was probably a troll.
Third, maybe I should get off of my high horse and start calling MD’s “Doctor.” (However, I’ll never–at least not ungrudgingly–call a history PHD-holder “doctor,” and I undertake not to demand anyone else call me doctor if/when I finally finish my dissertation.)
G-d, it must really suck being a doctor, sometimes? I vehemently disagree with the whole idea of paternalistic doctors… but, dammit, there’s a kid involved here. If the mother isn’t coming up with something compelling, what can you do but say “I think this is immoral — here are my reasons, and I’ll refer you to someone else…”?
This is that horrid vaccination issue (where parents are putting everyone in danger), writ stark and bold.
My sister and I were not of woman born but from our mother’s womb untimely ripped.
I came out right on time (I was older) and was going to be buttocks breech were I not caesarian.
My sister, however, had an inconvenient birthday (smack dab in the middle of the doctor’s vacation) and so she was caesarian a week and a half early because that best fit everybody’s schedules.
(Looking at that story written down, it strikes me as absolutely crazy and, surely, medical science would never have thought stuff like that would be anything close to appropriate.)
I assume being king of Scotland offers ample time for mindless diversions?
You wouldn’t believe the people who feel entitled to a piece of your time.
More money: More problems.
You can’t forget the true, last King of Scotland, Idi Amin Dada now, can you? Do you remember the stories of mass atrocities and slaughter being committed during his reign as “Field Marshall” Amin and the absurd explanations about how they occurred? Like, “bus crash kills over 100,000 in Uganda”. Or, “thousands starve to death over weekend due to lack of sugar”…etc
Tsk, Tsk, Dr. Saunders. You need to brush up on your Shakespeare. MacDuff was from his mother’s womb untimely ripped, but he never became King of Scotland.
My stars and garters! You’re right!
*hangs head in shame*
My younger son was an elective C-section due, primarily, to the difficulties encountered in our older son’s birth (he was an emergency C-section after 18 hours of unproductive labor). Anyway, I wanted the younger son’s middle name to be MacDuff (for the above reasons) but she nixed it emphatically.
By the way, that bit never made sense to me in in Lord of the Rings:
“Not by the hand of man will I fall!”
“OK, I’ll find an elf. Or a dwarf. Or an ent. What, is this supposed to be hard?”
I kind of enjoy the mental image of the Nazgul getting stomped by an ent.
This makes even less sense on the Discworld.
“I don’t know how we’ll nab him, Captain Vimes. There’s a proffersee that he’ll never be captured by any man.”
“‘Any man’, Sergeant Colon? I suppose we’ll have to send Angua, then. Or Detritus. Or Dorfl. Or Cheery, or … oh, what the hell, go fetch Nobby.”
That’s not fair, Nobby is a man, he has the official paperwork to prove it.
But the mere fact that he needed it still raises questions and besides, he still looks like a…. erm what does he look like anyway?
Also, I have an alternate scene. The Nazgul arrives at the university:
Nazgul: MOVE ASIDE MONKEY
Librarian: Ook?
My money would be on the Archchancellor. He’d probably assume they’d just crawled out of the Unreal Estates and make Ponder clean them up.
The problem is that Discworld already did that joke, in the book where they introduced Angua, in fact.
(and if you think you know what I’m talking about, noooo yoouuuuu doooooon’t!)
Was Idi Amin a Dadaist?
Nicely done.
Wait a minute, now—Mike, I assume your compliment was for one of the above readers. If not, I’m in shock, and thanks.
I’m curious about how medical ethics come into play here. Suppose you were ask to induce at 37 weeks for a reason you found non-compelling. As a doctor, are you bound to say “That would place the baby at risk, and thus I must refuse”, or is this a gray area where the mother’s and baby’s interests are both taken into account?
Were I an OB, my reply would be something along the lines of “Due to increased risks of health problems at earlier gestational ages, we do not schedule elective deliveries before 39 weeks” and make it a blanket policy.
The hospital where I deliver has a policy of no elective C-sections before 39 weeks. I know my OB wouldn’t. I think that’s getting to be more common practice.
This was a pretty big thing here in my neck this summer, but here it was the right that was demanding the State step in to force private hospitals to allow women to choose an early due date.
This was my very first ever League post:
https://ordinary-times.com/blog/2011/08/08/on-movement-conservatism-and-labor-no-the-other-kind-of-labor/
I am so sorry I overlooked your very first LOOG piece and didn’t comment! (Typically excellent writing, by the way.)
It astounds me that movement conservatives, supposed champions of the unborn, would have created a furor over a similar policy in Oregon. Simply astounding.
When I reread it this morning, I realize I wrote something to the effect of “I have Russell chimes in on this…” And here we are! Which is pretty cool.
Re: “The bottom line is women should have 99 percent of the say in what happens with their pregnancy and their bodies,”
The absurdity of this statement is reflected by the easy and very snarky rejoinder: “Okay, here’s a scalpel. Knock yourself out.”
I mean, come *on*. Whenever you engage in any activity that requires participation by a highly trained individual, you don’t have any goddamn right to try and trump that highly trained individual’s expertise. It *is* an Appeal to Authority: you’re making *yourself* the illegitimate authority. You’re not a doctor!
no, but you still have the right to make a morally abhorrent decision. it’s still your body and your baby
You can make all the decisions you want.
Nobody else needs to operationalize them for you.
You dont have the right to make all kinds of morally abhorrent decisions. Roughly speaking, certain kinds of morally abhorrent decisions like killing people (except in self defense) and even less abhorrent ones like taking other people’s stuff is considered illegal. i.e. you dont have the right to do them
There are some restrictions that are placed on what people may legally do. Now, this does not mean that theyare forbidden just because they are morally bad. Rather, many of the features of what would make these actions bad also indicate that we should make them illegal. They key thing is this. The kinds of reasons that make it the case that I shouldnt do something and the kinds of reasons that make it the case that something should be illegal can come apart in both directions. So, it is possible to be justified in restricting abortion even in cases where abortion is morally permissible.
It’s entirely possible to make a utilitarian argument that supports abortion but denies premature-for-convenience.
In an abortion, the intended outcome is a dead infant. (harsh statement, but that is the idea.) Methods, procedures, and conditions that would have a strong negative effect on the infant’s health and development aren’t a a problem.
In a delivery, you’re trying to end up with an infant who’s at the baseline level of health. And premature infants aren’t at that level. That they can get there with massive amounts of medical intervention doesn’t mean that they were healthy and viable at the time they left the uterus.
+1.
‘Look, we’re at 37 weeks, and I feel like I’m ready,’ ”
She feels like she’s ready? How can she possibly think it’s about whether she’s ready rather than whether her infant is ready?
I’m agreed with Dr. Saunders. I can’t go as far as Patrick and say you don’t have any right to trump the expert’s decision (the mother’s body is still involved, after all), but the doctor certainly has the right to refuse. (And after all, if it goes wrong, he’s the one likely to be blamed via lawsuit.)
Oh, I didn’t mean to imply “any” right.
But the “99%” thing is just absurd.
With your “nobody else needs to operationalize it for you,” I think we’re in full agreement.
Further:
I can imagine a set of circumstances wherein a 37 week old may indeed be recommended for a c-section. A risk analysis is a risk analysis: the risk that you’re going to do harm to the infant is (Doc, correct me if I’m wrong here) understood well enough for a doctor to give a list of reasonable probabilities and outcomes.
The question is, what are you comparing it to? What risk are you alleviating by having the pregnancy early?
There are several health conditions that warrant an early delivery. One easy example is preeclampsia. Nothing in this policy would prevent an OB from performing an induction or C-section early if there were a medical need.
Absolutely true. My middle child was c-sectioned 6 weeks early. Because of placenta previa it was necessary to protect the health of both my daughter and my wife. So if 6 weeks early, where the risk is greater, then certainly 2 weeks early.
And to be fair, convenience is a benefit that we all daily weigh against risk. But here the mother is the one getting the benefit and the infant bearing most of the risk.
By the way, if you’ve never seen a c-section, it’s pretty fascinating, if you have a strong stomach.
Three little words: “exteriorise the uterus”.
You don’t necessarily think “take out everything that is inside of a woman, find the baby, and then put everything back”.
My mom asked the anesthesiologist “how am I doing?” and he said “you look like an open can of Campbell’s Soup.”
Ah, the past is another country.
I have been to many, many C-sections and… I cannot hear those words being spoken today.
No, but you’re going to think it next time you’re at a c-section.
By the grace of God, my current job does not require me to attend them. (Not a small consideration when I took it.)
My abiding memory is 1) the doctors hauling on my wife’s cut open torso so hard that I was sure her skin was going to rip all the way around her body, and 2) the doctor’s arm disappearing inside my wife up to his shoulder, with me wondering when his hand was going to pop out of her mouth and wave at us.
Fortunately I’m fascinated by such stuff. I have a video of my stomach ulcer surgery, which is really cool to watch when you’re under the influence and listening to Pink Floyd.
I’m pretty sure I would have made a good EMT.
My wife doesn’t brag about her accomplishments, so sometimes I do it for her. With Dr. S’s indulgence, this will be one of those times.
One of the proudest moments of my wife’s career was when she performed a crash c-section in roughly a minute at 4am while (a) 20 hours removed from sleep, (b) without the crash c-section kit, and (c) without a trained assist. Healthy mom, healthy baby.
While my wife’s career has proven inconvenient in many respects, it’s hard not to be honored to be the man that such an amazing woman chose to spend her life with. It can take me more than sixty seconds to swap RAM out of a computer.
Absolutely awesome.
Will… dude… wow.
I have not much to add to or argue with the original post. Well done, doc.
One other thing worth stressing is that premature babies are expensive and complicated, even when the baby turns out just fine and there’s “no harm done” (though, we don’t always know what harm may have actually occurred). They can require extra care and always require much more monitoring. So a patient that asks a doctor or a hospital to pull a baby out early aren’t just asking the doctor to cut her open, but also asking for extra services (which can mean extra money if they get paid for it) and fiscal liability (if something goes wrong, or bill payment becomes a problem). My wife’s hospital doesn’t do early inductions at all, even when medically indicated, primarily because they don’t have the NICU for it.
More broadly, this is an area of particular interest in the Truman-Himmelreich household. My wife has a decided anti-interventionist philosophy, preferring that nature be allowed to run its course (even after 37 weeks) absent medical indication. This is rarely a problem (with patients, at any rate), even with the TBPs. In fact, even with her philosophy, she runs into patients that want to wait it out past the point that Clancy is ready to Cesarian. I could see it being a cultural thing, though, between Massachusetts and where we live.
Thanks, Will.
My wife has a decided anti-interventionist philosophy…
Your wife and I have a philosophy in common, then.
You know, this is actually an interesting depiction of how increased capability creates increased expectations, leading to increased costs.
Saunders describes how our ability to keep premature infants alive is leading mothers to insist that they be prematurely delivered by artificial means (C-section or induction). Truman points out that keeping premature infants alive is extremely expensive due to the intensive support required.
And this is why we “spend so much” on healthcare. You get the flu and don’t go to the doctor, I sprain my wrist and don’t go to the doctor, Mama spends ninety thousand dollars having her baby at 37 weeks and keeping it alive, and between us our per-capita healthcare spending is thirty thousand dollars a year and you’ve still got the flu and I’ve still got a bum wrist.
The really interesting question is whether the rest of us may appropriately tell Mama who wants to induce labor at 37 weeks, “No, you can’t do that.”
We seem to want to say that certain reasons (e.g., birthday selection) are too frivolous to justify such a decision, or at least such a decision made at in a manner that requires my flu-stricken butt and your bum-wristed pocketbok to shoulder some of the expense for that decision. But, if Mama has $90K on her own and wants to spend it on that, my instinct is to say, “Go for it,” and if the scenario is “Mama’s gonna die if we don’t do this,” then yeah, maybe I’m good with shifting the burden of that expense to the public and therefore partially to myself.
The pro-choice rationale breaks down here, which lends an interesting facet to this discussion. But I think even more interesting is that if we go along with the moral instincts that the motive behind sometimes regulating and sometimes not regulating this procedure relates to the motive for the procedure itself — that early inducement for birthday selection is appropriately prohibitable, but early incudement for preservation of life is not only acceptable but in some manner morally compelled — doesn’t that line of thinking necessarily ultimately lead us to the Death Panels that Sarah Palin warned us about? (And if so, why are the Death Panels such bad things?)
“The really interesting question is whether the rest of us may appropriately tell Mama who wants to induce labor at 37 weeks, “No, you can’t do that.” ”
Sure we can! There are plenty of things that doctors won’t do without a pressing need. Try finding a doctor to amputate a healthy limb, for example. (I was just looking for this friend of mine, okay? He had, like, an interest in amputation. It totally wasn’t ME.)
The doctor can say “artificial delivery at 37 weeks has serious health effects on the baby, both immediate and long-term, and I cannot in good conscience perform this procedure.”
On the other hand, if the mother has $90K and a doctor who’s willing, then I guess there’s no reasonable way for us to restrict her activity–IF there’s some means of preventing non-private funds from being used to counter the health effects. If, say, both the insurance and Medicaid/Medicare declared the support for the artificially-premature baby to be an elective procedure.
Really, I think that’s the crux of the matter–not so much that people make boneheaded decisions, but that the system is structured to deflect the consequences of these decisions. On the other hand, now I’m getting into “if you get government assistance then the taxpayers have a right to tell you how to spend it”, which is another can of worms entirely.
It’s not so much a question of whose dime is paying for all of this. (Though I do wonder if some of these early elective inducers might be more hesitant if told they would have to bear the costs of a NICU stay.) For me to primary concern is that of my prospective patient. If waiting two weeks will significantly improve the chances for health, and if the rationale for an earlier delivery is strictly based on convenience, then there’s really no way I could square a decision to deliver early with the Hippocratic oath. (All of this being academic, of course, as I don’t deliver babies.)
As far as “Death Panels” are concerned, I think it’s important to have a clear idea of what’s being discussed. If you question why it’s bad for some (presumably benevolent) entity to say “artificially prolonging your life indefinitely is not a cost that the public should be expected to pay,” then I share your inquiry.
Coming at this from the perspective of understaffed county hospitals, even if they were paying for it, there’s also the question of the resources being used. We can argue about why we have a resource shortage, but it does exist. Elective premature induction take up time, space, and resources that might be better spent taking care of others. Or, in combating the resources so that we have a surplus of NICU doctors and nurses, then we’re talking about training a lot of extra doctors and nurses (a burden the general population shares) to combat unnecessary conditions.
It’s not entirely unlike emergency room abuse, in that respect, even if the person in the emergency room can afford to pay their own bill.
For me to primary concern is that of my prospective patient.
I think that’s key. The mother is not the doctor’s only patient, so she’s not the only one to whom the doctor has the duty of “do no harm.”
I don’t think it’s at odds to be pro-choice and also think that elective delivery before 39 weeks should not be allowed.
I believe every woman should be able to choose whether to bring a life into the world. Nobody should be an incubator against her will. If I found out I was pregnant tomorrow, I’d immediately schedule an abortion. I want to be a mother, just not soon. But if I chose to give birth, whether to keep the child or to give it up, I believe I should defer to the doctor’s expertise on what is and isn’t a good idea for the child.
(I don’t think I need to clarify this, but just in case: unless the mother’s health is at risk. Not even her life, but her health. If her health is at risk should she carry to 39 weeks, I believe she should have the choice to deliver early.)
I think if a woman has decided to bring a baby to term, she should actually bring it to term. Ideally, unless it puts the mother or baby at risk, I’m all for letting the infant decide when, and the mother decide whether it’ll be C-section or vaginal. (Not always, of course, I tried to get born 3 months early, and I’m pretty glad they put my mother on the meds that stop that. And my stepsister had to have a C-section when my nephew still hadn’t budged three weeks after his due date.)
I mean, plenty of babies are born early with no ill effect. I’m one of them, my fiance is another. Both a full month early. But that wasn’t induced.
Here’s the thing; if you’re sure, at 37 weeks, that your baby is ready, well, that’s a nice sentiment, but if you haven’t gone into labor, I think the infant might think otherwise. If it’s not going to put you or the infant in danger to wait until 38 or 39 weeks, then you should just wait. It’s two weeks. Why wouldn’t anyone say to themselves, “Well, I feel ready, but if the doctor says we should wait, it’s better to be absolutely sure?” That just boggles me.
I am horrified that women are HAVING elective Caesareans! I had no idea.
I understand that more women were having them these days but thought this was largely Doctors trying not to be sued?
It HAS to be wrong. The Doctor should be the only person deciding on C section or induction and NO it shouldn’t be done just to fit in with his schedule either.
In the latest DW book SNUFF
SPOILER
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Nobby seems to be very like a goblin and might even be falling in love with one.