Sawbones: A Marital Tour of Misguided Medicine - Sawbones: C-Sections

Episode Date: June 24, 2014

Welcome to Sawbones, where Dr. Sydnee McElroy and her husband Justin McElroy take you on a whimsical tour of the dumb ways in which we've tried to fix people. This week: We open your velcro belly slot. Music: "Medicines" by The Taxpayers (http://thetaxpayers.net)

Saabones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books! One, two, one, two, three, four! We came across a pharmacy with a toy and that's lost it out. We were shot through the broken glass and had ourselves a look around.

Some medicines, some medicines that escalate my cop for the mouth Hello everybody and welcome to saw bones a marital tour of Miss guided medicine I'm your co-host Justin McRoy and I'm Sydney McRoy Hey Justin sister. I meant to tell you that something really disturbing happened to me the other week when you were out of town Oh, no, you know when you abandoned me right in the midst of my pregnancy For the election on three right in the midst of my pregnancy, my third trimester, you know, for the electronics commission for work. So you remember that when you left me here. Yeah, I was very recent. Very alone. I'm sure the wounds are still very fresh. Well, I was staying with my parents as you know, and my little sister Riley,

who is 13 for everyone listening. And for people who aren't listening, she's still 13. That's true. That she is 13. Her existence as a 13-year-old continues regardless of you, the listener. Think about it. That's interesting. But she asked me a question, and the question was, do I have a uterus even though I haven't been pregnant? Well, great. I was a little worried. About our public school sister? Yeah, I mean, she's had,

she says she's had sex ed. Oh she knows what a period is But she was a little unsure If in fact she did have a uterus yet or not and did you grow that when you got pregnant or Was that already there and this really got me worried? I mean is this is this like normal? If it makes you feel like it's the most 13 year olds not know if it makes you feel any better I had an extended period of time where I think you're aware in this of how these things were sort of comes gradually I had an extended period of time for a couple years In my youth where I thought babies came from the stomach and knew they lived in the stomach

I thought they emerged from the stomach through some sort of you know that stretch mark you see an appragment woman, I guess it's not a stretch point. I'm talking about the linear Niagara. Yeah, the linear Niagara, I guess. I thought that was a seam of some sort that opened to allow the baby to exit. Was it uncleared? Like with a zipper or with velcro? Some sort of velcro zipper, flesh zipper arrangement.

I was unclear of the specifics, but yes, for there was a period of time where I thought that was the way it worked. Well, I mean, I guess in an accent, sometimes that is the way it worked. I basically invented C-section, I guess I'm saying. I accepted C-sections.

Is that because you were born by C-section? Yeah, my guess, maybe. I don't know. I don't know. It was deeply ingrained, somewhere in my preadolescent psyche. Well, I hope you know now that you were wrong. Yes, I have gathered.

Yes, that there is no seam there. No seam that I can detect. I'm certain that if there were Velcro on the front of my stomach at this point, it probably would have burst open. I hopefully yes. Well, hopefully not, but. Hopefully yes, so we can get our baby out.

I want that baby. Do you know much about C-section in general? No, absolutely not. Is that a trick question? Like you know that I'm certainly don't know anything about C-sections. Well, you know there's no Velcro there now. I just figured out there's no Velcro there.

How can I know about C-sections? Sydney, tell me about C-section. You know I have a uterus though, right? Oh yeah. No question about that. Maybe a couple. You have at least one uterus. All right. Well, I will. I'll teach you about C-sections. I will endeavor to better educate my 13 year old sister as well. Yes. Because I think that's how I have a response. I really does. I mean, that's fair. It really does. Well, C sections, I guess, are near and dear to my heart because without safe C sections, I wouldn't be here, Justin, either.

And neither one of us. Neither one of us. This would be a boring podcast. It would. I don't. It would just be dead air for 30 minutes. Like that. That's what it would be like. Can you imagine 30 minutes. Like that. That's what it would be like. Can you imagine 30 minutes of that? I'm so glad that's what you were doing. I thought you were having a, like, an absentee or something.

No, no dice. I was just giving you a sample of more. Staring. A ball. A ball. A ball. A ball. So I think the most important thing I can tell you to start off with about C

section is what do you think Cessarian section C section, Cessarian section? And that is by the way C-section. As I was doing research I realized that a lot of people research C-S-E-A sections. No, that is not. It has nothing to do with the ocean. It's not a nautical term. It is a short for

cesarean section. Where do you think that name comes from Justin? Well, I know that comes from Julius Caesar. Do you know that you are wrong? Sydney, are you having a contraction? I am having a contraction. Okay, well let's just we'll just hold for a second. See, I wish I'd done the silence bit here. This would be a good place to hold as you have a contraction. Now, keep in mind folks, this is a Braxton Hicksing Traction. It's nothing to worry about, but there's gonna be a few of these over the next few weeks.

I'm not gonna edit everyone out. So we're all just vamp when city's having a Braxton Hicks contraction, and then once she's ready to continue the podcast, we'll just hop right back into it. Just remember, I correctly identified cesarean sections as being derived from Julius Caesar. That is where we left off Sids to how we doing. Okay. All right. Going away. She's going away. You're wrong, though. I'm going to start talking to the

sender. That must have been to add to the pain of a contraction knowing that not only where you're having to wait their contraction, but you had to wait to tell me I was wrong about something. That must have been excruciating. That is a commonly held misbelief, a common mis, I don't know, it's wrong is the important thing. Is that what you said? Is that what you told before there was a fact? Uh-huh, I have said that before. I thought that that was true. It is not.

It's even, I believe in websters, it's even defined that way. That that's where the words, that's where the term, cesarean section comes from. And that's wrong. The reason that we think that this is wrong, well, as one, the practice predates Julius Caesar and two, it's reference later that his mother, Orelia, survived. There's actually even some evidence she may have outlived Caesar.

Now, I don't know that for sure. But the fact that she survived and was noted to, you know, be alive later in his life makes it almost impossible that he would have been born by C section because at the time, of course, you couldn't perform a cesarean section and preserve the life of the mother. So that is absolutely not where it came from. So then the question is, where does this word come from if not from Caesar? I don't know. So there's several different theories and we're not 100% sure which I think is fascinating. With the top contenders.

So it may be related to what was called the Lex Ciceria or Imperial law is what that comes for, comes from and this was passed during the reign of Numa Pumpilius around 700 BCE. And basically it was a law that said that if a woman died while she was pregnant, you would remove the fetus from her and then bury them separately. And it was just a religious kind of thing, that it was not appropriate to bury them together. And so that is where, so it was a law passed by the Caesar. So that's where the Caesar part comes in. Because Caesar was a term for the ruler, not just Julius Caesar. And it involved removing the child from the admin. So they thought, well, maybe

that's where it comes from. This actually evolved in by Roman times so that not just when the woman died in childbirth, but if the woman was, you thought she was about to die during a delivery, you could go ahead and have the procedure done. And this was actually the first attempt to save the baby. Initially, it was just a religious thing. It's too late. We can't do anything, unfortunately. But this is a religious belief we need to, you know, do this procedure. By Roman times, they were really interested in increasing

the population. So they, so they started, you know, as a last resort, like, look, this delivery is going wrong. We've seen this before. We know mom's not going to make it. Let's go ahead and get the baby out and try to save a Roman citizen. A little baby Roman, a little baby Roman. We have all these tiny togas. That's how they come out. Right. We're with a little... The little toca.

With the little, when I'm trying to say the leaf. All of the leaf. No, they're all of their laurel reeds, aren't they? I guess it depends on where. What season? It's in fact. Here's the thing. Here's the facts, folks.

It's a tiny toca. And some sort of plant life on it's baby head, okay? We don't know about trees. We're not. Is it a tree podcast? Go to the Salwood. If you want that. The term also may be related to the word cedere, the verb which means to cut. And a child that was born via the cut was called a say sonays.

So that maybe where it comes from. Our old buddy, Pliny. Pliny the elder. Pliny the elder, he's back. He wrote about this. He was for some reason really interested in this whole topic. Just like the where the word came from, not particularly the procedures.

Just into it. Just really into it. And he thought that the original Caesar was probably born this way, not Julius, but the first Caesar. And the word Caesar comes from the procedure. So the first Caesar was born and they used that word that means to cut. and so they gave him that as his given name is his last name. And so all of his descendants were also named Caesar. So it could be the other way around you're saying. Exactly. Julia Caesar was named for the procedure as opposed to the procedure being

for Julia Caesar. It should be noted if you're not that familiar with plenty, he goes silly sometimes. He may have just been making that up. He did, because he made up this whole myth about all of the Roman infants that were born who were given the last name, which was a common last name, say so, were all born by C-section, which is absolutely not true, but he just said that.

I don't even know why you make that up. Yeah, whenever you hear somebody's inventing myths, that's when you need to get worried about their veracity is like a historical source. And not even exciting myths. No, it's just making up, like how bored are you, Plenty? The saint, Nanatus, that comes from Nanatus, not born. And that was named, he was named so because he was born via

Cessarian section. Wow. And it was not considered true true birth. Now my mom would argue. Yeah right. That point. But at the time it was not. I'm in her 42 hours of labor would certainly submit that it was a birth that it was a version. Absolutely. I think many women would. Bindu Sara who is the second emperor of India, was born by C section, because his mother accidentally drank poison when she was close to delivering. Okay. I don't know how that, how you're in labor. And then you accidentally drink poison. It's a weird series of events.

You think you'd be a little more careful. I Stay away from poison at least at that point. You've made it that far. You know what I shouldn't The baby is so cool. I would love some poison the baby's so close. I'll just hold out for a few more weeks Oh, what the heck? Let's be bad. Let's just have some poison. It's whatever 4th of July was back then Now to be fair Let's be bad. Let's just have some poison. It's whatever 4th of July was back then. Let's do it. To be fair, if you look back at some ancient Chinese records, they may have been doing this procedure like 700 years prior to these accounts. Almost certainly they would. So almost certainly they were.

We just don't have good records to say for sure that they were. But it wouldn't surprise me at all. Now again, everything I'm talking about were procedures and I don't think I've defined by the way C section, but I didn't have so necessary. You do a cut, the bottom of the abdomen, just above the pubis, you do a cut you do a cut about, most call it six inches lateral and you fold back the skin, you fold back the muscle that's there, you remove the baby via that method, and then you stitch some on back up. That's pretty good, honey. Well, we did have that childwork class, so I do exactly remember that from the last.

Don't forget you also got to cut a hole in the uterus there. I know. The baby's not actually in the abdominal cavity. Right. Fine. OK. Yes. Yeah.

But that was really good. Thanks. Well, I do. I do. So there you go. So yes, that is what a C section is. To this day. Yeah.

It's not. It's not a very complicated procedure in explanation. I will do it. I will do it. I can do it. You need to be done. No. It's not it's not a very complicated procedure in explanation. I could I will do it. I could do it. You know, done. No. Take a shot. Now up to this point, the procedure was really only done for the baby. It was done in cases where the mom either had just died or was not expected to survive. So there wasn't any effort made to

save the life of the mom. You hate the I deep Now what, Caesar's not in a elected position, right? It was passed down by birthright, right? Real life. Yeah, no, I don't think you were elected to Caesar. I think you were. Birthright, right? Yeah. So I would be interested, and maybe it was vote, I don't know,

but I would be interested to know if like the predetermination that this child would be Caesar would factor in to, there might be a connection there, but like we definitely need to save this baby because they're Caesar. I mean, they could be the next Caesar. I think you're right. I don't know if I'm making that. So I think it's-

Well, no. Well, I would say that you're probably right. I don't know, but I would say you're probably right, because when I mentioned the Emperor of India, Bindu Sara, that was very much why that procedure was done was because he was going to be the Emperor. That we know. I know that there was still a 50-50 shot in their part, right?

Well, that's true. They wouldn't have technically been able to tell, but they just couldn't take the risk of a baby boy dying for his mother. And I think there was some divine, like if you read about it, it's like, well, and they just knew that they had to save this baby. And like, there's like a, you know, divine intervention kind of aspect. There, some of the women may have survived during Roman times. This has been tested many times, but there's no good evidence of this. The first recorded evidence that a mother survived

a C-section is actually from the 1580s, and it was performed by a Swiss pig-gelder. Do you know what a pig-gelder is? I do not know what a pig-gelder is. I do not know what a pig-gelder is. I didn't either. It is a one who castrates pigs. Okay, that's a full-time job, huh? I guess. Good living there.

Jacob Nufr. Is this a good living room? I think Jacob did well. And he had a lot of knowledge of animal anatomy, I think. His wife was in labor for several days and not doing well. They had gotten 13 midwives involved, which I love to see like, after you're at the eighth and you're like, I don't know, call another one. Maybe don't, and they just kept calling midwives and she kept laboring and she was not doing well.

So we actually petitioned the government and said, I want to do, I want somebody to come do a C section. I mean, he didn't call it that. He knew that this was a possibility. Ye old baby slice, whatever they call it. What have they called it? Nobody would do it. So he did it himself.

I wonder if this is the first, there's probably an older one that I'm just not thinking of, but like, is this the first effective surgical treatment that we deliver? Like, is this the oldest surgical treatment that's like still consistently performed, do you think? You know, I don't know. I know it is one of the oldest. Say for like circumcision, but that's not still consistently performed, do you think? You know, I don't know. I know it is one of the oldest.

Say for like circumcision, but that's not really a medical treatment as much as the original just practice. So I don't know. I would say this is probably- Always consistently practiced. If not the oldest, absolutely one of the oldest. And it is said that many times that C-sections are one of the oldest regularly done surgical procedures.

I mean, there's amputations, but we probably will do this for the right reasons. No. Maybe with infection. We may have bailed for that out. Now, this was something we recognized the need for pretty early. We just didn't know how to do it well. I'm just strategist. Let's keep moving.

Except for Jacob, who didn't know how to do it. He based what he did, like sewing up, you know, everything for his wife on how he had sewn up animals. Awesome. And the record is that she lived, the child lived to the age of, ripe old age of 77. Which in the 1580s is like the oldest dude ever.

Super old. And it also says that she had several other children, including twins that she delivered vaginally. That's crazy because that means you would have to keep C section in them. No, she had vaginal deliveries after that. Okay. Whoa.

You don't have to have a second C section after your first C section. It's more rare, right? Nowadays. Yes. That's a whole other thing though. We'll get there. We'll open that kettle of fish. There's also some weird case from the 1600s that cited of a woman who was

nine months pregnant and was gored by a bowl in the abdomen Okay, like the bowl accidentally See sectioned her and the baby survived. Okay. Is that the oldest evidence of a bull performing a certain procedure? That probably is. Except for presumably like many, many thousands of butthole dectomies that they performed on unsuspecting farmers throughout the years. I don't know how, like how the, what kind of goring

has to occur before the surgery. Yes, that's, yeah, that's very human of us of us like if you go or man's butthole then that's just a bad bad ball. Bad. If you go or a baby it's a C-section. You're a surgeon. We call it a C-section. You're a ball surgeon.

It's a miracle. I don't think I'd cite that at the C-section myself. It's very inclusion and spacious. As you can imagine from all these examples, mortality was very high for a long time, even as we got a little more rigorous about how we went about that, as of like 1865 in the UK when they were actually keeping rates of C-sections and mortality and all that kind of thing, the rate of mortality from a C-section was 85%. I mean, it's insane, right? I mean, there's so little we understood about the circuit laboratory system and all that

stuff. Exactly. Bleeding and infection. Yeah. We just, we didn't know what we were doing. But we were doing, I mean, and again, we get into the heroic era of medicine, which we've talked about a lot, where do anything, anything is better than nothing. Right.

It's interesting. We actually learned some from a lot of our European travelers who went to Africa in the 1800s, especially in Rwanda, in Uganda. They were doing sea sections there and using herbs and different, like, kind of native plants and alcohol-based things to anesthetize women and then disinfect the area and certain herbal pastes to try to improve wound healing.

And they actually were having some success. I'm not suggesting it was 100%, but we learned a lot from those techniques. Yeah. The first, I think this is really cool. The first C-section in the British Empire was in the first like actually performed, we're not just, you know, randomly. I don't know, grab a knife, save the baby. The first actual, you know, rigorously performed C-section was in South Africa.

It was sometime between 1815 and 1821 at Sketchey. And it was performed by Dr. James Barry, who was a surgeon, and one other really interesting thing about James Barry Was a woman a doctor He lived his entire life as a man from a young age This is true, Dr. James Barry Decided it was easier in this world of 1800s to live as a man. He lived his entire life

and records indicate he was born a woman and his autopsy showed that he was a woman but he lived his entire life as a man which afforded him the ability to do a lot of things that women weren't allowed to do at the time. Wow. I know. I sense that that's a whole other episode, by the way. Here's to you James Barry. The first C section in the US. Do you know where it took place? Well, I have the sheet in front of me, so just keep rolling. OK.

Well, in 1794, it was in Mason County. Yeah. West Virginia. Oh, wonderful. How mom would take me home. Technically at the time, it was Virginia, but we were all, I hate listening about that.

Listen, listen. That's under the bridge. That's why I don't have the bridge. That was always West Virginia. It just didn't know it yet. It's ours now. We claimed you shouldn't have thought of that before. Eat that old dominion.

You should have annexed it. The surgeon was Dr. Jesse Bennett. A man. Yes, a man. He performed it on his wife, Elizabeth. They were out living in their log cabin and she was in labor and she was not progressing well. So he did what he had to do.

He laid out an operating table, a wooden plank across a couple of barrels, gave her a whole bunch of lodinum. That's what you had. And he saved her life. I'm going to circle back around to James Berry for you saying, because I'm curious about something. I want to clarify terms, because it's important. Was James Berry living his life as a man, like, a sexual thing do you know or was it

purely a professional sort of cover. You know I don't from what I read and I I have not done thorough research on him because actually I intentionally didn't because I thought well this could make a really cool episode. I want to just appropriate gender pronouns and what have you. I just didn't know if it was a you know a ruse or a choice that James and I see it. From what, from the little bit of reading I did, I think that it's sketchy exactly why the decision was made. Was it just purely I am a woman, but I know that if I, if I pass myself off as a man, I will get more advantages. I'll get to do the things I want to do

with my life. Or was it truly a case of, I, you know, I feel that I was born in the wrong body, I feel I am a man, and so I'm going to live my life as a man. My impression was that it was more the former, that it was, I want to be afforded the opportunities of a man. Well, look into that. But I think that would be a really cool thing for us to look into. Moving on, I'm sorry, I keep derailing as we have so much to do.

Well, I just want to say, Dr. Bennett, after he saved his wife and his baby's life, went ahead and took out her ovaries while he was in there. Whoa! Uh, for the sole reason... Not cool, Jesse. Well? Unless she was like, okay with it. Well, there's no record who knows.

We didn't ask women at the time if they were okay with anything, right? We barely do now. Justin Stamfordically his face frozen, knowing that if he waits long enough, this moment will pass. He did it, at least as documented, to prevent her from having to go through this again, because he was so worried she would die. That is what he said.

He was so worried she wouldn't survive. And that if she got pregnant again, this that she might die. So he did this to let's all just hope he had this conversation with her before. Okay. Yeah. Let's tell ourselves that little fairy tale. What do you think?

Um, just so I can sleep at night, audience, please. There was a little bit of a shift as we move forward towards, you know, we still don't know how to do this very well to routinely save the life of mom. So maybe we're focusing wrong. Maybe mom is our patient and we don't need to worry so much about baby. Right. So there was a brief period of time where we did craniotomy's on the fetuses, which basically involves, you know, breaking a hole in the child's skull. I don't like it. I know. As a way to remove the baby. Obviously, this caused serious damage to the baby if the baby survived.

These procedures... No! Yes. These procedures also caused serious damage to mom. They used to do these high four-ceps deliveries. Oh, oh, oh. Anyway, we won't get into it. But this was not any better of an option than the you know No anesthesia, no antibiotic

C-sections they were doing There was a brief period where it became very fashionable to after a C-section go ahead and remove everything do a hysterectomy Right remove the uterus the thought was that you remove where the most likely source of infection and the most likely source of bleeding afterwards. But again, then the woman could never have children again. So not a great option, although outcomes were improved by this. Now, as we move through history, multiple things improved outcomes. We started developing anesthesia. We understood antiseptic technique. We got better surgical techniques,

kind of like you talked about, that we do that. You described a low transverse incision on the other one. That's why I thought I was describing. You were. And that was a better way of doing things as opposed to a long classical incision that went straight down the middle of the belly.

More like you were thinking as a child. Right. Antibiotics, of course, blood transfusions. As C-section C became safer, they became more common. And you know what really boosted this? What? Rickets. Why? Because a lot of women at the turn of the century, as we're going into the 1900s. A lot of people who lived in urban areas no longer had access to fresh dairy. So they were born with rickets, where they weren't born with rickets, they developed rickets. Right.

And these women as they grew older had deformed palvuses from rickets. Which means they couldn't pass the baby vaginally. Exactly. So the C-section rate went way up. that maybe vaginally. Exactly. So the C-section rate went way up. Uh, you know, uh, I want to hear about some of the, uh, the, the myths, you know, that

we've come up with about C-sections. Well, Justin, I would love to tell you about that. But unfortunately, it's that time of the month again where you got to pay your bill. Oh, that time of the month. Yeah. I was very confused. It had been that time of the month for a while. I wanted to go to the billing department. Sydney myths folklore you promised. Okay so first of all there is, I don't know that I would consider to myth necessarily that babies born by C-section are stronger.

I think that's true. Yeah, personally. As far as I can tell. No, all evidence points. I don't know another me. It is stronger than me. Adonis and Bacchus were both born by C-sections. Alright, so there we go.

Fine, fine company. So that's you and me, right? Basically. Strongest people I know. A Sclepius, the God of Medicine, he was delivered this way, by none other than Apollo. Gods have to be delivered by C-section. I guess. That's that's weird to me.

Like drifted out of each other. Although, you know, Athena came out of Zeus's head. So right, VSC section. I don't know if that's a C-section. I don't know that that's a C-Sex. I don't know if that counts. What's the girl's C-Sex? Moving into literature, you probably are familiar with this.

Shakespeare and Macbeth wrote that this is, a lot of people have asked this question, Macduff makes the point of telling Macbeth that he was born of C-Sex, and he doesn't say, say, is ripped from his mother's abdomen, something to that effect. I'm asking you, because you... You know, you see it at a grade all that stuff. You know that all of the pins on what, fully oh. You know, the bard. Did you really finish?

Do you have a degree? Five years later. But this is because it was foretold the Macbeth could not be killed by someone of woman born and that and remember as I said at the time you weren't considered to be born in the traditional sense if you were born by C-section. So that's why Macbeth could kill Macbeth. Perfect. There you go. In various religious beliefs throughout time, not currently. There was actually a little bit of discrimination in the Mishnah and Judaism.

Jewish twins were prevented from inheriting property if they were born by C-section. We don't miss a beat to discriminate against people doing it. Whatever you got, we'll discriminate against you. Prior to 1500 in Islam, it was believed that you were born of the devil if you were born by this method. Okay.

Catholics were in favor of C section, but only because one, they were against any of the methods that were available to save mom. Cool. And two, because then you could at least baptize the infant. We are all about baptizing in the Catholic Church. Those seem like both really cool reasons to be in favor of these things, actually, for sure.

Cool church. There's also the whole science stuff that's cool, advancing our medical knowledge. I'm not saying that that was necessarily part of it. Yeah, right. Maybe not a figure in the decision-making process. And I think we mentioned this. This is just, this isn't a myth.

This is a truth, but it's an interesting fact. I think we talked about in the self-surgery episode that there was a woman in Mexico in 2000, Inaz Ramirez, who delivered her own baby VSA section. Inaz Ramirez, you role. It has very cool. That's the only one that we know of in history. I mean, it may have happened, but the only one that we know of in history.

I mean, it may have happened, but the only one we have good documentation of. And she survived in the baby, which is even cooler. And I read this last year in December of 2013, a woman in Brazil had an emergency section performed, which is interesting because when the doctors got in there, they figured out she wasn't pregnant. Whoa! What? She had a condition called pseudocyesis,

which some people call a hysterical pregnancy, although I am against the term hysterical, refer to our hysteria episode. Yeah. But it's a psychiatric condition. She thought she was pregnant. She manifested a lot of symptoms of pregnancy Came rushing into she never got any prenatal care obviously right rushed into a hospital No, it's your sounds or anything nope saying she was 41 weeks Presenting as if she's pregnant doctors looked for a heartbeat couldn't find one ruster to the OR did a C section and low and behold No, baby, that is so crazy and low and behold, no baby. That is so crazy.

Now, today, you kind of alluded to some of the things that exist about C-sections today. I mentioned that Ricketts was a big reason why C-sections rose in the early 1900s and moving into like the 30s and 40s. Even though Ricketts is no longer a problem, we have never really returned to the rates of C-sections prior to Ricketts, which is crazy. They got normalized then. Yes, they became normalized. We got really good at it. I mean, the fact is that today C-sections are very safe.

For the most part, they're very safe procedures as long as it's not an emergent C-section, you know, everything is done very routinely. It's planned and even emergent C-sections are usually very safe. But the World Health Organization advises that any country's C-section rate should not exceed 15%. Do you know what our rate is in this country? No, it's about a third 32.8 or 9% Which is pretty high. It's been still it had been steadily climbing up until the last couple years It's been staying the same so it has not decreased at all So why is it said why is it, Sid, why is it without passing judgment?

Why is the WHO sort of saying that they should make up more than 15 percent? What is the issue? It's all evidence-based. I mean, their recommendation is based on outcomes. Outcomes are better in general for moms and babies in countries where their C-section rate is less than 15%. Mortality outcomes and morbidity outcomes and the, you know, not just if the mom and baby make it, but how healthy they are afterwards.

We're not super, you know, we're not super well informed about this specific moment, but there is some research like that we were talking about, and that we actually heard about some in our birth class that says that that moment is sort of an important bonding moment, right? I mean, it is. It is. If a vaginal delivery is possible, that, you know, going through that process and that immediate bonding between mom and baby that can occur with immediate skin to skin contact right after

you deliver is very important and can encourage breastfeeding, which we know is we talked about in our previous episode is the best if you can do it. That's not again not to take away anything from people out there listening who might have had sick sections. As we've said already both our mom said see sections There's no judgment here, but it is part of, and I think we've talked about this few times, this medicalization of birth. It is very convenient sometimes for doctors to suggest a C-section when it may not be completely

medically necessary. Exactly. It's just like I said, thank God we have safe formula for babies that, you know, when their moms are unable to breastfeed. Thank God, we have safe C-sections for women who cannot deliver vaginally. Right. But the fact is there are a lot of factors that go into what I would consider an alarmingly high C-section rate in our country. And especially if you look locally, you know, the C-section rate in our state is very high.

look locally, you know, the C section rate in our state is very high. In the local area, I looked at some rates at local hospitals and I won't go into the hall. It ain't good. But it's not good. There was at least one that had 100%. Yes. Not a lot of deliveries, but 100% of them are C sections. Sorry, let me just reiterate 100%.

And a lot of these factors are that some of our interventions, as far as the monitoring we do, inducing labor, some of the procedures we do during labor and delivery, can precipitate C-sections. There's the convenience factor. It's efficient. There's that whole and, you know, this does play a small part in it, the liability. It's safer just to go ahead and do the C-section if there's any question.

They say that patient preference plays a huge role. That's a myth. Women are not asking for elective C-sections by and large. About one percent of women in their first time having a baby are asking for a C-section electively. So that's not part of the problem. Now, you mentioned second pregnancies having a C-section. You don't have to. You can do something that we call V-backing,

vaginal birth after cissarian. You can do that, but a lot of doctors don't feel comfortable with it. So they'll urge you to have a repeat C section instead. I mean, here's the thing, and it's interesting, if I can step out of my role as a doofus, I mean, I'm still a doofus, but this is something that we've like thought and read and talked about a lot recently.

And it's hard as parents because the message that you get is almost certainly everything will work out fine, but that is the hardest odds to play. And I think that it's something that doctors, some doctors, some less scrupulous doctors, and not even just individual doctors, but a system constructed around this has institutionalized. It's like, well, there is a statistical advantage to having a C section at this point. And it may be very slight, but when you're pregnant and you've been waiting nine months for a baby, like that statistical advantage is like a big, big deal.

And you lose things like that skin is going to contact or the importance of a vaginal birth if possible. It becomes very hard when you're, you know, there's almost nothing that you put up against the safety of a child that you won't sort of go for. And I think that maybe the system has sort of turned that against parents in some cases. Exactly. And that's why I would say the best thing you can do is be constantly asking questions. There's nothing wrong with that. And your healthcare provider should be answering them.

And if you're not satisfied with that answer, they should keep talking until they give you the answer that you're looking for. You never, you're never forced to have anything done. I think that's an important thing and I don't think all moms know that. No, you see a lot of language. I read a piece about this. You see a lot of language in writing about birth that your caregiver might allow you to hold the baby for a certain amount of time or the doctor may allow you to move around,

et cetera, et cetera. There is no allowing. You're the mom, you're giving birth. It's your show. No, you have rights and you can ask if things are safe. And I would never encourage a woman to do something that's unsafe, simply because she wants to. But at the end of the day, you ask the questions,

is this safe? Is this necessary? Do I have to be induced right now? Can I wait longer? They have to give you honest answers. You're gonna find a horse in your bed tomorrow. Doctors are gonna be so mad at you. Well, I mean, it is questionable

if you start considering that a lot of C-sections are done around five or six in the evening. Somebody wants to go home. All we're saying. It's just ask the questions. Sometimes, you know, the fact is, your doctor is telling you that you have to have a C-section because you do and you need to listen to them. But ask that all I'm saying is ask the question. That's it.

That's it. That's it. Just be informed. Yeah. Because you always have a right to ask questions and get answers and keep asking until you get more answers. We've kind of chatted about this for a while, huh? I know, but it's very important. We've been thinking about it. It's very important. Give us a pass. So if you need a C-section, thank God we've got them. But if you don't, just find out. Just ask, find out if you don't. It's worth asking, that's all we're saying. Thank you to you for listening to this episode of Saw Bones. We don't usually get so preachy.

We don't normally get preachy, I'm sorry. Please don't fight with us. Expecting and yeah, it's been, we've got a lot on our mind. It's been a thing. Thank you to people tweeting about the show, Shantae, who is, or maybe Shantae, and T.E.A. is the end. She said she's a little sad, the solvents about breast milk

didn't mention the trend to use it as a cure for everything. Of course, it's been used, I'm sure, restoratively, over the years. We will actually, I've been trying toatively, over the years. Many, we will actually, we, I've been trying to be better about this retweeting people who add sort of like addendums because obviously we got to have our, we can't cover everything. If you know something interesting or can, uh, uh, share, you know, something additional about a topic, let us know because we, I love retreading this. Yeah, please do. I didn't cover Amber

Necklaces at all in the TV episode, and I know a lot of people wanted to share that. So please share it. They covered it on one bad mother, actually. They did a TV episode right out. Well, check that out. It's another show of the Max Fun Network.

I know Samantha said that her grandma, who had kids in the 50s, told her mom, who had kids in the 80s, that she was horrified, that her mom was going to breastfeed her. It was untoward, I guess. So that's super cool. Thank you for the Marty, Allie, Jennifer, Miss Ada, Van. There's like five A's there.

Mia, Nightmare, Fem, John, Wine, Ryan, Codden, Cell, John Thomas, Mason on so many others tweeting about our program. You can either use the at-solbones to tweet about us. If you're going to do that, don't put it at the beginning because then only people have already followed us, see it, etc. So, or you can use hashtag solbones. It's all the same.

And use the link to our show, www.solboneshow.com is the best link to us. And thanks for spreading the word around. Also thanks to KCRW's press play for having us on their program. That was a lot of fun. Yeah, to check that out. Check that out. Yeah.

It's more us if you haven't got any air fill yet. June 20th. Yeah, June 20th episode of that program. So you can listen to our interview there. That was a lot of fun. You got another contraction? You look contraction, you first. I was, it's over now.

Oh wow, you covered that like a bro. Man. Thanks. I'm super impressed. I mentioned one bad mother on the maximum fun network. There's a ton of other great shows on their Jordan Jesse Go judge John Hodgman, lady to lady, Ono Ross and Carrie, Wampampow. My brother, my brother and me. Oh, thank you, my dear.

So many others, they're all waiting there for you at MaximumFun.org. That's us where you're going to find our forums. So you can discuss the episode, just listen to with other fans of the shows. That's always a lot of fun.org. That's that's where you're going to find our forum. So you can discuss the episode just listen to with other fans of the show. So that's always a lot of fun. And we have an email address, saw bones at maximumfund.org. If you want to suggest a topic, Twitter's not the best place for that because they can continue to get lost in the shuffle. If they're at the email address, they'll stay in the workflow. Or if you just want to say hi, whatever, do that. And I think that's going to do for us. What we done?

I think we're done. Thanks to taxpayers. Let's use their music. Folks, that's going to do it for us until next Tuesday. I'm Justin McRoy. I'm Sydney McRoy. That's always the best. Drill the hole.

I'll make your head. Alright! Maximumfund.org Comedy and Culture Artistone Listener Supported fun.org. Comedy and culture. Artists owned.

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