Tuesday, December 6, 2011

Medical Tourism: Elective C-Section Edition

So far my efforts looking into option #4 (arrange to have baby #2 outside of the province, and outside of the country) have not yielded a lot of success. I've contacted one Canadian based company that specializes in medical tourism in the US called Timely Medical Alternatives, and one German company called Erikson Medical.

Neither response was positive, but at least the response from Timely was polite and brief. "Thank-you for your inquiry. Unfortunately, we do not offer c-sections. I'm sorry that we cannot help you."

The German response...well I'm reminded of the Seinfield episode with the soup nazi - "No C-section for you!". I'll be honest it hasn't exactly provided the best start to my day.

The email from Erickson starts of nice enough:

Hello Mrs. W. - thank you for your request. we do not think that we can help you. In Germany c-sections are mainly favoured in cases of emergency.

Had the email ended there, it would have been negative but not insulting. Very much similar to the email from Timely. The email did not end there. Rather it continued...

Responsible doctors do not recommend planned c-sections.

Ummm...so does this means that if I find a doctor that will respect my well-informed request for a c-section and my autonomy as a person, that that doctor is irresponsible? Of course the email does not end there either, it continues further:

A birth is a natural event and natural birth is the best way for the mother to bring her child to this world, and it is known that to go through birth is important for the further life of the child.

Hurricanes are natural events. Earthquakes are natural events. Forest fires are natural events. Heart attacks and kidney stones are again very natural events. Further, are all those babies - you know the roughly one in three who are born each year via c-section irreparably harmed as a result of their births?? I don't think so. What's important for the further life of the child is not the 'how' of its birth. Will the child have loving parents? A warm-dry place to sleep at night? Access to education? Good food to eat? Guidance and nurturing? Of course the email doesn't even stop there.

It is a fairytale that a c-section is more easy for the woman. The abdomen has to be cut through which means a scar you have for the rest of your life and which can cause problems, and a long period of recovering after the c-section during which you have pains, are not able to carry, while you have to take care of then two children.

It's a fairytale that a vaginal birth is more easy for the woman, it's not - at least not for all women. It particularly isn't easy for the woman who has absolutely no desire to experience natural childbirth. Many women have life-long issues associated with their vaginal births - for which they would happily trade a c-section scar. I, for one, would happily trade the memory of natural childbirth and its sequalae for the memory of an elective c-section and the scar. I am aware of the additional recovery associated with c-sections and am more than prepared to make arrangements for the care of myself and my children during that time of recovery. Of course the email doesn't even end there:

I know what I am talking about, I myself have three children, one of them with an emergency c-section. That was the worst birth.

Thanks for relating to me your personal experience of an emergency c-section. An emergency c-section is NOTHING like an elective c-section. And then it continues:

Of cause there are pains during the birth, but isn`t it also interesting to experience, what a body is able to do?

I've experienced what a body is able to do - not that I wanted to, but I did. Thanks, but no thanks...continuing:

And if you decide yourself to take an epidural (I had this one time) you do not feel anything and still you have the softer choice of a natural birth for you and the child.

Epidural or not - I would still be aware of the large object passing through my vagina, when I do not want a large object passing through my vagina. Didn't like the first time, won't like it next time. And since when is a vaginal birth the 'softer' choice for the child - has she seen the shape of some kids after they go through a 'natural' birth? ...there is yet more:

Another point of not recommending the planned c-section in Europe is the risk of a long flight in the state of high pregnancy. Do you want to come months earlier or do you want to risk a birth "above the clouds" with none professial medical help at all? This obviously is much too dangerous.

I get the logistics of planning a foreign birth. It is perhaps the one aspect to it that is a big detraction. If it was an option (which it doesn't appear that it is) - I would work with it. If that meant going to Europe several weeks before the baby and staying for a few works after, then that is what would be done. Still there's more:

So go into yourself and consider again. Of course it is beautiful to have a second child. And the second birth usually is much easier and shorter of time than the first one. Talk to your doctors and mention your fears, there are possibilities to release pains. Maybe you have a midwife who you appreciate and who can be with you and accompany your birth. And then plan your natural birth which really can be an overwhelming experience!
I wish you the very best!

I spend a lot of time 'into myself' - my decision is not about pain and there is no way I'd consider a natural birth. So it's very obvious that: "Dieses Baby wird nicht in Deutschland geboren werden!"


  1. Wow that's condescending.

    I have two children - one assisted vaginal delivery with epidural, one emergent c-section with no labor. The c-section was completely painless. Recovery had some rocky patches, but the scar on my belly has been much easier for me to deal with (physically and emotionally) than the torn labia resulting from use of vacuum.

    So I'm on your side. Women should have choices in birth, including the choice of planned cesearean on maternal request.

  2. The *only* European country I would look at for this is Switzerland (Suisse Romande only, ie, the French part of Switzerland).

    I could have warned you about Germany -- they don't normally offer epidurals, which are considered somewhat shameful. A good woman is supposed to push that watermelon through her vagina or else she is a failure -- that is the basic attitude in that part of the world.

    And they are pretty bossy about it too, hence that obnoxious email is par for the course.

    It's funny how this is the case in the German-speaking part of Switzerland too; very sexist.

    In any case, the Swiss private hospitals in Geneva and Vaud are accustomed to satisfying the requests of their clients. Besides Grangettes, try LaTour, which is a more affordable option. (nicer than a Canadian hospital, but not stellar). I mean, since you're asking, you may as well cast a wide net, right?



    Your best bet is probably to find care in Alberta, but I am not sure how to go about it. Or how to go about finding a hospital in the U.S.

    I still can't believe that you are in this position because of the state of health care in BC!

  3. You can come to America. Here in Oregon we can take care of you :-)

  4. Stacey - that seems to be the plan now....just figuring out logistics ;)

  5. Mrs. W, I can guarantee that you will be able to have an elective cesarean at a private maternity hospital in London, UK. I can also guarantee this option in Italy where women have the legal right to demand the birth of their choice. South Africa and Brazil are also good options.

    Have you considered a different state in Canada? I understand that in states other than British Columbia, it is easier to ask for and get an elective cesarean.

  6. I can't believe you don't have the option of an elective c-section in Canada?? I am in Australia and I had an elective c-section for my twins. As much as I would have loved to experience labour, I didn't want to risk the health of my babies - particularly Twin B - so I opted for a c-sec...in fact, my Obs pretty much recommended I have one! In Australia, Obs are also quick to suggest c-sections for breech babies or large babies. Move here!! ;)

  7. Out of curiosity, when are you going to schedule your c-section? Before of after 39 weeks. I cannot speak for other professionals, but I am not opposed to elective c-sections, just those performed before 39 weeks. Same goes for inductions without a good medical indication.

  8. Evidence says 39 weeks, and that is the plan unless a medical indication (like going into labour or other medical difficulties arise) - vaginal birth is not an acceptable mode of delivery for me...

    I think there always needs to be a discussion about the risks and benefits that are associated with any treatment plan and that the course of action needs to be tailored to the specific woman and child. I don't think blanket policies or rules in medicine are good - there's an art to good health care...and such decisions must be left to the experts (the doctors) and the patients who must live with their consequences.