Comment by basseq | Hacker News Reader

Comment by basseq | Hacker News Reader

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Disclaimer: There's a really bad stigma about c-sections and mothers who have them being "less" or "worse" because of it. I'm careful to point this out before we dive into a discussion on making accusations of "poor self-control". That said...

If you remove those c-sections that are medically necessary or recommended ("known indicators for cesarean delivery" is the language used in the abstract), then you're left with that population that truly "chose" to have a c-section. The association is stronger in this population.

I'd want to tie this back to those demographics. What kind of people truly choose a c-section? Is there something about that demographic that correlates to obesity for other reasons? Are obese women more likely to be counseled towards c-sections? Again, why? It's unclear if they normalized for this.

Incidentally, I think your speculation is probably wrong. You assume that c-sections are (or are regarded as) the lower-pain option. You can have a painless "natural" birth with an epidural, and post-birth recovery is going to be "painful"--in different ways--with either path. In other words, don't think people choose c-section for pain management in the first place, which invalidates the rest of your logic chain.

Interesting, and I think you may be right. I do think women choose c-sections because the are scared of natural birth for whatever reason.

It's probably true that there is some demographic component to this correlation, though I would assume the would control for that.

I do think women choose c-sections because the are scared of natural birth for whatever reason.

I think that is pretty rare.

From what I have seen, women are much more likely to genuinely choose a C-section because they have a career and need to have the baby on a set schedule so they can get back to work. Having a baby the natural way is a fairly messy organic process that does not readily fit into the highly scheduled lives of modern two-career couples.

IIRC, only about 5 percent of babies show up on their actual due date. Most are either early or late. I have read plenty of articles where career women scheduled a C-section so they could schedule the birth and also schedule time off from work. Waiting for a baby to show up when they feel like it is rather inconvenient not only for you, but for your employer if you are anyone of any importance. It can amount to being willing to leave the entire department in a lurch when you suddenly drop everything. Babies can be anywhere from several weeks early to two weeks late, from what I gather. That leaves a window of potentially two to three months in which baby might decide "now's the time." In fact, my understanding is that a baby three weeks early isn't even classified as a preemie. So there is potentially a five week window for a "normal" birth.

Actually, having a c-section would be worse for "career" focused mothers.

Sure, you get to schedule your due date, but you are having a surgery. It takes longer to recover from a c-section then a natural birth. There is driving and lifting restrictions for weeks. FMLA leave is usually extended for those with c-sections by a few weeks.

And as for scheduling, you can define a maximum date, but the baby can still come early. Just because I'm schedule to have a c-section on September 1st, doesn't mean I can't go into labor in August 15th.

  In fact, my understanding is that a baby three weeks 
  early isn't even classified as a preemie.

Correct: 37 weeks is considered "term", with a standard due date being somewhere between 39 and 40 weeks. My son was ~3 weeks early: he was totally fine, but definitely a "oh, I guess this is happening now!" moment.

Anecdote: he was 7lbs. 7oz. (right around average) and 3 weeks early. He likely would have been a monster at his due date, and may have been a c-section because he just would have been too big. Is that normalized in the study? Or are we flipping causation? Instead of "c-sections are correlated with obesity risk", is it "obesity risk is correlated with c-section"?

You are confusing induced labor with c-sections. Many natural births are scheduled and labor is medically induced...there are fewer babies born on weekends for this reason. Basically once you're within a week of the due date, doctor and mom have wide discretion to induce labor and begin the natural birth.

I don't think so:

We know that the risks of C-sections are greater than risks of vaginal birth, at least with your first pregnancy. So why are women opting for C-sections, even for their first birth? Some theorize that the combination of improved C-section safety, along with increased maternal age, has lead to women being able to control when and how they are going to give birth. This type of control is attractive to women who are balancing family and career -- they can perfectly plan maternity leave, right down to the date of the last conference call. Another popular theory is that some women, fearing the pain of vaginal delivery and wanting to avoid urinary incontinence, jump at the chance to give birth via C-section.

http://health.howstuffworks.com/pregnancy-and-parenting/preg...

I do know of cases where women are genuinely terrified of giving birth, as the GP suggests, and will opt for a C-section for that reason. But I think a more common reason is that women increasingly have careers.

I had both my children vaginally. I was a full-time wife and mom for many years. Two career couples have a much greater need to control the timing of things, including processes that, organically, cannot be relied upon to happen at a set time. The slack in my family was generally provided by the fact that I was a full-time wife and mom, so only my husband really needed to have a highly scheduled life. I was relatively free to be available as needed. Two career couples have no one in that position.

(Also:

According to the U.S. Centers for Disease Control, about 33 percent of American women who gave birth in 2011 had a cesarean delivery. (The c-section rate in the United States has risen nearly 60 percent since 1996.)

http://www.babycenter.com/0_c-sections-giving-birth-by-cesar...)

This is totally wrong, women are afraid of c-sections and many c-sections start as natural births and go until the baby begins to falter. In fact, many women choose to have natural birth second child AFTER having a child via c-section even though natural birth after a c-section (VBAC) is very high risk for mom.

Women who are "afraid" of natural birth will get an epidural to help mitigate the pain, not a c-section.

My only knowledge here is personal experience having talked to women swearing they will only ever have C-sections due to fear of natural birth.

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