2

votes

Vitamin D and the formative years, could this in part be driving the increase in C-sections?

Answered on September 12, 2014
Created September 17, 2011 at 8:28 AM

Hypovitaminosis D in childhood (rickets) causes bone deformations, which can reduce the probability of surviving to adulthood, and perhaps more importantly, can cause pelvic deformations in girls that later may cause their death during delivery under primitive conditions, and also the death of their offspring. [Vogel and Motulsky, 1986].

Snagged from http://drbganimalpharm.blogspot.com/

Both the sunscreen and "keep your kids inside so they don't get kidnapped or shot in a drive-by" crazes started in the 1980's, those girls are now grown and having children. Our current c-section rate is 34% as opposed to the recommended rate of no more than 10% (which I suspect is largely driven by hospital protocols, profit, and OBs preferring quick deliveries).

But, could we be looking at that number swelling even more for physiological reasons as these girls born in the '80's and '90's, and those of even more paranoid parents today, are covered in head to toe sun-blocking clothing, and spf 50 for the little outdoor time they do get? (The sun paranoia seems to be quite prevalent from what I've seen on playgrounds around town this summer, and I'm in Seattle with a really wimpy UV index. I've also learned to not admit that I do not put sunblock on my child because I am apparently a bad mom if I don't.) Is there a sub-rickets level of vitamin D deficiency that will cause pelvic deformations that won't be caught at your basic well child visit?

Edit I forgot to add that I've seen a number of references to plain ol' rickets making a comeback in the US over the last 5 years. I haven't read any specific papers on it yet, so I don't know what percentages, but if it is appearing in the legs, I would guess it is also appearing in the pelvis.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 21, 2011
at 07:55 AM

Thank you both Grace and Dragonfly for wonderful work on this! I've learned a lot in the last 72 hours. Oh, and Grace, my photo site seems to be broken, I just renewed it, so my host has some explaining to do, but if you are still curious you can check out some of my work at: http://www.nuzart.com/search.php?query=satoriphotos&x=0&y=0

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 04:51 PM

Most certainly, and I wouldn't ever throw this into the discussion with someone preparing for their own labor, the system causes enough self-doubt as it is, but I might discuss it with parents when I see them flipping through the Sun Precautions clothing catalog next to me on the bench at the park.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 19, 2011
at 03:08 PM

I do think that the other effects of D deficiency have a much higher impact on the C-section rate than pelvic geometry. Regardless, we just need to get the word out!

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 19, 2011
at 03:06 PM

Thanks, Grace! Upvote!

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 19, 2011
at 02:06 PM

Happy Now~ I use my real name which is on my blog.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 07:39 AM

I guess we also have to ask what Vogel and Motulsky consider to be "primitive conditions". Personally, I would consider that to be a solo birth, or one attended by emotional support only. The midwifery maneuvers for shoulder distocia are pretty advanced.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 06:58 AM

Dragonfly, what do you go by on FB? Checked out the blog, nice! I had a postpartum doula site that I was pretty proud of. I just took it down last month when I decided I needed to retire for a while because I hit a "nurturing wall" and burned out a bit trying to balance doula work with motherhood. Heck, I still feel like I could use a doula much of the time. I plan on getting a placenta encapsulation site up at some point because and I'll probably have a lot of educational stuff on there. I'm researching my butt off during my son's naps to see which direction I want to take things next.

3864f9a2af09b1b447c7963058650a34

(3703)

on September 19, 2011
at 06:56 AM

Does that help? Human babies (unlike primates) have to make some serious twisting and turning in the pelvic cavity, right? Not much wiggle room. But on the other had if 1/3 of babies are born with 'soft head disorder' which has increased in frequency (?vit D deficiency) that may not be a problem. It is not inconceivable that it helps to have a vit D deficient baby from a D deficient mom -- the bone issues may cancel out.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 06:15 AM

I thought the studies were topical because they all pointed to the way vitamin D deficiency could cause bone malformations. I just made the leap that the pelvis was also made of bones.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 19, 2011
at 02:35 AM

Create a website, schedule talks for CBEs, call yourself a pregnancy coach and speak with authority. Throw enough studies at them and they will not question your credentials. (lol, that's what I've done, anyway!) Check out my website & blog & friend me on FB and I'll send you more links, if you want...I used to live in Port Townsend, so I know the environment of which you speak... And be aware that Gail Hart is not so fond of high D supplementation, but I am on a FB group with her and am working on it!

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 01:33 AM

Well done Dragonfly. I hadn't even thought about going straight to my local midwives and talking about primal nutrition and the need for vitamin D. Our local midwifery school just got swallowed up by Bastyr university, and I believe it is fine institution, but it touts a vegetarian (leaning towards vegan) cafeteria and I don't know how that will influence what our future Seattle midwives are being taught about nutrition. This is where my credentials leave hanging, I don't know how much advice they will take from a postpartum doula with a BA in photography who studies nutrition as a hobby.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 19, 2011
at 01:20 AM

FaceBook is a powerful way to share information about Vitamin D, BTW...

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 19, 2011
at 01:19 AM

And I am the eternal optimist! I'm doing as much Vitamin D education as I can with the doulas & midwives I come into contact with (I'm a pregnancy coach & mostly work with moms who choose home births.) From what I've seen, the grass-roots education about D is spreading fast, so the scenario you are describing is pretty unlikely. Two prominent midwives in Taos & Santa Fe have recently gone Primal (one thanks to me!) so the shift is happening!

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 01:12 AM

Being as cynical (and I believe deservedly so) we all are about "the need" for the current percentage of c-sections, that isn't quite where I was going with the question, but it is so hard to separate because of how broken the system is. Maybe we have talked this into the ground, but I am wondering if anyone is willing to follow me into a theoretical future where midwifery prevails, home birth is the norm, but people are still refraining from sun exposure, fear more than 2000iu's of D, and eating all those "healthy whole grains", and the c-section rate suddenly jumps from 3% to 20%.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 19, 2011
at 01:09 AM

As you can see from my answer, I totally agree with Grace as far as the effects of Vitamin D deficiency with regard to pregnancy--but there is NO evidence in her answer to support your hypothesis about pelvic deformations contributing to C-section rates.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 12:48 AM

Hmmm...Totally off topic, but I wonder how often awarded answers are down voted this much?

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 12:39 AM

Another thought, how much study has gone into rickets in recent history? I'm guessing not much, considering it was largely eradicated for a while there. If it was from the time when women were receiving x-rays just before labor (horrifying!) and doctors did not understand a thing about relaxin or head molding then perhaps "pelvic malformations" are less of a big deal than I fear. But, I would want someone who had been trained by Ina May by my side just in case I needed some tricky maneuvering if I was one of those little girls covered from head to toe in spf 50 for every playground trip.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 12:30 AM

I am not attempting to do a disservice to women here, relaxin is a powerful hormone and head molding during delivery do work beautifully together. I am certain that our current c-section rate is an outside in, rather than inside out problem. Inductions before the body is ready are most certainly to be blamed in a majority of cases. But I am still worried about how far that matrix can be pushed, there are theories about several lines of humanoids in our history being wiped out because of infant head circumfrence increasing faster than pelvic outlets were growing.

3864f9a2af09b1b447c7963058650a34

(3703)

on September 18, 2011
at 08:01 PM

Dragonfly -- My husband had rickets in high school -- and it wasn't from his description 'classic' leg-bowing rickets. He is very tall, muscular and darker skinned. There are a lot of factors that play into osteomalacia and development of rickets. He was eating a lot of cornmeal and staying indoors and studying at an elite high school which I think were all factors. Deficiency of vitamin D is multifactorial and just putting a bandaid by popping a pill doesn't get to the heart of it. In the paleosphere, what I love is that we are not as guilty of this as much as mainstream SAD medicine.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 04:48 PM

I think that protein (and mineral) deficiency is the issue when a non-nutritive starch becomes 90% of the diet.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 04:46 PM

I think when ice or any non-nutritive starch becomes the mainstay of the diet, nutrional deficiciencies--especially PROTEIN--become the issue.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 04:17 PM

Grace~ Please see my comment to the original question above.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 04:16 PM

I think it is a disservice to women to imply that their pelvises may be malformed due to Vitamin D deficiency AND that is what caused their C-section, induction, etc. Our physiology allows women with a LARGE variety of pelvic outlets to give birth. Read this:http://www.midwiferytoday.com/articles/pelvis.asp

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 04:09 PM

The connective tissue that holds the bones of the pelvis together will soften during unhindered pregnancy and labor and the babies skull is likewise designed to "give" to allow the baby to safely pass through the pelvic outlet. Interventions, especially induction before the baby is ready to be born, does not allow these hormones to do their work. The semi-sitting position so popular in hospital settings likewise decreases the maximum possible size of the pelvic outlet by not allowing the tailbone to move out of the way as the baby spirals out of the birth canal.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 04:01 PM

Happy Now~ Your hypothesis about subclinical pelvic malformations would be valid if the pelvis was a fixed outlet through which the baby must travel. Fortunately, we are designed to survive and reproduce and we are designed perfectly to give birth even if our bones aren't perfectly formed.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 02:32 PM

I've read a lot of stories about rickets in my D research. My understanding is that most symptoms of rickets "disappear" as soon as appropriate D supplementation is started. This is why several families have been arrested for child abuse because the real cause of their child's broken bones is no longer apparent.

Bb8a6d3fb3cc48759cf8c1bf00c065b1

(90)

on September 18, 2011
at 11:00 AM

The rice alone cannot be blamed - the lack of balanced nutrition absolutely plays a part but I have heard several anecdotes that contrasts areas where commercial rice is consumed versus areas where wild rice is prevalent and PPH is not nearly as common in those places.

Bb8a6d3fb3cc48759cf8c1bf00c065b1

(90)

on September 18, 2011
at 10:55 AM

Firstly, I'm referring mostly to South East Asian countries and my direct experience of this is Indonesia. I was wrong to broadly group such an expansive continent. My understanding is that commercial hybridised (that's the bit I didn't explain properly originally - sorry - it's grown in half the time, and susceptible to mold and heavily treated with pesticides etc) white rice was rolled out in the 60's as part of intensive aid efforts... And when that happened people began to rely very, very heavily (like 90% of diet) on rice...and the postpartum hemorrhage rate shot up and stayed there.

3864f9a2af09b1b447c7963058650a34

(3703)

on September 18, 2011
at 10:31 AM

majkinetor -- it attempts to give a reason WHY people are deficient in addition to overutilization of sunscreen and being indoors ;) Happy Now -- OMG absolutely you may take tidbits ANYTIME!!! I love LOVE love your comments, sunny happy outlook and OPTIMISM!! I tried accessing your website earlier but can't get it... Wish I could see your pictures!

77877f762c40637911396daa19b53094

(78467)

on September 18, 2011
at 08:50 AM

The studies listed has nothing to do with the question. We all agree that D is deficient in most people.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 18, 2011
at 07:36 AM

When my husband's mother was in the late part of her pregnancy with him they tried to schedule and arbitrary induction on a Wednesday so that the OB wouldn't miss his golf game on Thursday. She had the fortitude to refuse. I kind of liked it better in the '70's when doctors were arrogant enough to admit things like that to your face, rather than this coy "it is in the best interest of the baby" nonsense.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 18, 2011
at 07:30 AM

Part of my concern about this is related to transfer rate. I worry that my work to normalize home birth could turn around and bite me in the ass, if home birth's acceptance were to increase at the same rate as this possible sub-clinical rickets hip malformation population started having babies. If this has the potential to happen, I think we are right at the beginning of it now so a statistical trend couldn't be noted for another decade or so, and I worry that an increase in transfer rates could prove the doubters right about the safety of home birth.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 18, 2011
at 07:27 AM

Man, sorry about your c-section experience that sounds truly awful, and from my postpartum doula experience, sadly, not uncommon. I am certain they would have performed a c-section on me in about 3 seconds if I hadn't transferred to the hospital with an entourage of 2 midwives and a doula to run interference. I don't see how any woman can be expected to navigate the system (critical thought for paperwork, vetting interventions, and self-advocating) while simultaneously doing the intense inner work of allowing ones body to take over that needs to be done for labor to progress properly.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 18, 2011
at 07:06 AM

Hello! And thank you for an amazing answer. I hope it is okay, that I've been using tidbits from your blog to jumpstart questions here. I just started reading it this week and have been very inspired.

3864f9a2af09b1b447c7963058650a34

(3703)

on September 18, 2011
at 06:06 AM

Sondra -- I think you have spectacular gifts. The people you touch are very lucky indeed ;)

Medium avatar

(2169)

on September 18, 2011
at 01:21 AM

you said EXACTLY what my boyfriend's mom told be yesterday. and she's the head nurse of labor and delivery at a hospital. She says that happens constantly. If I have babies, it won't happen to me!

Medium avatar

(2169)

on September 18, 2011
at 01:19 AM

I JUST talked to my boyfriend's mom about this. She is the head nurse of labor+ delivery at a hospital. She told me that lots of doctors are eager to jump to a C section the moment there's even a tiny little minor problem with a birth because the doctor can do the deliver in an hour and a half, but if they deal with the problems, they might be there for 12 hours or so. Also, people these days are "above nature" IMO, we have so much control over nature that women want control over their deliveries too. It's "more convenient" to have the baby on this day instead of this other one etc.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 12:21 AM

Thanks, Grace! I've been gifted some fabulous birth teachers in my journey.

3864f9a2af09b1b447c7963058650a34

(3703)

on September 17, 2011
at 09:58 PM

Sondra -- Great blog!! A book like about fat-based nutrients for pregnancy and lacatation is Nina Planck's books (and ignore the grain stuff except some white rice). Vets are great (my favorite is Peter at Hyperlipid blog). Moms and pediatricians have to 'read' their bodily cues of children too (and of big kid e.g. adults) *aa ah*

3864f9a2af09b1b447c7963058650a34

(3703)

on September 17, 2011
at 08:24 PM

Can you explain -- how does rice increase postpartum hemorrhage? I think rice increases vision problems in Asia for centuries. Soy may have a big problem on the gender-bender effects -- Asian men just don't have the same musculature as non-soy eating countries except the northern countries which eat MEAT MEAT MEAT.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 17, 2011
at 04:20 PM

This is what I've always suspected, with things like 13 hour birth windows, 1cm/hour requirements, and my favorite c-section grooming line, "according to the ultrasound we just did it looks like your baby might be too big to push out." (The supposedly too big baby was 7lbs. 9oz., wtf?) Birth is a confidence game, and my doula filled me in that they say that line to every single woman at the hospital I transferred to. There is certainly something fishy going on if saying things like that is part of the protocol.

07154e6d8e42065f230d06249700fe5b

(2057)

on September 17, 2011
at 01:47 PM

Don't pescatarian diets cause issues with blood thinning and excessive bleeding? White rice seems like a strange thing to blame... It's not like they're not eating anything else.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 17, 2011
at 01:39 PM

plus one........

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 17, 2011
at 01:39 PM

i can hear the PHD gurus coming to tear you apart in 1.....2.....3......

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 17, 2011
at 01:38 PM

plus one for being spot on

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 17, 2011
at 01:37 PM

plus one for reading my mind.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 17, 2011
at 01:36 PM

my belief is a bit more sinister.......they get paid more to section and it simultaneously reduces the risk of delivery a baby from a medical legal stand point. I think these days a woman has to push for a vaginal delivery in most cities. In many hopsitals the OB depts seem to have forgotten how useful the evolutionary escape pod can be.

2c8c421cf0e0c462654c7dc37f8b9711

(2729)

on September 17, 2011
at 10:21 AM

Interesting question! I've always thought the C-section thing was overly aggressive OBs pushing too many interventions (scheduled inductions, epidurals, etc), but maybe you've got something here. I'm also a "bad mom" who doesn't slather her kid in sunscreen, and we live in the south where there's a lot more sun. Looking forward to reading the answers you get.

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7 Answers

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3864f9a2af09b1b447c7963058650a34

(3703)

on September 17, 2011
at 08:44 PM

Happy Now,

Great ideas and post!! haa

Seriously I think you are totally right on!!!

The 'high fiber' USDA/AMA/ADA industrial complex adds to our epidemic levels of vitamin D deficiency in addition to the neolethal factors that you list. A great way to deplete out minerals (iron, mag, calcium, zinc, etc) and lower vitamin D levels is by consuming unsoaked, refined oatmeal, corn, soy (soymilk) and wholehealthygrains...

How much subclinical rickets is out there? I don't know but it doesn't take much to affect fertility and optimal delivery I strongly suspect. Like Weston A Price made observations on our dental health and cavities, I think refined carbs has caused similiar degrees of neolethal damage on our reproductive health and pelvic bone structures -- microscopic and subtle but hugely significant adverse changes.

Hormones -- when vitamin D is low naturally progesterone is often low too -- Progesterone is the hormone of pregnancy which sustains and regulates the pregnancy. It is suppressed by birth control. The orchestration of pregnancy initiation, hormone cascades and subsequent timing all rely on HORMONES. Yes I think vitamin D, one of the master hormones, is imperative. The medical literature is riddled with studies showing strong association and links between vitamin D deficiency with pre-term labor, proteinuria, pre-eclampsia, pre-term hypertension, and gestational diabetes. Connection? It's not just vitamin D -- it's the whole happy high carb, whole grain, mineral effects, saturated fat and omega-3 deficiencies, and subsequent hormone deficiencies, insulin dysreguation, bone changes, etc.

I had a C-section with my first but it was a weird anatomical thing (hymnal ring) which the 2nd birth, a VBAC, appeared to take care! The ring got cut! Suffered a 3rd degree laceration which is WORSE than a C-section in recovery. I had midwives at both deliveries who were fantastastic but wish I had a doula or midwife throughout the pregnancy.

MacAuliffe T, Pietraszek A, McGinnis J: Variable rachitogenic effects of grain and alleviation by extraction or supplementation with vitamin D, fat and antibiotics. Poultry Sci 1976;55:2142-47.

Hidiroglou M, Ivan M, Proulx JG, Lessard JR: Effect of a single intramuscular dose of vitamin D on concentrations of liposoluble vitamins in the plasma of heifers winter-fed oat silage, grass silage or hay. Can J Anim Sci 1980;60:311-18.

Sly MR, van der Walt WH, Du Bruyn DB, Pettifor JM, Marie PJ: Exacerbation of rickets and osteomalacia by maize: a study of bone histomorphometry and composition in young baboons. Calcif Tissue Int 1984;36:370-79.

Clements MR, Johnson L, Fraser DR: A new mechanism for induced vitamin D deficiency in calcium deprivation. Nature 1987;325:62-65.

Batchelor AJ, Compston JE: Reduced plasma half-life of radio-labelled 25-hydroxyvitamin D3 in subjects receiving a high fiber diet. Brit J Nutr 1983;49:213-16.

Cordain, Loren -- unpublished, he reports of cereal grains lowering serum vitamin D via increasing the rate of inactivation of vitamin D in the liver

EDIT: For Dragonfly!

J Clin Endocrinol Metab. 2009 Mar;94(3):940-5. Epub 2008 Dec 23. Association between vitamin D deficiency and primary cesarean section. Holick et al

Abstract BACKGROUND: At the turn of the 20th century, women commonly died in childbirth due to rachitic pelvis. Although rickets virtually disappeared with the discovery of the hormone vitamin D, recent reports suggest vitamin D deficiency is widespread in industrialized nations. Poor muscular performance is an established symptom of vitamin D deficiency. The current U.S. cesarean birth rate is at an all-time high of 30.2%. We analyzed the relationship between maternal serum 25-hydroxyvitamin D [25(OH)D] status, and prevalence of primary cesarean section.

METHODS: Between 2005 and 2007, we measured maternal and infant serum 25(OH)D at birth and abstracted demographic and medical data from the maternal medical record at an urban teaching hospital (Boston, MA) with 2500 births per year. We enrolled 253 women, of whom 43 (17%) had a primary cesarean.

RESULTS: There was an inverse association with having a cesarean section and serum 25(OH)D levels. We found that 28% of women with serum 25(OH)D less than 37.5 nmol/liter had a cesarean section, compared with only 14% of women with 25(OH)D 37.5nmol/liter or greater (P = 0.012). In multivariable logistic regression analysis controlling for race, age, education level, insurance status, and alcohol use, women with 25(OH)D less than 37.5 nmol/liter were almost 4 times as likely to have a cesarean than women with 25(OH)D 37.5 nmol/liter or greater (adjusted odds ratio 3.84; 95% confidence interval 1.71 to 8.62).

CONCLUSION: Vitamin D deficiency was associated with increased odds of primary cesarean section.

G (aka animal pharm)

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 04:17 PM

Grace~ Please see my comment to the original question above.

77877f762c40637911396daa19b53094

(78467)

on September 18, 2011
at 08:50 AM

The studies listed has nothing to do with the question. We all agree that D is deficient in most people.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 07:39 AM

I guess we also have to ask what Vogel and Motulsky consider to be "primitive conditions". Personally, I would consider that to be a solo birth, or one attended by emotional support only. The midwifery maneuvers for shoulder distocia are pretty advanced.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 19, 2011
at 01:09 AM

As you can see from my answer, I totally agree with Grace as far as the effects of Vitamin D deficiency with regard to pregnancy--but there is NO evidence in her answer to support your hypothesis about pelvic deformations contributing to C-section rates.

3864f9a2af09b1b447c7963058650a34

(3703)

on September 18, 2011
at 10:31 AM

majkinetor -- it attempts to give a reason WHY people are deficient in addition to overutilization of sunscreen and being indoors ;) Happy Now -- OMG absolutely you may take tidbits ANYTIME!!! I love LOVE love your comments, sunny happy outlook and OPTIMISM!! I tried accessing your website earlier but can't get it... Wish I could see your pictures!

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 19, 2011
at 03:08 PM

I do think that the other effects of D deficiency have a much higher impact on the C-section rate than pelvic geometry. Regardless, we just need to get the word out!

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 18, 2011
at 07:06 AM

Hello! And thank you for an amazing answer. I hope it is okay, that I've been using tidbits from your blog to jumpstart questions here. I just started reading it this week and have been very inspired.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 19, 2011
at 03:06 PM

Thanks, Grace! Upvote!

3864f9a2af09b1b447c7963058650a34

(3703)

on September 19, 2011
at 06:56 AM

Does that help? Human babies (unlike primates) have to make some serious twisting and turning in the pelvic cavity, right? Not much wiggle room. But on the other had if 1/3 of babies are born with 'soft head disorder' which has increased in frequency (?vit D deficiency) that may not be a problem. It is not inconceivable that it helps to have a vit D deficient baby from a D deficient mom -- the bone issues may cancel out.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 12:48 AM

Hmmm...Totally off topic, but I wonder how often awarded answers are down voted this much?

3864f9a2af09b1b447c7963058650a34

(3703)

on September 18, 2011
at 08:01 PM

Dragonfly -- My husband had rickets in high school -- and it wasn't from his description 'classic' leg-bowing rickets. He is very tall, muscular and darker skinned. There are a lot of factors that play into osteomalacia and development of rickets. He was eating a lot of cornmeal and staying indoors and studying at an elite high school which I think were all factors. Deficiency of vitamin D is multifactorial and just putting a bandaid by popping a pill doesn't get to the heart of it. In the paleosphere, what I love is that we are not as guilty of this as much as mainstream SAD medicine.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 06:15 AM

I thought the studies were topical because they all pointed to the way vitamin D deficiency could cause bone malformations. I just made the leap that the pelvis was also made of bones.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 04:51 PM

Most certainly, and I wouldn't ever throw this into the discussion with someone preparing for their own labor, the system causes enough self-doubt as it is, but I might discuss it with parents when I see them flipping through the Sun Precautions clothing catalog next to me on the bench at the park.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 21, 2011
at 07:55 AM

Thank you both Grace and Dragonfly for wonderful work on this! I've learned a lot in the last 72 hours. Oh, and Grace, my photo site seems to be broken, I just renewed it, so my host has some explaining to do, but if you are still curious you can check out some of my work at: http://www.nuzart.com/search.php?query=satoriphotos&x=0&y=0

11
9a0239d19c91526e11a28300fc6f4032

on September 17, 2011
at 11:00 AM

As the mother of two kids born of unplanned cesarean sections let me tell you that the majority of cesareans have nothing to do with pelvic issues. There is a whole host of things from the cascade of interventions trying to control how a woman labors (breaking her waters, administering pitocin, giving an epidural, then being put on a timeline) to bad doctors who want to go home at 5pm instead of care for their patients and put them on a timeline or parents who opt for cesarean (either for medical or selfish reasons). Of course there is a lot in between there. :) I attempted a VBAC with my second child. There's a lot of politics in this issue and I'm trying to not let my own personal experience taint what I'm saying here and I hope to avoid any kind of war of words here. Just know that pelvic deformations are extremely rare. There are very few cesareans "necessary" because of that sole reason.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 17, 2011
at 01:37 PM

plus one for reading my mind.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 18, 2011
at 07:36 AM

When my husband's mother was in the late part of her pregnancy with him they tried to schedule and arbitrary induction on a Wednesday so that the OB wouldn't miss his golf game on Thursday. She had the fortitude to refuse. I kind of liked it better in the '70's when doctors were arrogant enough to admit things like that to your face, rather than this coy "it is in the best interest of the baby" nonsense.

Medium avatar

(2169)

on September 18, 2011
at 01:21 AM

you said EXACTLY what my boyfriend's mom told be yesterday. and she's the head nurse of labor and delivery at a hospital. She says that happens constantly. If I have babies, it won't happen to me!

9
Bb8a6d3fb3cc48759cf8c1bf00c065b1

on September 17, 2011
at 12:11 PM

As a doula, childbirth educator and aspiring midwife, I would definitely agree with the previous commenters. Our C-Section rate it a cultural/social phenomena driven by a system that treats birth as an illness - where women are scared of their own bodies, and thus acquiescent to the 'experts.' The cascade of interventions, particularly induction of labour, is the cause of our sky rocketing c-section rates.

Postpartum hemorrhage however, particularly prevalent in Asian countries that rely primarily on white rice for satiety, could well be blamed on nutrition.

07154e6d8e42065f230d06249700fe5b

(2057)

on September 17, 2011
at 01:47 PM

Don't pescatarian diets cause issues with blood thinning and excessive bleeding? White rice seems like a strange thing to blame... It's not like they're not eating anything else.

Bb8a6d3fb3cc48759cf8c1bf00c065b1

(90)

on September 18, 2011
at 10:55 AM

Firstly, I'm referring mostly to South East Asian countries and my direct experience of this is Indonesia. I was wrong to broadly group such an expansive continent. My understanding is that commercial hybridised (that's the bit I didn't explain properly originally - sorry - it's grown in half the time, and susceptible to mold and heavily treated with pesticides etc) white rice was rolled out in the 60's as part of intensive aid efforts... And when that happened people began to rely very, very heavily (like 90% of diet) on rice...and the postpartum hemorrhage rate shot up and stayed there.

Bb8a6d3fb3cc48759cf8c1bf00c065b1

(90)

on September 18, 2011
at 11:00 AM

The rice alone cannot be blamed - the lack of balanced nutrition absolutely plays a part but I have heard several anecdotes that contrasts areas where commercial rice is consumed versus areas where wild rice is prevalent and PPH is not nearly as common in those places.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 04:46 PM

I think when ice or any non-nutritive starch becomes the mainstay of the diet, nutrional deficiciencies--especially PROTEIN--become the issue.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 17, 2011
at 01:39 PM

i can hear the PHD gurus coming to tear you apart in 1.....2.....3......

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 04:48 PM

I think that protein (and mineral) deficiency is the issue when a non-nutritive starch becomes 90% of the diet.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 17, 2011
at 01:39 PM

plus one........

3864f9a2af09b1b447c7963058650a34

(3703)

on September 17, 2011
at 08:24 PM

Can you explain -- how does rice increase postpartum hemorrhage? I think rice increases vision problems in Asia for centuries. Soy may have a big problem on the gender-bender effects -- Asian men just don't have the same musculature as non-soy eating countries except the northern countries which eat MEAT MEAT MEAT.

9
1da74185531d6d4c7182fb9ee417f97f

on September 17, 2011
at 12:07 PM

If the home birth transfer to hospital rates were at 30 percent I'd think you were on to something, but The transfer to hospital rate is 16% (which includes stuff like hemorrhage, medic issues with baby,) and the csection rate is 8% among intended home Births. Something is amiss!!! I speak from c-section experience. The cascade of interventions at my birth were horrible, ineffective, and I am certain were the cause of my failure. The best thing to do is follow the money... Hospitals Make about 4-8 grand on a vaginal birth and 14-20k on a C-section. AND it saves time and liability. That's what the problem is.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 17, 2011
at 01:38 PM

plus one for being spot on

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 18, 2011
at 07:27 AM

Man, sorry about your c-section experience that sounds truly awful, and from my postpartum doula experience, sadly, not uncommon. I am certain they would have performed a c-section on me in about 3 seconds if I hadn't transferred to the hospital with an entourage of 2 midwives and a doula to run interference. I don't see how any woman can be expected to navigate the system (critical thought for paperwork, vetting interventions, and self-advocating) while simultaneously doing the intense inner work of allowing ones body to take over that needs to be done for labor to progress properly.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 18, 2011
at 07:30 AM

Part of my concern about this is related to transfer rate. I worry that my work to normalize home birth could turn around and bite me in the ass, if home birth's acceptance were to increase at the same rate as this possible sub-clinical rickets hip malformation population started having babies. If this has the potential to happen, I think we are right at the beginning of it now so a statistical trend couldn't be noted for another decade or so, and I worry that an increase in transfer rates could prove the doubters right about the safety of home birth.

5
Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 17, 2011
at 12:48 PM

Honestly, I don't think pelvic malformations are contributing very much, if at all, to the C-section rate. Vitamin D deficiency plays a role for sure, in the context of nutrition.

Our fear-based birth culture is the largest contributor. Many of the interventions (mentioned by other posters) that contribute to C-sections take place within this culture. And they start during pregnancy where women are taught to trust the "experts", rather than their own bodies.

And certainly nutrition is a factor!

Normal birth physiology isn't rocket science and really should be taught in school. As a pregnancy coach, I am shocked at how much misinformation is out there--even amongst many obs, midwives and childbirth educators.

Veterinarians are good sources of understanding about normal birth in mammals and they understand that interference in the natural process usually creates more problems than it solves.

I wrote a recent blog post about Vitamin D deficiency in pregnancy that contains a long Vitamin D Council newsletter on the subject. You might find it helpful.

http://sondrarose.blogspot.com/2011/08/vitamin-d-deficiency-pregnancy.html

Oh, and a really great book to read about physiological birth and the relative risks & benefits of "normal" birth interventions is Gentle Birth, Gentle Mothering by Dr. Sarah Buckley.

3864f9a2af09b1b447c7963058650a34

(3703)

on September 17, 2011
at 09:58 PM

Sondra -- Great blog!! A book like about fat-based nutrients for pregnancy and lacatation is Nina Planck's books (and ignore the grain stuff except some white rice). Vets are great (my favorite is Peter at Hyperlipid blog). Moms and pediatricians have to 'read' their bodily cues of children too (and of big kid e.g. adults) *aa ah*

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on September 18, 2011
at 12:21 AM

Thanks, Grace! I've been gifted some fabulous birth teachers in my journey.

3864f9a2af09b1b447c7963058650a34

(3703)

on September 18, 2011
at 06:06 AM

Sondra -- I think you have spectacular gifts. The people you touch are very lucky indeed ;)

5
77877f762c40637911396daa19b53094

(78467)

on September 17, 2011
at 10:19 AM

I believe that increase in C section is because of epidural and absence of education [ there are women who pre-order it ]

Epidural per se is great, but you need to be prepared for delivery more then without it. This includes detailed knowledge of delivery phases, types of delivery, breathing strategies, physical training, pushing techniques and so on. Rarely woman does that or if she does, its not appropriate.

There might also be problems with oxitocyn analogues in combination with epidural but this is part of the same problem.

Vitamin C deficiency and general nutrient status, not just that of Vitamin D is more probable because of the hospital food which is always junk, high level of stress and surgical procedure.

4
D3ff004d4a0c42b67cc2c49a5ee9c0f3

(5801)

on September 17, 2011
at 12:07 PM

Basically, it looks like it comes down to either reducing legal liability, money, doctors intentionally not informing women, and convenience. All the articles I read state that even though 31% of births are by C section, only 4% are medically required - a number that remains unchanged since they started keeping records in the 1960s.

Here are a few quotes that I found just googling "rise in C Sections"

OB/GYN Peter Bernstein of Montefiore Medical Center in New York says some doctors encourage patients to schedule C-sections because they think they're less likely to be sued than if they perform a vaginal delivery. And "women are more ambivalent about what they want."

Focus groups have suggested one out of 10 women pregnant for the first time would allow the equivalent of a coin toss to determine how they should deliver, he says.

Current research suggests that some labor interventions make a c-section more likely. For example, labor induction among first-time mothers when the cervix is not soft and ready to open appears to increase the likelihood of cesarean birth. Continuous electronic fetal monitoring has been associated with greater likelihood of a cesarean. Having an epidural early in labor or without a high-dose boost of synthetic oxytocin ("Pitocin") seems to increase the likelihood of a c-section.

Many health professionals and/or hospitals are unwilling to offer the informed choice of vaginal birth to women in certain circumstances.

Given the way that our legal, liability insurance, and health insurance systems work, caregivers may feel that performing a cesarean reduces their risk of being sued or losing a lawsuit, even when vaginal birth is optimal care.

Many health professionals are feeling squeezed by tightened payments for services and increasing practice expenses. The flat "global fee" method of paying for childbirth does not provide any extra pay for providers who patiently support a longer vaginal birth.

The national U.S. cesarean section rate was 4.5% and near this optimal range in 1965 when it was first measured (Taffel et al. 1987). In more recent years, large groups of healthy, low-risk American women who have received care that enhanced their bodies' innate capacity for giving birth have achieved 4% cesarean section rates and good overall birth outcomes (Johnson and Daviss 2005, Rooks et al. 1989). However, the national cesarean section rate is much higher and has been increasing steadily for more than a decade. With the 2007 rate at 31.8%, about one mother in three now gives birth by cesarean section, a record level for the United States.

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