Cesarean section

“ Munde speaks of twins being delivered by Cesarean section. Franklin gives the instance of a woman delivered at full term of a living child by this means, in whom was also found a dead fetus. It lay behind the stump of the amputated cervix, in the culdesac of Douglas. The patient died of hemorrhage.
Croston reports a case of Cesarean section on a primipara of twenty-four at full term, with the delivery of a double female monster weighing 12 1/2 pounds. This monster consisted of two females of about the same size, united from the sternal notch to the navel, having one cord and one placenta. ”

“ There are few greater incursions on a body than forcing a woman to complete a pregnancy and give birth. For every woman, those experiences involve all manner of physical changes, medical treatments (including the possibility of a cesarean section) , and medical risk. Just as one example, an American woman is 14 times more likely to die by carrying a pregnancy to term than by having an abortion. ”

“ In a hysterotomy, as in a cesarean section, the doctor removes the fetus by making an incision through the abdomen and uterine wall to gain access to the uterine cavity. A hysterectomy requires the removal of the entire uterus. These two procedures represent about 0.07 percent of second-trimester abortions. National Abortion Federation, 330 F. Supp. 2d, at 467; Planned Parenthood, supra, at 962–963.
B After Dr. Haskell's procedure received public attention, with ensuing and increasing public concern, bans on "'partial birth abortion'" proliferated. ”

“ Should a physician be present when a pregnant woman has recently expired, and the child may still be living in the womb, it will be an easy and important task to perform the Cesarean section as soon as possible, and baptize the little one before it dies. ”

“ Tait remarks that he ‘feels certain that the decision of the profession will be, before long, to give up the performance of such operations as are destructive to the child, in favor of an operation that saves it, and subjects the mother to little more risk. The operation of Cesarean section, or the Porro amputation of the pregnant womb, will revolutionize the obstetric art, and in two years we shall hear no more of craniotomy; for the improved method will save more lives, and is far easier of performance. ”

“ Essentially, appellant's complaint alleged that the defendant doctors' and institutions' medical negligence in unnecessarily inducing his wife's labor, failing to discontinue the induction, failing to perform a cesarean section, failing to resuscitate her or the unborn baby, and failing to obtain informed consent, proximately caused Mrs. Aka's and her unborn son's deaths. Appellant also averred that JRMC's, AHEC's, and AHEC's faculty supervisors' failure to train and supervise AHEC resident physicians proximately caused both deaths. ”

“ As used in this section, the term ``born alive ́ ́, with respect to a member of the species homo sapiens, means the complete expulsion or extraction from his or her mother of that member, at any stage of development, who after such expulsion or extraction breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, regardless of whether the umbilical cord has been cut, and regardless of whether the expulsion or extraction occurs as a result of natural or induced labor, cesarean section, or induced abortion. ”

“ Hippocrates, Celsus, Avicenna, and the Arabian School invented a number of vulnerating instruments to enter and crush the child’s cranium. With the advance of the obstetric art, more conservative measures were gradually adopted, such as the forceps, version, induction of premature labor, and, finally, Cesarean section. ”

“ Kelly reports the history of a woman of forty who died in her eighth pregnancy, and who was delivered of a female child by version and artificial means. Artificial respiration was successfully practised on the child, although fifteen minutes had elapsed from the death of the mother to its extraction. Driver relates the history of a woman of thirty-five, who died in the eighth month of gestation, and who was delivered postmortem by the vagina, manual means only being used. The operator was about to perform Cesarean section when he heard the noise of the membranes rupturing. ”

“ What circumstances will justify the Cesarean Operation, and of what value is the section of the Symphysis Pubis, or Sigaultian operation? Where the size of the pelvis [449] will not admit the passage of the child, surgical aid is indispensably necessary; but, says Dr. Merriman, [450] it becomes every man to set out with a determination that he will not hastily, nor without due cause, have recourse to instrumental assistance ”

“ As a nation that values the health of women and children, we must not turn our backs on this problem. There is an emerging national consensus that we must put a stop to these so-called drive-through deliveries. The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics have issued guidelines recommending a minimum stay of 48 hours following most normal deliveries, and 96 hours following most cesarean sections. Sixteen States have enacted laws to guarantee that level of coverage and 25 more are considering such a move. ”

“ Whenever the child can be brought away by the natural passages, though it be piecemeal, it always is so brought, unless the danger to the mother be greater than by the cesarian operation, in which case that operation is resorted to. By means of an instrument called the Cephalotribe, which crushes the head, the child may be brought away, unless very large, when the pelvis only measures two inches. When the passage is less than two inches, the only resort is to the cesarean operation, which sometimes succeeds, and saves both mother and child, though more frequently the mother sinks. ”

“ When the narrowness of the pelvis is discovered only during labour, the treatment varies with the condition. If the woman is not septic, and has not been repeatedly examined by the vagina, and if the surroundings are favourable, caesarean section is done; if she is septic, the indications are for the section, or symphyseotomy or craniotomy. Where the conjugata vera is below 5 centimetres in length, the caesarean section is the only method to get the child out, dead or alive, and after the child has been delivered, the uterus, if septic, is removed. ”

“ When the contraction is such that a living fœtus cannot be brought forth, the accoucheur has then to choose between the Cæsarean section or miscarriage.
During pregnancy, abortion will present an extreme and last resource. And it would seem more humane to sacrifice, before the period of viability, an embryo whose existence is so uncertain, in order to protect the mother from the perilous chances of symphyscotomy and the Cæsarean section. ”

“ If there is ground for supposing that septic infection of the mother has begun, the conditions are explained, and if she wishes to have the caesarean section done the risk is left to her. When the breech or face of the child presents in contracted pelves, the condition is especially unfavourable for the child. ”

“ A group of gynaecologists maintain that when fibromata cause dangerous symptoms in pregnancy the uterus should be taken out in part or wholly if the tumour is so deeply involved in the uterine wall that it can not be separated. This operation, of course, kills the foetus. At times the child is viable, and a precedent caesarean section will save it. Surgeons do not remove fibromata merely as a precaution, as they sometimes do in the case of ovarian cysts. Other surgeons say it is safe to wait. If the channel of delivery is blocked, these men wait till term and then do caesarean {42} section ”

“ Often the obstruction is so dense as to require a large bistoury to divide it, and even that is not always sufficient, and the Cesarean operation only can terminate the obstructed delivery; we cannot surmise how conception could have been possible. Staples records a case of pregnancy and parturition with congenital stricture of the vagina. Maisonneuve mentions the successful practice of a Cesarean operation in a case of congenital occlusion of the vagina forming a complete obstruction to delivery. ”

“ By use of the forceps, by skill acquired in version, by procuring premature labour, and especially by asepticism in the Cæsarean section and other equivalent operations, medical science has found much improved means of saving both the child and its mother. Of late years such progress has been made in this matter, that craniotomy on the living child has passed out of reputable practice. But abortion proper, before the fœtus is viable, is still often employed, especially in ectopic gestation; and there are many men and women who may be called professional abortionists. ”

“ Journal of Obstetrics and Gynæcology of the British Empire, 1907, xii. 335.
Wallace, Arthur J. On Repeated Cæsarean Section. Ibid., 1902, ii. 555.
CÆSAREAN SECTION IMMEDIATELY AFTER THE DEATH OF THE MOTHER
It occasionally happens that a woman in whom the course of pregnancy is nearly complete dies suddenly from disease, such as hæmoptysis, hæmatemesis, cardiac trouble, or uterine hæmorrhage in the preliminary stage of labour; or is killed by accident. In some such circumstance attempts are sometimes made to rescue the unborn child, by performing Cæsarean section. ”

“ Plainly, if the pregnancy is to be terminated at a time when there is no chance of life outside the womb, a physician would not be required to exercise any care or skill to preserve the life of the fetus during abortion no matter what the mother's desires. The statute would appear then to operate only in the gray area after the fetus might be viable but while the physician is still able to certify "with reasonable medical certainty that the fetus is not viable." ”

“ She forgets all her suffering, when she clasps the little innocent to her breast. In ancient times, miscarriage was thought to be a curse on the female, as it endangers her life, by bringing on hemorrhage, from the adhesion of the placenta. There is a difference between miscarriage and abortion: an exclusion of the fœtus six, and sometimes seven weeks after the cessation of the menses, is termed miscarriage; between that and six months, an abortion; and between that and nine months, premature labor. Sometimes the fault lies in some deficiency on the part of the ovum. ”

“ By mandating tests to determine fetal weight and lung maturity for every fetus thought to be more than 20 weeks gestational age, the statute requires physicians to undertake procedures, such as amniocentesis, that, in the situation presented, have no medical justification, impose significant additional health risks on both the pregnant woman and the fetus, and bear no rational relation to the State's interest in protecting fetal life. ”

“ After sufficient dilation the surgical operation can commence. The woman is placed under general anesthesia or conscious sedation. The doctor, often guided by ultrasound, inserts grasping forceps through the woman’s cervix and into the uterus to grab the fetus. The doctor grips a fetal part with the forceps and pulls it back through the cervix and vagina, continuing to pull even after meeting resistance from the cervix. The friction causes the fetus to tear apart. For example, a leg might be ripped off the fetus as it is pulled through the cervix and out of the woman. ”

“ First, the person performing the abortion must "vaginally delive [r] a living fetus." § 1531 (b) (1) (A) . The Act does not restrict an abortion procedure involving the delivery of an expired fetus. The Act, furthermore, is inapplicable to abortions that do not involve vaginal delivery (for instance, hysterotomy or hysterectomy) . The Act does apply both previability and postviability because, by common understanding and scientific terminology, a fetus is a living organism while within the womb, whether or not it is viable outside the womb. See, e. g., Planned Parenthood, 320 F. Supp. ”

“ Advanced obstetricians advocate the performance of the Cesarian section or its modification—the Porro operation—in preference to craniotomy, because nearly all the children are saved, and the unavoidable mortality among mothers is not much higher than that which attends craniotomy. Of one hundred women on whom Cesarian section is performed under favorable conditions and with attainable skill, about ninety-five mothers should recover and fully the same number of children. ”

“ The placenta can generally be seized by two fingers and removed; but if persevering efforts are necessary, they should not be relinquished until the safety of the mother is assured, which cannot be while the ovum, or membranes, or placenta remain in the uterus separated from their connections.
But it should always be considered especially important to PREVENT THE ABORTION. If a woman is prone to miscarry, she ought, as soon as she is pregnant, to lie down a great part of the day; she must keep her mind calm and unruffled, and must live on plain diet ”

“ The Attorney General concedes, and we agree, that if an abortion procedure does not involve the delivery of a living fetus to one of these "anatomical 'landmarks'"--where, depending on the presentation, either the fetal head or the fetal trunk past the navel is outside the body of the mother—the prohibitions of the Act do not apply. ”