Hi Henci, 

I'm trying to study up on what's out there about H1N1 and scheduling Cesareans.  I'm worried that docs will use that as a way to encourage moms to have unnecessary cesareans.  Do you have any info? 

The thing with H1N1 is that it disproportionatly affects pregnant women more than the regular seasonal flu (4% vs. 1%), right? 

And I know women shouldn't wait to be tested for the flu -- just get the anti-virals if they feel sick and maybe have a standing prescription with their dr. if they need them over the weekend. 

And when the vaccines come out, that will help with a lot of women's fears.  It's good there's also a non-thimerosol one, although I doubt the moms I know who don't like thimerosol (sp?) will get the the vaccine anyway. 

So, the key thing I'm trying to figure out is, are the effects of this flu like the effects of the regular seasonal flu (on mom and baby)?  If so or if not, in what situations is scheduling a cesarean an evidenced-based idea and when not?  I've not read of the flu as an evidence-based reason to schedule a cesarean.  One woman in Columbus Ohio died after the cesarean (baby was fine).  Seems not a good idea to have a majoy operation if you're sick! 

Perhaps current data about the N1N1 isn't out there for the public yet; maybe the CDC is holding onto it.  But wanted to check with you.  Thanks for any help!  :-) 

Lucy Juedes, LCCE in Southeast Ohio

I would not be surprised if obstetricians used H1N1 fears to schedule cesareans. You can always find a reason to do what you want to do, and H1N1 is as good as any. I'm sure it will be used a reason to deny women the companionship of doulas and loved ones and friends, as if somehow hospital staff posed no risks. Frankly, an epidemic makes a very, VERY strong argument for planned home birth for any woman who does not anticipate a substantial probability of needing the resources of a hospital because of her medical or obstetric complications. The last place a pregnant woman, new mother, and newborn should be is in an environment where sick people go and where there are many strangers coming into contact with her and her baby. 

-- Henci