Hormetic Stress Biohacking Type 1 Diabetes CGM

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Photo: Unsplash.com Medical Disclaimer : The content on this blog is purely for informational purposes only. For medical advice, diagnosis and treatment, consult your doctor. The ultimate goal for anyone living with Type 1 Diabetes (T1D) is stability. You want fewer spikes, fewer crashes, and more time spent in your target blood sugar range. Read more on blood sugar spike . For years, standard medical advice focused purely on matching insulin doses to carbohydrate intake. While this foundational math is necessary, it often leaves people riding a frustrating blood sugar roller coaster. Today, a new wave of tech-savvy individuals is looking beyond the traditional playbook. They are combining the principles of biohacking, the physiological benefits of hormetic stress, and the real-time data of Continuous Glucose Monitors (CGMs) to transform how they manage their health. This approach does not replace insulin. Instead, it aims to make the body more resilient, predictable, and res...
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Cesarean Delivery vs Vaginal Delivery: What the Experts Say

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Cesarean Section vs Vaginal Delivery? Photo: Engin Akyurt/Unsplash.com


Cesarean deliveries on maternal request account for appropriately 2.5% of births in the United States, according to the Journal of American Medical Association (JAMA). These are planned cesarean deliveries before the onset of labor without medical or obstetrical indications. 

Although the American College of Obstetricians & Gynecologists (ACOG) recommends planned vaginal delivery for pregnant individuals without maternal or fetal indications for cesarean delivery, the increased safety of cesarean delivery over the past 2.5 decades has led to reconsideration of maternal requests for cesarean delivery, JAMA said.

ACOG acknowledges patient autonomy and honors the choice of delivery on maternal request after appropriate counseling regarding the risks and benefits of planned vaginal vs cesarean delivery, and states that planned cesarean delivery on maternal request should not be performed before 39 weeks of pregnancy.

 According to the Journal, the World Health Organization (WHO) recommends cesarean delivery only for medical indications. Fear of labor pain, potential adverse fetal outcomes, and pelvic floor damage are cited as reasons pregnant individuals might choose cesarean delivery over vaginal delivery.

Maternal Outcomes: Vaginal Delivery

Vaginal delivery occurs for 75% of nulliparous individuals in the US with a term, singleton, vertex pregnancy, and is associated with fewer days to pain- and opioid-free recovery and decreased postpartum infection, thromboembolism, and anesthetic complications compared with cesarean delivery performed in the absence of any complications of labor and delivery and without maternal medical risk factors that may have constituted a medical indication, JAMA stated.

"Planned vaginal delivery is also associated with a shorter hospital stay compared with planned cesarean birth. However, compared with pregnant individuals who undergo planned cesarean delivery, those who plan a vaginal delivery and undergo labor induction experience higher risks of chorioamnionitis and postpartum hemorrhage due to unforeseen labor complications or unplanned cesarean delivery," the Journal stated.

Maternal Outcomes: Cesarean Delivery

According to JAMA, in a random sample of 4458 women enrolled in a large US health maintenance organization, the lifetime risk of pelvic floor disorders was 27% among those who underwent cesarean delivery for any indication compared with 42% who underwent vaginal delivery.

However, individuals who undergo planned cesarean delivery on maternal request are at increased risk of adverse events during subsequent pregnancies, including uterine rupture and placenta accreta spectrum, which involves abnormal placental adherence to the uterine wall, it stated.

Hemorrhage due to placenta accreta spectrum can be severe and may require hysterectomy at the time of cesarean delivery. The risk of placenta accreta by the third cesarean delivery increases. For patients undergoing a third cesarean delivery, there is a 1% overall risk that a hysterectomy will be required, most commonly to manage placenta accreta spectrum, JAMA stated.

Cesarean Delivery on Maternal Request vs Planned Vaginal Delivery: Infant Risks

According to the study published in JAMA, 15 randomized clinical trials comparing planned cesarean delivery with planned vaginal delivery, planned cesarean delivery was associated with a lower risk of low umbilical artery pH, an indicator of fetal hypoxia; neonatal birth trauma, including nerve injury, skull fracture, or long bone fracture; tube feeding requirement; and hypotonia compared with planned vaginal delivery.

Shared Decision-Making and Patient Autonomy

ACOG specifically notes that counseling should include a discussion about the reasons for the patient’s request and should inform pregnant individuals about the increased risk of placental abnormalities and the risk of hysterectomy at the time of delivery in subsequent pregnancies.

 "Although hospitals may be reimbursed at a higher rate for cesarean delivery, in many states, obstetric services are billed by the physician using global obstetric codes, which are similar for each mode of delivery.

"Cesarean delivery on maternal request currently accounts for approximately 2.5% of births in the US.  Shared decision-making should include a discussion of the risks and benefits of planned vaginal vs cesarean delivery for both birthing individuals and their infants, future childbearing plans, and the risk of pelvic floor injury," ACOG recommended.


Cesarean Delivery vs Vaginal Delivery, which one do you prefer? Have your say.

SOURCE: JAMA


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