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The Skyrocketing Number of C-Sections: Time’s Misleading Assertion That It is Moms Who Are Mostly Responsible For Driving Up The Rates

lmarshalls Icon Posted by Lucinda Marshall

April 21st, 2008

According to Time magazine, “Choosy Mothers Chose Cesarians“. Just like choosy mothers pick the best day care or pre-school or what kind of food to feed their children? Well not exactly.

“Rates of C-sections have been climbing each year in the past decade in the U.S., reaching a record high of 31% of all live births in 2006. That’s a 50% increase since 1996. Around the world, the procedure is becoming even more common: in certain hospitals in Brazil, fully 80% of babies are delivered by caesarean. How did a procedure originally intended as an emergency measure become so popular? And is the trend a bad thing?”

Well one way it became so popular might be by referring to it as a procedure instead of major surgery. But is it the mothers who are actually driving the numbers up, as the headline implies? Guess again.

“Some of the rise in C-sections can certainly be attributed to women with routine pregnancies… who make a pragmatic decision to keep their deliveries just as uneventful. Preliminary data suggest that such cases account for anywhere from 4% to 18% of the total number of cesareans.

So never mind that the headline makes it sound as if this is the delivery method of choice for Moms who care about their kids, the reality is that only a small percentage of these numbers is attributable to maternal choice.

According to the article, better surgery outcomes, obesity and multiple births also contribute to the increased rates of cesarians and one OB opines that giving birth is now less about the miracle of giving birth and more about delivering the kid “safely and without incident.” Okay, let’s say this again, cesarian sections are a kind of major surgery and major surgery is risky.

But as the article points out,

“(There) are some powerful fiscal forces as well, such as soaring malpractice rates for obstetricians. Since doctors are sued more frequently after vaginal births than cesareans, surgery is often the prudent choice when there is even the slightest indication of a difficult vaginal birth.Vaginal delivery can, for example, lead to future incontinence and pelvic damage, while babies born by C-section may suffer from respiratory problems because of not being exposed to certain hormones during the birthing process.”

Well yes indeed, it would certainly be more prudent for the doctor who consequently makes more money and doesn’t have to bother with the fuss and muss of being sued, but just an observation, most women who deliver vaginally do not have ongoing incontinence problems. I’m not saying it doesn’t happen, but if it were that big a deal, the adult diaper section at the grocery store would be a whole lot bigger and not to belabor (sorry) the point, but C-section risks are about a whole lot more than the baby not being exposed to certain hormones. It is also about the baby being exposed to anesthesia, the mother having a major incision in her gut and a longer recovery period with a whole lot more risk of complications than recovery from a vaginal birth. It should also be pointed out that the U.S. has one of the highest infant mortality rates in the ‘developed’ world, a number that has been attributed in part to high C-section rates.

No doubt there are times when a C-section is totally necessary but when the rate of those times suddenly skyrockets over a few years to more than 30% of the time, it isn’t about medical necessity. It is about medical greed and mothers being given very poor information about the birthing process and the extent to which medical decisions are de facto being made by insurance companies.

Cross-posted from the Feminist Peace Network blog.

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