Cesarean section is a BIG deal

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Let’s talk c-section. Chances are many of you have no idea what is going on in hospitals and that c-section is a big deal and should be avoided at all costs, except when mother’s and/or baby’s lives are truly in danger. It is not a minor procedure, it has numerous short-term and long-term negative effects, you need to educate yourself before being talked into scheduling one for no life-threatening reason.
Find excellent information on why cesarean sections are so common in the US. Believe me, you won’t like what you’ll read: Why Is the National U.S. Cesarean Section Rate So High?

“More recent studies reaffirm earlier World Health Organization recommendations about optimal rates of cesarean section. The best outcomes for women and babies appear to occur with cesarean section rates of 5% to 10%. Rates above 15% seem to do more harm than good (Althabe and Belizan 2006).

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). Since then, 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, after more than a decade of increasing steadily, has recently experienced the first dip since the mid-1990s. With the 2010 rate at 32.8% (Hamilton et al. 2011), about one mother in three now gives birth by cesarean section.

Most mothers are healthy and have good reason to anticipate uncomplicated childbirth. Cesarean section is major surgery and increases the likelihood of many short- and longer-term adverse effects for mothers and babies (some of these harms are listed below). There are clear, authoritative recommendations for more judicious use of this procedure (U.S. Department of Health and Human Services 2000). So why is a pregnant woman’s chance of having a cesarean section so high?

Reasons for the High Cesarean Section Rate:
The following interconnected factors appear to contribute to the high cesarean rate.

-Low priority of enhancing women’s own abilities to give birth
Care that supports physiologic labor, such as providing the midwifery model of care, providing continuous support during labor through a doula, and using hands-to-belly movements to turn a breech (buttocks- or feet-first) baby to a head-first position, reduces the likelihood of a cesarean section. The decision to switch to cesarean is often made when caregivers could use watchful waiting, positioning and movement, comfort measures, oral nourishment and other approaches to facilitating labor progress. The cesarean section rate could be greatly lowered through such care.

-Side effects of common labor interventions
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, and epidural analgesia appears to increase the likelihood of cesareans performed in response to “fetal distress.”

-Refusal to offer the informed choice of vaginal birth
Many health professionals and/or hospitals are unwilling to offer the informed choice of vaginal birth to women in certain circumstances. The Listening to Mothers survey found that many women with a previous cesarean would have liked the option of a vaginal birth after cesarean (VBAC) but did not have it because health professionals and/or hospitals were unwilling (Declercq et al. 2006a). More than nine out of ten women with a previous cesarean section are having repeat cesareans in the United States. Similarly, few women with a fetus in a breech position have the option to plan a vaginal birth.

-Casual attitudes about surgery and variation in professional practice style
Our society is more tolerant than ever of surgical procedures, even when not medically needed. This is reflected in the comfort level that many health professionals, insurance plans, hospital administrators and women themselves have with cesarean trends. Further, the cesarean rate varies broadly across states and areas of the country, hospitals, and maternity professionals. Most of this variation is due to “practice style” rather than differences in the needs and preferences of childbearing women (Baicker et al. 2006, Clark et al. 2007).

-Limited awareness of harms that are more likely with cesarean section
Cesarean section is a major surgical procedure that increases the likelihood of many types of harm for mothers and babies in comparison with vaginal birth. Short-term harms for mothers include increased risk of infection, surgical injury, blood clots, emergency hysterectomy, intense and longer-lasting pain, going back into the hospital and poor overall functioning. Babies born by cesarean section are more likely to have surgical cuts, breathing problems, difficulty getting breastfeeding going, childhood-onset diabetes, and asthma in childhood and beyond. Perhaps due to the common surgical side effect of “adhesion” formation, cesarean mothers are more likely to have ongoing pelvic pain, to experience bowel blockage, to be injured during future surgery, and to have future infertility. Of special concern after cesarean are various serious conditions for mothers and babies that are more likely in future pregnancies, including ectopic pregnancy, placenta previa, placenta accreta, placental abruption, and uterine rupture (Childbirth Connection 2006).

-Incentives to practice in a manner that is efficient for providers
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. Some payment schedules pay more for cesarean than vaginal birth. A planned cesarean section is an especially efficient way for professionals to organize hospital work, office work and personal life. Average hospital charges are much greater for cesarean than vaginal birth, and may offer hospitals greater scope for profit.

All of these factors contribute to a current national cesarean section rate of over 30%, despite evidence that a rate of 5% to 10% would be optimal.”

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