Rate of Caesarian Sections Steadily Increasing

Wednesday, September 01, 2010

Baby (Flickr: Kimberly Calderon)

A new study shows that Caesarian sections account for about 1/3 of births in the U.S. And that number is expected to rise. Is the C-Section becoming the new natural and safe way to give birth? We want to hear from you: what's so natural about "natural" birth, anyway?

The study, published by the American Journal of Obstetrics and Gynecology, reveals that the main reason women have c-sections is because they've given birth via c-section in the past.  Also, drugs are being used more often to induce labor and induced labor, as opposed to spontaneous labor, is twice as likely to result in a c-section.  

Dr. Randi Hutter Epstein, author of "Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank,"says doctors' fear of malpractice lawsuits are behind the rising number of Caesarian sections.  Hutter Epstein says many doctors think, "You're never going to get sued for doing a c-section -- only for not doing one."

Dr. Mitchell Maiman, Chairman of the Department of Obstetrics and Gynecology at Staten Island University Hospital in New York, advocates avoiding c-sections, if vaginal births are possible.  Maiman says his hospital has very strict protocols and guidelines, when it comes to inductions of labor.  There is also an emphasis on educating women about the potential risks involved with c-sections.  And, if a the surgery is performed in the hospital, Maiman says, "We review every c-section to make sure there was a correct indication."

Some comments for our Facebook page:

Lynn Golden: I beg your pardon...I have experienced both a vaginal birth and a c-section. The first one almost killed me - literally, hence the second one. Are you implying that getting a child out of your body should only be achieved in one way? I will concede that unless one uses absolutely NO medical assistance...i.e. birth at home, with no mid-wife or doula, and no pain relief, and no post-childbirth treatment, then a woman has not had a "natural" birth. However, in many cases, c-section is not only desirable, it is necessary, and those mothers participate in childbirth as well...and as someone who took 8 weeks to recuperate and dealt with 2 1/2 hours of separation from her child after a c-section, there was absolutely NOTHING easy about it.

That said, I remember my OB telling me at some point in BOTH deliveries "Whatever it takes to get that baby out safely and keep the Mama around to take care of that baby..." Yes, c-section for vanity or convenience IS distasteful...but we are lucky that we have this option, as opposed to the alternative.

Rachel Melat-Robnett: My daughter was born vaginally, it was an extremely difficult labor, nearly 72 hours, and my doctor wanted me to have a c-section. Even through all the pain I stuck to my guns and refused, although I did eventually have an epidural. Of my friends and family with children, I am one of the only mothers who has NOT had a c-section!


Dr. Randi Hutter Epstein and Dr. Mitchell Maiman

Produced by:

Amanda Moore

Comments [10]

Danielle Fielding from Western, NY

Joy, pregnancy alone causes that problem not vaginal birth. I had a c-section and I still dribble urine. Pregnancy does not come without a price sometimes and for many mother's a weak bladder is one of them. This is especially true for women who are multiparas.
Let me guess the doctor who wanted to give you a c-section was a male?

Sep. 01 2010 04:04 PM
Joy from Livonia, Michigan

Your story didn't touch on one of the big reasons that many European women and their doctors opt for C-sections -- avoiding damage to the woman's pelvic floor muscles. My doctor recommended a C-section but my midwife said I didn't need one. In retrospect, I wish I'd followed his advise. Everywhere I went for the next 10 years, I had to scope out a bathroom first thing. Eventually I had surgery to try and fix the problem, but this operation was a marginal fix at best.

Sep. 01 2010 08:57 AM

I think the host (Celeste) misunderstood what Dr. Maiman was saying -- the doctor said that it is safer for a mother to have a vaginal birth, and that the risk of morbidity increases significantly with each caesarian, not vice versa.

Sep. 01 2010 08:48 AM
Adam from Lake Orion, MI

This is just another moment where american people are doing what their doctors just tell them. The American health care system needs to be fixed. If malpractice lawsuits were not around would doctors use them as much? Holistic medicine and natural birth are what god gave us, this is just man changing the natural order of things to create a finacial gain.

Sep. 01 2010 08:42 AM
Joe from New York, NY

I'm surprised that no one really brought up cost. If a doctor makes more money and gets the convenience of choosing the time of delivery, why wouldn't he/she push for a c-section?

Sep. 01 2010 06:56 AM
Liz Woods from Ithaca, NY

I have heard the practice of "defensive medicine" cited as a primary reason for not offering natural birth unless it falls within very strict parameters. This indicates something broken with our litigation system, and forcing new mothers and infants to pay the price for this by limiting birth choice is unconscionable.

There are increased short-term costs for C-section over natural birth - in my case, $18,000 versus $5,000 - and long-term "costs" for both mother and child. The astonishingly invasive rearrangement of the lower internal organs has a high chance of producing chronic issues with digestion and elimination for the rest of a mother's life.

Certainly I stand strongly in favor of the natural process of birth, and I feel that three things are necessary:

1) a shift in our society about the attitude toward birth, embracing the process and teaching our people that natural birth is not to be feared as dangerous or painful, which it need not be

2) a shift in our medical practices away from "convenient" fixes such as drugs (pitocin and epidurals) and C-section

3) a shift in our medical support systems - malpractice insurance policies, and hospital policies - to allow natural birth to be a first choice.

With my daughter, a VBAC almost 5 years ago at 9 pounds 9 oz, I had to search for five months to find an OB/GYN who would take my choice to deliver naturally as a serious choice. I had the very good fortune to find exactly the right people and I am forever grateful for this.

Sep. 01 2010 06:54 AM

Don't trust your body, fear nature.

Kate Koler, Vbac is not a natural birth, or limited to one, it's a vaginal birth after cesarean.

It CAN be a natural birth, but with epidurals and inductions and interruptions, it can hardly be referred to wholly as 'natural'

Move to canada, we love vaginal births.

Aug. 31 2010 03:27 PM
Danielle Fielding from Western, NY

As a mother who had a c-section there is nothing natural about it. It's invasive, cold and impersonal. And it does not come without it's risks to mother and baby up to and including death.
WHO wants the c-section rate down substantially.
Thanks to the litigation happy, rising costs of malpractice insurance and women who don't take charge and educate themselves in birth, because they think doctors are gods, interventions keep piling up and the inevitable c-section happens.
With c-sections and interventions rampant maternal and fetal deaths have DOUBLED in the past ten years and is higher than 40 other industrialized nations.
People need need to stop looking at birth as a medical issue and look it for what it is; a natural bodily function.
There are true emergencies, I understand that, but "I'm sick of being pregnant", "Your baby is too big" (unless you have diabetes your body won't make a baby you can't give birth to), and other petty excuses are NOT reasons for medical intervention which will probably land you in the cold sterile room, numb from the neck down and having your baby coldly and impersonally extracted from your body.
Thank goodness for advances in medicine, huh?

Aug. 31 2010 01:32 PM


patton oswalt on natural childbirth

Aug. 31 2010 01:04 PM
Kate Koler from Marathon, FL

It seems that many doctors and soon to be mothers are scheduling c-sections for a matter of convienance. in my opinion this is very sad; take the time to experience this miracle!
The bigger issue at hand is the insurance companies. Unfortunatly I had to have a c-section due to a medical emergancy and many doctors will not allow for a v-bac (natural birth) once a mother has had a c-section. I am currently trying to find a new insurance company and have been told that I would not be covered for a second c-section- as it is pre-exsisting. My current insurance also said I would not be covered unless it was a medical emergancy - which an elected c-section (by the Dr.) is not a medical emergancy.

Aug. 31 2010 12:43 PM

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