Recently there was an article about cesarean births on the CNN website, entitled "What doctors don't tell you about C-sections". Here's the link: http://www.cnn.com/2009/HEALTH/11/11/caesarean.section.risks/index.html
I encourage you to read it for yourself before reading my response to it.First, if you're a mom who has had a cesarean, please understand this is not a personal rant against you or your choices, but rather a forum to educate those who are facing birth, and where decisions will be paramount. Your cesarean birth perhaps was completely necessary - or it may *gasp* have been unnecessary despite what your doctor told you.
I was happy to see that the author described cesareans for what they are: major abdominal surgery that comes with many risks. It shouldn't be viewed as "routine" or "just as safe as vaginal birth". (and yes, many people in the birthing world will tell you just that about cesarean births). Yes, surgery is safer now than years before, but it still comes with risks., and I'm glad the author listed a few.
Now, about the percentages. Here, in BC, our cearean rate is roughly 28-33%. North American rates on an average are at 30% (and climbing). Here's what the author says:
When the procedure is needed -- when the mother or baby is in distress or other factors make a vaginal delivery hazardous -- it can be a lifesaver. But only about 5 percent of C-sections are true emergencies, estimates George Macones, M.D., chairman of the departĀment of obstetrics and gynecology at the Washington University in St. Louis School of Medicine, in Missouri. Around 3 percent are completely elective, meaning there's no medical reason whatsoever, but the vast majority of C-sections actually fall into a gray zone: the baby looks big, mom is past her due date, labor isn't progressing well.Now, the problem I see is this. 5% are true emergencies. Okay. 3% are completely elective. That's a total of 8%. The WHO recommends a cearean rate of no higher than 15%. That still leaves 7% (!!!) of the "gray zone" for a normal percentage. Instead .......we're seeing that instead of 7%, the gray zone c-sections are at an astonishing 22% (based on a 30% rates of total cesareans in North America.). WHY? There's something amiss here --- because women today are designed and built by our Creator the SAME WAY they were hundreds and thousands of years ago.
Next, the author starts to delve into reasons why "cesareans are so hot". (grooannn)
Reason #1: Better technology is picking up more potential problemsThis isn't a good thing folks. The routine intevention of continuous fetal monitoring has definitely (as in research/studies) NOT improved outcomes for babies or mothers. The "distress" they're seeing as they watch the machine instead of the mother, could be normal variations that weren't picked up before when routine continuous ultrasound weren't used. It appears many times that "distress" is misinterpreted, and leads to unnecessary cesareans every day. And electronic fetal monitoring doesn't allow the woman the freedom to move and respond to her labour. This often leads to increased pain, anxiety and tension .....thus leading to a labour that doesn't progress well. We need to toss the monitors out for healthy, low risk women. This is why midwives (who by the way have excellent outcomes) don't use routine monitoring, instead using Doppler ultrasound to assess the baby's wellbeing before, during and/or after a contraction, enabling the mom to be in whatever position she wants, where she wants, coping how she wants. Those labours usually progress much better, than those labours where mothers are restricted in movement due to a machine.
Reason #2: Moms are older.Okay. So, a 44 year old woman, who's in good physical health is automatically "high risk" for a cesarean delivery based on her age? Unfair. Totally unfair. And it further destroys her confidence. Now, older age, combined with poor health and/or obesity is another story. They also talk about fertility treatments for older moms resulting in multiple pregnancies - leading to cesarean delivery. They say it's hard to know how the second baby is coming out -- assuming (wrongly) that all second babies come out breech. So cesarean becomes the "default" birthing method. Except ...breech birth via cesarean has NOT been proven safer than vaginal birth. Our SOGC is relooking at this -- and I for one am glad. It's time to give mothers more choice when it comes to multiples and breech babies!
Reason #3: More of today's moms-to-be are overweightBleh. I don't know of any studies that have proven this. And what constitutes overweight? According to the BMI, I am obese. Whatever. Maybe to some small 4 foot woman in the Orient I am.

Besides, I've seen many "overweight" women give birth just fine thank you very much. And they say "heavier women give birth to heavier babies." I'd like to see the stats on that one. It isn't about your weight ....it's about the growth of the baby as you grow - and being overweight doesn't automatically mean a big baby! With that logic, we'd see underweight or very slim women giving birth to small babies all the time. And well ...... I know ALOT of smaller women who have given birth to 9 lb. 10 lb babies. "nuff said.
Reason #4: More inductions mean more C-sectionsNo way Sherlock!!! Lamaze has been saying this for years. And a 22% induction rate? That's WAY TOO HIGH. Doctors and midwives and mothers --- we need to learn to let our babies be born when they're ready. That's usually the best way. Yes, there are medical reasons to induce, but "having a big baby" does not constitute a medical reason, and wanting to schedule your baby's arrival to coincide with someone else's birthday or the schedule of a visiting relative is selfish. Being a few days past your due date isn't a good reason to induce either. I still hear stories of women being "scared" into an induction at around their due dates because the "baby is too big". There's more to birth than the size of your baby. And we should be "making" mothers go at LEAST 10 days past due date, or even better, a full 2 weeks. Pregnancy is considered fullterm from 37-42 weeks, not 40 weeks only. Sigh. And unfortunately, too many doctors today do not share with the mother what the risks of induction are. They tell them it's safe. I'm all for informed decision making. Sure, tell them its safe --- but tell them the risks too. And tell them that a cesarean is a big risk factor.
(
and then there's the issue of nutrition in pregnancy - something many doctors aren't on top of. Poor nutrition leads to unnecessary weight gain and "bigger" babies. Midwives also pay more attention to this - ensuring the mother is eating well, so that the weight gain is okay, and the threat of a "big" baby is lowered.)Reason #5: One C-section leads to anotherWell, that's changing hopefully. More and more mothers need to start asking for and demanding a VBAC. And in my experience, in my estimation, in my research, having a midwife attended birth for a VBAC is your greatest chance at a vaginal delivery after a cesarean. The article talks about the inherent risks of a VBAC (ie - uterine rupture), but only pays "lip service" to the risks of repeat cesareans : uterine rupture (before labour), hemorrhage, placenta accreta, placenta increta, -- just to name a few.
The rest of the article just seems to trigger fear. Fear of the unknown and fear of the risks of vaginal birth versus cesarean. It's summed up in this sentence:
When a normal pregnancy takes a turn for the worse, few procedures work better or are easier for doctors to master than a C-section.Okay - who wouldn't want better or easier?? But is that all there really is to it? I disagree.
The risks of cesareans are greater than those of any vaginal delivery. And the sooner we as a culture start respecting birth for what it is, and start acknowledging that our Creator God gave us bodies to birth our babies with time and patience, the better of we'll be. Yes, I AM thankful for cesareans for those who need it. Yes, time and again, we hear of stories of babies and/or mothers that were saved because of this necessary intervention. (ie - the 5% of emergencies) But, I hear way more stories (especially in prenatal reunion classes) of unnecessary cesareans (the grey zone), or stories of women who were "pushed" into cesareans instead of being given extra time, support and patience.
Those are my thoughts. Feel free to disagree.

Or agree. I encourage responses and conversation about this, but anything that is disrespectful, or has foul language in it will be deleted. Thank you.
Chatboard (0)