To C or Not to C

Cesarean Section otherwise known as C-section is the most common surgical procedure done in the United States. Crazy right? A procedure that used to be considered a last resort option and is utilized and necessary for high-risk pregnancies is now overused and often performed on many low-risk women who have no medical need for it. C-sections can be life saving for both mom and baby when it is medically necessary. Chronic health conditions like high blood pressure or heart disease, fetal distress (often caused by too many medical interventions), or abnormal positioning of the baby are some examples of a medically necessary c-section. What is not an example is a doctor claiming your baby is too big for vaginal birth. That is hardly true.  

Some facts and statistics:

• U.S. rates of c-sections have increased from 22.7% in 1990 to 32.7% in 2013 according to the CDC (2). This rate was roughly 5% in 1970.
• Roughly one in every three women in the U.S. deliver via c-section. That is a very high rate!
• Before the late 18th and early 19th centuries, c-sections were performed when vaginal birth seemed impossible or after the woman had died during labor.  

Why the significant increase? Some women are opting for c-sections because they feel pressure from medical providers when their labor is not “progressing fast enough”. Most women desire vaginal delivery and of those with first time c-sections, 63% indicated that the doctor was the decision maker (1). Women are ultimately being rushed to have a baby. Others want their babies born on a certain day or fear the pain of childbirth, so they elect to have a c-section. An elective c-section is a scheduled c-section for nonmedical reasons. Some women are told they cannot have a vaginal birth if they’ve had a prior c-section. This is a false claim. It’s called a VBAC which stands for vaginal birth after cesarean. Some doctors just aren’t comfortable with VBACs so find a doctor who is. Fetal distress seems to be another major reason for c-sections which means the baby is not getting enough oxygen or there is a spike or drop in the baby’s heart rate. Ultimately, scheduled births are easier for hospitals and doctors to manage with regard to scheduling nursing staff, management of supplies and equipment, and doctors get greater reimbursement with surgical intervention and the use of technological equipment. Meanwhile, natural birth is unpredictable and operates in its own time.  

Hospitals are businesses. We must remember that. Their goal is to get as many people in and out as possible so when it comes to a woman who wishes to deliver her baby naturally without interventions, “ain’t nobody got time for that!”  ​

If you are thinking of getting a c-section consider this. Recovery time is much longer with a c-section, it increases the risk for complications including infection and blood clots, and mortality rates have been linked to the increased rates of c-sections in the U.S. The Department of Health and Human Services has set a national recommended rate for C-sections at 23.9%. Most U.S. hospitals exceed that rate. In addition, the World Health Organization has set a recommendation even lower, between 10% and 15%. The current rate of c-sections in the U.S. is roughly 32%. This is far from acceptable.

What can you do as an expectant mother or someone who hopes to become pregnant? Do your homework. Look into c-section rates of hospitals in your area and make comparisons to decide which hospital is right for you. I’ve provided a link below which will allow you to make that comparison in a simplified manner. I encourage you to keep it moving if a hospital does not meet the national recommendation. If there are no other hospitals in your area however, go with the hospital with the lowest c-section rate who you believe will treat you with respect. Other options include utilizing midwives to attend a home birth or in a stand-alone birth center or birth in a hospital that has midwives. Midwives do not perform c-sections and will promote the more natural path. Either way, it is highly recommended to tour hospitals or birth centers before deciding to birth there because it gives you the opportunity to ask questions and get a feel for how you will be treated in their facility. Remember, you are the consumer, this is YOUR body and YOU HAVE OPTIONS!

To learn more about hospital ratings when it comes to c-sections click on the link below. After typing in your location click on the maternity care tab for more information.

https://www.leapfroggroup.org/compare-hospitals

Sources:

1. McIntire Sherrod, M. (20017). The History of Cesarean Birth From 1900 to 2016. Journal of Obstetric, Gynecologic & Neonatal Nursing,46(4), 617-618. Retrieved from https://www-sciencedirect-com.archer.luhs.org/science/article/pii/S0884217517300382.​
2. https://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_06.pdf