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Hot Topic (7/28): C-sections for convenience worth the risk?

Posted by on Jul. 28, 2009 at 2:35 AM
  • 18 Replies



Question: How did you give birth to your first baby?


Hospital birth, no induction, vaginal delivery.

Hospital birth, induction, vaginal delivery.

Hospital birth, induction, c-section.

Hospital birth, scheduled c-section.

Birthing Center, vaginal birth.

Home birth, vaginal birth.

Home birth, transfer to hospital, c-section.

Only group members can vote in this poll.

Total Votes: 43

View Results

 By Sarah Nightingale | AVALANCHE-JOURNAL

Tuesday, July 28, 2009

When push comes to shove, it looks like giving birth naturally might be going out of style.

Cesarean sections made up more than 30 percent of live births in the United States in 2006, the latest data from the National Center for Health Statistics shows.

Many of the operations are not emergencies; they are chosen by women - or their providers - because of fear, convenience or social reasons, according to local experts and national organizations.

The problem, they say, is the risks of surgery outweigh the risks of vaginal delivery.

C-sections - practiced for centuries as a way to rescue mothers or babies who become distressed during labor - have risen from less than 5 percent of births in the 1960s to about 20 percent in the 1990s to more than 30 percent in 2006, said Edward Yeomans, professor and chair of the Texas Tech Health Sciences Center Clinical Obstetrics and Gynecology program.

"The C-section was a good thing when it started because it saved lives," Yeomans said. "But it's out of hand when we are doing them for frivolous reasons."

One reason they are so prevalent here - the U.S. was topped only by Italy, Mexico and Korea in a 2005 study of 25 countries - is because once a woman has a C-section, her chances of having a vaginal birth decrease, Yeomans said.

Vaginal births after C-section are rare because of the small but serious risk of a tear in the uterus at the site of some C-section incisions, according to program services director for the March of Dimes Lubbock Division Amy Johnson-Rubio.

"In reality, vaginal birth after C-section is very safe (for most people)," Johnson-Rubio said. "A lot of physicians won't allow it. I think that's unfortunate."

Another reason mothers might opt for medically unnecessary C-sections is because they are afraid of a vaginal delivery or because the surgery is becoming more commonplace.

"People are hearing that their friends were induced or had a C-section, so it's becoming more normalized," Johnson-Rubio said. "I think it's alarming."

Other reasons people elect for the surgery - or schedule an induction before they reach full-term - may be to deliver before a holiday, before the end of the tax year, or when relatives are in town, Yeomans said.

"Sometimes it can be difficult to talk them out of it," he said.

C-sections, however, are not necessarily the easy - or safe - way out.

A study in the southwestern U.S. showed almost half of all newborns admitted to Neonatal Intensive Care Units were scheduled deliveries, according to the March of Dimes Web site. Another recent study, published in the "New England Journal of Medicine," found more than a third of C-sections are performed too early.

Babies born before 39 weeks - considered pre-term - can experience a host of problems, Johnson-Rubio said.

"So much happens in the last few weeks," she said of brain and lung development that remains far from complete just weeks before a baby reaches full-term.

For the mother, Yeomans added, there can be other complications, including injury to the bladder and bowel, blood loss, and the potential for infection. Most concerning, he said, is a phenomenon, known as "placenta accreta," in which the scar on the uterus from the first C-section causes the placenta of the second baby to attach too tightly to the uterine wall. If it doesn't detach during childbirth, fatal hemorrhaging can occur, Yeomans said.

Since the risk for accreta increases with subsequent pregnancies, it is recognized by the American College of Obstetricians and Gynecologists as a primary reason doctors should avoid Cesarean delivery on request for women desiring several children.

* * *

What do you think about the increased c-section rate? 

Were you aware of the risks that a c-section poses to the mom and her baby, especially if the baby is born before 39 weeks gestation?

Are you concerned about this birth trend?



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by on Jul. 28, 2009 at 2:35 AM
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Replies (1-10):
by on Jul. 28, 2009 at 2:48 AM

My first baby died in my womb one day before his due date...  .  They induced labor and I had to go through hours of labor and pushing to bring my little angel Robert into the world just to bury him a few days later... 

I had four other births all natural, with NO MEDS AT ALL!  No inductions, No C-secs.

by on Jul. 28, 2009 at 2:49 AM

I think C-Section might be used for convenience by docs and families.  I also think C-Section happens for good reason. 

I was planning for a water birth...but I never went into labor.  Went into the hospital where ultrasound revealed low amniotic fluid and was induced from there. ( I was in my 42nd week) I labored for 13 hours - 8 of which WITHOUT epidural.  After epidural, petocin (sp?) was cranked and I still was not getting that baby out.  C-Section.  Beautiful baby boy.

If I ever have a 2nd, I will do a scheduled C-section since, I doubt, no one will be able to tell me if I'll go into labor for the 2nd and even if I do, will I then delivery vaginally?  Not worth it to me. 

Is the C/S rate alarming?  I don't know.  I certainly didn't choose C/S the first time, but most likely will with the 2nd.  Why is the rate going up?  I've heard stories about docs pushing C/S to increase their bottom line.  Now, that's scary. 

I wouldn't let docs. take my kid (unless absolutely medically necessary) before week 40.  Should I go into labor before week 40 with kid 2, then we'll take it as it comes.  

by on Jul. 28, 2009 at 6:33 AM

i had an elective C section for my first bc the thought of pushing out a baby vaginally scared the living crap out of me.

so yes i fall into the catagory.  i have never experienced a better way to birth my children.  i have 2 of them and both via C section.

i actually did go into labor with my 2nd and let me tell you i would NEVER wish that pain upon ANYONE.

my recovery from both my C sections were a breeze... actually it was less painful then BOTH my breast augmentations or my root canal.

i knew from before i was ever pregnant if i were to give birth it would NEVER be vaginally, and my 1st question to my OB when i got my BFP was "will you do an elective C section, for no other reason then its how i want to give birth" and obviously he said yes.

by Member on Jul. 28, 2009 at 8:52 AM
Well, here's my story:

I had been having trouble with my gall bladder the entire pregnancy. I was to be induced due to pre-eclampsia on Sunday March 5th 2006. I woke up at around 2:30 am on Saturday March 4th with really bad pain in my upper left abdomen. My XMIL decided that I was in labor - which I was not, even I knew that at the time - and she immediately shuffled me off to the hospital. They put me in the L&D room and my doc came in later that morning (around 11:00) and said that he'd go ahead and induce me on Saturday. My pitocin drip was started at 1:34 pm, at 5:34 pm he came in and performed an AROM - artificial rupture of membranes (he broke my water). THAT hurt like hell. At 9:36 I still had not progressed past 2 cm, WITH pitocin, and my water being broken. So he told me that he could let me labor another few hours or do an emergency c-section. I opted for the section because I was ready for this to be over. I felt really strange and uncomfortable having people deal with me (and that includes family members). I felt like people were just tired of dealing with me in general and would be happy to get me off their hands. Anyway, when he got to my DS, he found out why I wasn't progressing - the cord was wrapped around DS so much that he couldn't descend. The cord was around one leg, his abdomen, and his neck. It was the cord around his leg that was keeping him from descending. But there was not really anyway that I could have had a vaginal delivery.

As for sections of convenience - I don't like them. Docs schedule them so they won't have to do anything for the weekend. Moms schedule it so they will have a definite date to tell people to come by. Nature is not allowed to take it's course these days. I really wanted a vaginal delivery, but the way things turned out, I had no choice. I think I'll try for a VBAC this time if I can.

by Member on Jul. 28, 2009 at 9:05 AM
Well, to each his own. I am more afraid of "going under the knife" than having children, so I had 2 of mine at a birthing center, no meds, and the other labor wouldn't progress so I was in a hospital and given pitocin, but still had her vaginally.
The only thing I would be worried about with elective sections would be the risk of delivering when the baby isn't ready. If you're ok with jeopardizing your babys health and life so that you won't have to labor for a few hours, that's your business. But I won't be listening to the outcry and news reporters when a baby dies being delivered by elective C-section...
by on Jul. 28, 2009 at 9:05 AM

I'm not opposed to a C-section if necessary.  But for convenience?  Nope, not me!  I recovered VERY quickly and easily from my vaginal delivery and I was up walking around just a couple hours after giving birth.  C-sections are major surgery and take a long time to recover from.  I think they are GREAT when needed, but why choose surgery just for convenience, especially when a vaginal delivery has a much quicker (and less painful) recovery??


by New Member on Jul. 28, 2009 at 9:10 AM

I am so sorry to hear that. I can see why you chose not to take meds and go natural.

by Member on Jul. 28, 2009 at 9:27 AM


by on Jul. 28, 2009 at 9:46 AM

I had all 3 of my kids vaginally with no inductions.

But...thats how I chose to have a child. If someone else chooses to have a C section for convenience...go for it. Your body your choice.

by anxiouss on Jul. 28, 2009 at 10:16 AM

I think that every woman has the right to choose how to have their child.

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