Recent Posts

Saturday, January 9, 2010

Is the rising c-section rate in this country going ignored?

The current c-section rate in this country is hovering at about 33 percent. I don't expect everyone to know the exact percentages, but it would be nice if some people for whom this might pertain would at least know and understand, simply, that it's definitely on the rise.

I had a conversation yesterday with two friends, one of whom has had two vaginal deliveries - both induced - and the other, two sections due to breech presentation. One woman has a sister currently five months pregnant with her first child, and she's scared to death of having a c-section. "Well, the current c-section rate in the US is at about 33 percent," I said, stating that her fears were completely founded. Both women looked at me in complete shock and had no idea that that many sections were being performed.

How can you not know? Based just on the experiences of our common friends, it's so obvious it's like a slap in the face. When several of us were each expecting our second child, our friends held a baby shower. I recall thinking during that shower that all four of us had had c-sections, and three out of the four of us were on either our second or third section. I was the only one who had a successful VBAC. (One woman, a nurse, had attempted one with her second but was unsuccessful due to fever during labor. At least she considered it as an option, though!) Another of us - one who was also on her second section - mentioned to me that her doctor actually admitted once, somewhat tearfully, that she "loves surgery." Well, I wanted to say to her, no shit she loves surgery. This woman is on the American College of Gynecology Liability Committee, so VBACs are definitely a no-go in her book!

I live in a unique community. My husband is a teacher, and we're required to live on campus with other couples and families, many of whom are near my age and have small children. So in a sense, we are all 'victims' of the modern obstetrical system and all have similar stories. Of those women who are older - say, those who are over 50 - their birth stories are dramatically different, and reflect the days in which doctors had knowledge and experience at avoiding a cesarean. Breech vaginal births, twin vaginal deliveries - none of them, that I know of, had c-sections, and know even less about the current trend in surgical deliveries because they are far-removed from their childbearing years.

All these women my age, then, reflect different levels of income, education and backgrounds. Most of us have different obstetricians and some of us have labored in different hospitals. And even though I obviously haven't talked to every pregnant woman in the US, we reflect that trend of an increase in c-sections. How can that not be troubling, or even obvious?

When I think of the people I know who have had children in the last 15 years or so, I am one of three women who've had a VBAC. I know of only two women who have dared to have a successful home birth. And yet, I know 17, including myself , who've had c-sections, all but one of them repeat, and from what I can tell, only one was truly a matter of life or death (the mother had advanced HELLP Syndrome). That figure could actually be substantially higher, but I haven't discussed birth with all of them, so it's hard to say.

It seems that obstetricians aren't held very accountable for the increasing rate of sections they are performing. Yes, there are a number of reasons for them - some of them even legitimate - but it makes you wonder about the not-so-good reasons for them, and why OB's are still getting away with it. The World Health Organization recommends that the rate not be above 15 percent, and our rate is more than double that - and yet no one is waging a mass offensive to change this. That's not to discount the groups, individuals, bloggers and organizations who make it their life's passion to educate people about this - but, even with their efforts, there are still large circles of women who either think people like Ina May Gaskin and Henci Goer are "fruity," or don't even know who they are. ("Ricki Lake? She had that talk show, right? What's she got to do with this?" *sigh*)

Essentially, the increasing rate of cesareans is going unnoticed by the people it should matter most to: those who think VBACs are extremely dangerous and yet don't bat an eyelash at having their second, third or fourth c-section. Those whose doctors still get away with inducing for convenience because their baby had the grave misfortune of being due near a holiday weekend. Those first-time mothers, past their due date by 48 hours, who are sectioned after the Pitocin drip failed to work because their cervix wasn't ripe yet and only were allowed to labor for a measly eight hours. And now with the revelation that some health care providers are refusing women who elect for a repeat section - no doubt at the dire advice of their doctors - it appears clear that, no matter which choice women make, they are being punished, instead of the people who are really to blame. When a fear-mongering doctor builds his practice around half-truths and misinformation in order to protect his bottom line instead of yours, it's not a wonder.


The Deranged Housewife said...

See this link:

"Cesarean delivery on maternal request" is a complete load of crap that shifts the "blame" back on the mother, not the doctor who strongly discouraged a VBAC or pushed for an induction that ultimately failed. This should read "cesarean delivery on physician demand." >:/