Friday, December 16, 2005

Surgical Births: Cesarean Sections

A recent article was published by the International Cesarean Awareness Network or ICAN. ICAN is a nonprofit organization. The organization promotes the improvement of maternal-child health by preventing unnecessary cesareans. They provide education , support for cesarean recovery, as well as and promoting vaginal birth after cesarean or VBAC.

The article discusses the rising Cesarean rate, the falling VBAC rate, and the increase in elected Cesareans. Cesareans were originally reserved for emergencies. "Experts state that any laboring woman faces unpredictable complications--such as umbilical cord prolapse, acute fetal distress, or hemorrhage from a placental abruptiont--that might require an emergency cesarean. The odds of these complications are 2.7 percent, " states Nicette Jukelevics of Mothering Magazine. What I find interesting is that a US study found that mothers are four times more likely to die from a cesarean unrelated to health problems, compared with women who have vaginal births. Other complications associated with Cesarean sections include blood transfusions, prolonged healing and recovery, difficulty breastfeeding, failure to thrive, as well as future complications in subsequent pregnancies. Also, a traumatic birth of any kind can leave a woman feeling disempowered, violated, or betrayed. Healthy babies born by Cesarean are more likely to have difficultires, including respiratory problems that require intensive care.

The Cesarean birth rate is the highest it has ever been, 29.1%, in the US. The cesarean delivery rate rose 6 percent in 2004 and the rate has increased by over 40 percent since 1996. Much of this is due to the drop in VBAC, which dropped by 13% in 2004. In some hospitals VBACs are being banned. There are currently about 300 hospitals where VBACs are not permitted, including about 50 in California. This means that once a woman has a C-section she will not be permitted to birth vaginally. The saying goes "once a Cesarean always a Cesarean." I want to know what happened to a woman's right to choose.

"The recommendation by Consumer Reports is for pregnant women to be informed about the cesarean rate of their physicians and hospitals, and to look for rates below 15 percent in women who haven't had the procedure and about 60 percent in those who have. Another recommendation is to ask about the doctor's willingness to try non-surgical steps first. Alternatively, Consumer Reports also recommends women consider giving birth in a hospital with a certified nurse-midwife, if available, since their births have lower cesarean rates than births with obstetrician." The article also explores out of hospital options and includes several links and resources. "Giving birth in a free-standing birth center or at home with a midwife is another option that women should study. Midwifery care has been proven over and over to be a safe alternative for most pregnant women", says Jamois. "Countries where the majority of babies are born into the hands of midwives, such as The Netherlands, have cesarean rates below 10 percent, and they boast the best maternal and infant health outcomes in the world."

ICAN article
VBAC article

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