The U.S. hit its all-time high C-section rate, 29.1 percent, in 2004, the Centers for Disease Control reported
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The rate of C-sections in the United States continues to climb every day, reaching all time highs despite efforts by many to reduce the number of elective C-sections occurring. In 2004 alone more than 1.2 million Americans underwent cesarean deliveries, representing roughly 30% of all births in the United States. That increase represents a
40% increase over the rate of cesarean deliveries in 1996.
Why Are Cesarean Section Rates Climbing?
There are many reasons for the increase in cesarean births. Many have associated rising malpractice insurance costs and doctor's fears of lawsuits if something were to go wrong with a vaginal delivery. Fear and speculation alone however are not enough to warrant a rise in c-section deliveries. The increase is not however solely the result of physician decisions. More and more mothers are expressing their preference to undergo elective cesarean rather than try a vaginal birth, particularly first time mothers.
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The cesarean birth rate is increasing even among healthy mothers who may have no indicators suggesting a need for c-sections. The federal government recently announced their goal of reducing the number of c-section births to just 15% by 2010. The World Health Organization and other reputable health care agencies support a move to 15% or lower. In some cases including in Chile and Columbia, the cesarean rate has climbed to mind boggling rates, up to 40% of all births in some cases.
Why are cesarean deliveries so popular? There are many reasons. For one, cesarean births are planned deliveries. A doctor can plan the delivery around his or her schedule, as can the parent. In some case a reduced risk to the fetus exists particularly if the fetus is experiencing distress. Pelvic floor damage is often minimized when cesarean sections are used. Cesareans also provide physicians a means of accommodating patient’s requests.
Cesarean vs. Vaginal Delivery
A normal vaginal delivery is much safer than a cesarean delivery in both cases, provided the vaginal birth is uncomplicated. The recovery time for both mother and baby is also often less with a vaginal delivery.
There are multiple risks associated with cesarean deliveries. Among the more commonly reported risks include:
Risks associated with anesthesia use.
Increased risk of infection.
Risk of bowel or bladder injury resulting from surgery.
Risk for air or amniotic embolism.
Risk of uncontrolled bleeding.
Risk to fetus of respiratory distress syndrome.
Increased risk of placenta previa or uterine abruption in future pregnancies.
Risks for recurrent cesarean sections.
Cesareans are indicated in certain cases including:
When the baby is in a frank breech or transverse lie.
When a risk of HIV or herpes transmission to baby exists.
Previous c-section with a vertical incision, which may increase the risk of uterine rupture.
Twins where one baby is in breech or risk of prolapsed cord is imminent.
Failure to progress or fetal distress.
Bleeding associated with placenta previa, placental abruption or other placental problems.
Maternal disease, which may include severe eclampsia or other condition.
What Is VBAC and Can It Lower C-section Rate?
VBAC stands for vaginal birth after a cesarean delivery. Many hospitals are now banning VBAC due to malpractice constraints and new healthcare regulations which hospitals are simply not capable of adhering to. New regulations often require a fully staffed medical team be available for emergency c-sections at all VBAC deliveries, which many smaller hospitals are simply not able to accommodate. Generally women who are candidates for VBAC include those that have had a low transverse incision with previous cesarean deliveries, those with adequate pelvic space and those who are capable of preparing emotionally, mentally and physically for labor.
Is A Vaginal Delivery That Bad?
Many women report they forget any pain associated with a vaginal delivery the moment they see their child. There are many benefits to having a vaginal delivery. These include:
Faster recovery rate.
Decreased risk for respiratory distress syndrome in babies.
Faster bonding with baby and ability to breastfeed immediately.
Less risk and more safe option in most cases.
Lower cost and shorter hospital stay.
More involvement during the birth process.
Modern anesthetics including the epidural have also enabled vaginal births for many women to be a pain free and very enjoyable process. If you are considering a cesarean section, be sure you consult with your healthcare provider about your choices. It is important that you are an equal partner in all decisions regarding your body and your baby. You deserve to know and understand the risks and benefits of any birthing choice.
