photo by aka Quique
An increase in the number of (unnecessary) Cesareans means more women are dying, unnecessarily. Like so many other facts of modern life (don't get me started), a lot of people would like to see this information suppressed or distorted. But there it is. A striking quote from the study of maternal deaths in California: the current trend represents “the most significant spike in pregnancy-related deaths since the 1930s…it’s more dangerous to give birth in California than it is in Kuwait or Bosnia.” Don't think the problem is just California--they're just the first ones to be honest about it.
So much for the lifesaving benefits of modern medicine, so frequently touted when the safety of homebirth is questioned, as it often is in the media these days.
Kind of makes that live elective C-section on the Today show (the one the doctor characterized as "orderly, routine and scheduled for this timeframe, just the way these are supposed to go...as happens at countless hospitals all over the country,"--indeed) seem a little in poor taste. The doctor in this case notes that the Cesarean was scheduled--mind you, with no "trial of labor" first--"because in both of their families, babies run big and she was past her due date and those are two indications that a cesarean section is a lot safer than having a vaginal delivery."
I'm sorry, what?! With countless increased risks of morbidity and mortality to both mother and baby, there are VERY few situations in which a SCHEDULED ELECTIVE PRIMARY CESAREAN TO A HEALTHY WOMAN CARRYING A HEALTHY FETUS is "a lot safer than a vaginal delivery." As a matter of fact, her own professional organization notes that "the evidence does not support prophylactic [ie scheduled] Cesarean delivery for suspected macrosomia [large baby]," and studies have estimated that it would require over 1,000 such Cesareans to prevent one permanent birth injury (generally the concern over giving birth vaginally to a large baby). Even more sobering, if such a policy of rampant unnecessary Cesareans were enacted, for every 3.2 brachial plexus injuries (the most common birth injury, a kind of nerve damage to the arm) prevented, one maternal death would occur due to the complications of Cesarean. And I don't think there is a professional out there who could give you any kind of support for the statement that going past a woman's due date (or guess date, as it is sometimes known--because the 40-week mark is simply the midpoint in the normal "due month," which encompasses full-term deliveries anywhere from 38 to 42 weeks) is an indication for scheduled Cesarean.
Bad, bad medicine. And women are dying, literally, to bear it out. It makes me want to scream.
Meredith Viera (who gaily tells the woman that SHE had a Cesarean and so knows that she'll be "on her feet in no time") notes toward the end of the show, "They chose the right way to deliver, that’s sure… by c-section."
I'm sure glad I chose the WRONG way to deliver my 10-lb (2-oz) baby--one that isn't contributing to the rising toll of dying mothers.
7 comments:
As much as I enjoy the Today show, I was very angry when I heard the bit about the mother needing a C-section because of the size of her baby. I am so glad that my doctor was a old fashioned yet long bearded hippy. I miss him every time I go to the doctor!
Katie - I think your moms friend Ann Coulter understands why the c-section rate has increased.....Lawyer John Edwards specialized in babies with cerebral palsy whom he claimed would have been spared the affliction if only the doctors had immediately performed Caesarean sections.
As a result of such lawsuits, there are now more than four times as many Caesarean sections as there were in 1970. But curiously, there has been no change in the rate of babies born with cerebral palsy. As The New York Times reported: "Studies indicate that in most cases, the disorder is caused by fetal brain injury long before labor begins." All those Caesareans have, however, increased the mother's risk of death, hemorrhage, infection, pulmonary embolism and Mendelson's syndrome.
Aunt Lorri
Amen sister. The rate of c sections in this country makes me CRAZY. I wish more women would take the time to educate themselves and question their doctors recommendation for a c section. I have a really big problem with many of the reasons people say their doctor says they "need" to have a c section. I love to hear your perspective on it.
I agree that liability is one thing driving the Cesarean rate up. Doctors will tell you it's the only thing, and that their hands are tied by lawyers and patients who are rabid to sue them.
However, on a daily basis, what I see is a different reality. The "failure to progress" (or as we call them, "failure to progress by dinnertime") Cesareans outnumber those for supposed fetal indications (a large baby, questionable fetal heart rate tracing, etc)--in other words, those that could potentially become the object of a lawsuit-- probably 5 to 1. These are purely doctor's convenience Cesareans, many of them the follow-up to a doctor's convenience induction.
Therefore, the liability issue is something that I see more driving the repeat Cesarean rate or the breech Cesarean rate, since much has been made of the "liability" of VBACs and breech birth--but for many, many women who end up with Cesareans, and some who end up dying from them, their surgery was driven not by some lawyer, but by the ticking of the doctor's watch.
I need to discontinue the commenting on blogs. Apparently I suck at it. I was amen-ing your original post :) Not the comment prior to mine, although I would agree that litigation is one of the causes of the increased rate of c sections as well. But I do think that argument is very convenient and easy to make. I don't buy it. My doctor better tell me my life or the baby's life is in danger before they recommend me for a c section, otherwise he or she will be getting an ear full. This issue really strikes a cord with me. It drives me nuts every time I see young, healthy women with healthy babies having c sections.
Wow way to go having a v.b. with your daughter weighing 10.2! My husband and I are stationed over in Germany and they do c-sections so often here, every single one of the women I know who has given birth here has had a c-section! I think they do it if the baby is 8+ pounds to prevent complications. We are expecting this August and I am afraid they are going to tell me I need one when maybe I really don't since it is more the norm over here.
~Sally
ps-congrats on your baby girl!
Sally, I'm sorry to hear that! Have you looked into a midwife? They might be able to support you in your options. Good luck, and thanks for your kind words!
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