By: Shelagh McNally for Uterus1Doctors, health practitioners and health organizations are starting to sound the alarm bells on the “too posh to push” trend. Pregnant celebrities were the first to start this highly-controversial practice of choosing a surgical C-section delivery over natural childbirth when there is no compelling medical reason to do so. Since then the rate of Caesarean deliveries has steadily risen.
| At a Glance |
Medical Reasons for a C-section:
Breech birth or when the baby is not in a favorable position for birth (malpresentation)
Ante-partum bleeding during pregnancy
High blood pressure or other maternal illness such as heart disease, toxemia, preeclampsia, eclampsia
Maternal HIV infection
Baby has become too large for vaginal delivery (macrosomia)
Baby’s head is too large to pass through the birth canal
Maternal soft tissue disorder
Previous C-section or uterus surgery
Umbilical cord prolapsed
Placenta attached in abnormal location or prematurely separated from uterine wall
Multiple babies (quintuplets, triplets or twins) |
According to a new study in Obstetrics & Gynecology women requesting C-sections over natural childbirth rose 44 percent from 1994 to 2001. In 1994, these elective C-sections accounted for nearly one in five C-sections (19.7 percent). In 2001, the percentage had reached 28.3 percent. According to a report in the March 2005 issue of Pediatric nearly 28 percent of all U.S. babies born in 2003 were delivered by C-section – an all-time high. One that The World Health Organization finds alarming. The WHO issued a report stating that only 10-15 percent of C-sections births were appropriate worldwide and they are recommending that elective C-sections be avoided They are gaining in popularity because the operation promises a pain-free, quick and easy delivery that can be scheduled at a convenient time for the doctor and mother. Devotees claim it saves the mother and baby from any trauma at all. But the biggest allure might be the idea of maintaining a “honeymoon” fresh pelvic floor with no stretching or problems from incontinence sometimes associated with a vaginal birth. But while C-sections are safer than ever thanks to improvements in operation technology, the operation poses serious risks. Women are still four times as likely to die as a result of this surgery and they take longer to recovery both physically and physiologically from the birth. In 1 to 2 percent of cases, C-sections lead to infection, damage to other organs during surgery or severe bleeding in the mother. The infant’s gestational age is often miscalculated with baby being removed from the womb too early. Risks to the mother increase with each successive C-section, and the procedure isn't recommended for women who plan to have more than two children.
C-section mother often take longer to establish breastfeeding routines, which lead researchers to look at the natural bonding process. They are finding evidence suggesting that a vaginal delivery is crucial to the bonding of mother and baby and when a C-section is introduced without labor the interrupted bonding process is lessened. In a study in England conducted by the National Collaborating Centre for Women's and Children's Health (NCCWCH), some women talked about feeling deprived from the sense of achievement and as a result having their postpartum depression heightened. England’s National Health Service (NHS), in conjunction with the NCCWCH has started a campaign to stop this upward spiral of optional Caesareans that costs twice the amount as natural childbirth. They point out that lack of information, loss of confidence in giving birth without medical intervention, fear of pain or pelvic floor damage and the false perception that a Caesarean section is an easy way out are not valid reasons for allowing the “too post to push” trend to continue.
In the United States there are other factors to consider as well. “With malpractice premiums hovering at $150,000 to $200,000 per year, obstetricians can no longer afford to take even the slimmest risk associated with natural childbirth,” says Dr. Benjamin Sachs, a professor of obstetrics and gynecology at Harvard Medical School. “The opportunity for a woman to elect to have a caesarean section should be as available as the opportunity to have a safe, natural childbirth,” he said. “Our responsibility as physicians is to counsel at both ends of that spectrum, explain the issues and try to provide support for women.”
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