C-Section Rate Reaches Record High in U.S.
The number of women giving birth by cesarean section is at an all-time high, raising concern among doctors.
"We at the March of Dimes have great concerns not just about the rate, but about what's driving it," says Alan Fleischman, M.D., medical director of the March of Dimes.
A new report, based on information from 19 states, found the number of cesarean deliveries rose significantly, from 27 percent of births to 34 percent, between 2002 and 2009.
Dr. Fleischman says the findings in the report aren't surprising,"but they are quite dramatic."
According to the report, these are some of the reasons for the rise in cesarean deliveries:
- Convenience in delivery timing for the doctor or the mother.
- Women giving birth later in life, which raises the risk for complications during pregnancy and delivery.
- Increase in maternal risk factors, such as obesity and diabetes.
- Increase in multiple births, sometimes because of the increase in fertility treatments.
- Increased willingness of doctors to perform C-sections.
- Pregnant women's lack of understanding of the potentially serious complications of C-sections.
- Pregnant women requesting C-sections.
- Fear of malpractice for not doing a C-section.
- Common labor practices, such as inducing labor or using epidural drugs.
Dr. Fleischman thinks too many babies are delivered early to minimize risk, in part because the outcomes of infants delivered after 34 weeks are good. "But not as good as [a full-term birth]," he says.
"Cesarean section should be done at the right time and for the right reason. Some cesarean sections are being done too early and not for the right reason. Convenience for the woman or her doctor isn't the right reason."
Cesarean delivery can be dangerous for the mother. Complications include blood clots, excessive bleeding, infection, longer recovery time, and injury to the bladder, uterus, or bowel, according to the report. The risk for complications is even higher in obese women, where a cesarean is a major operation.
In addition, infants born before term can also experience an increased risk for complications such as breathing difficulties and even death.
Always talk with your health care provider to find out more information.
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More and more American women are deliver their babies by cesarean birth, which means the baby is born through a surgical incision made in the mother's abdomen and uterus. And today, many women who have had cesarean births are choosing to have later babies vaginally (referred to as a VBAC or vaginal birth after cesarean) if no risk factors are present.
Why attempt vaginal delivery?
- Less risk. The major risks of VBAC are that the cesarean scar may tear during delivery or that the uterus will tear. However, a vaginal delivery usually has fewer complications for the mother than cesarean birth. A cesarean delivery requires major surgery and is performed under anesthesia.
- Shorter recovery. The mother's recovery is often shorter after a vaginal delivery, and she will usually have less discomfort than after a cesarean birth.
- More involvement. Since general anesthesia is sometimes used during cesarean delivery, the mother cannot always remain awake and experience the actual birth. The hospital may also place more limits on the number of people allowed in the delivery room during a cesarean birth.
Factors that could influence your decision about VBAC include the type of incision made in the uterus during previous cesarean birth(s), multiple births, the size and position of the baby in the womb, and medical conditions such as high blood pressure or diabetes.
Always talk with your health care provider to find out more information.
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