While reading the newspaper over dinner yesterday evening, I came across an article titled “C-Section Birth Rate Surging: Impatience with Labor May Explain Some of Increase” by Shari Roan of the McClatchy News Service. The article presents significant statistics on cesarean sections in the United States, noting that the cesarean section rate has doubled since 1996 and now accounts for one-third of all births in the country. This indicates a substantial increase in the number of women undergoing major surgery to give birth over the past sixteen years. The shift in birth methods raises questions about the factors driving this trend, including potential changes in medical practices and societal attitudes toward childbirth.
Roan reports that this rise in cesarean rates is partially attributed to the impatience of both attending doctors and laboring patients, suggesting a shift in how childbirth is managed. The article references a study by the Eunice Kennedy Shriver National Institute of Child Health & Human Development, which found that cesarean rates are twice as high for women who undergo artificial induction compared to those who experience spontaneous labor. The study suggests that many cesareans are performed before women are fully dilated, often after only a few hours of active labor, despite the fact that normal labor can be unpredictable and lengthy. This data highlights the need for greater awareness and education about the natural progression of labor, which can vary widely among women.
Although cesarean sections are sometimes necessary for medical reasons, most women can give birth vaginally, and the increase in cesarean rates calls for careful consideration of the circumstances under which these procedures are performed. The article emphasizes that it is crucial for expectant mothers to be prepared for a potentially long labor process and to avoid unnecessary medical interventions that could lead to a cesarean. Understanding the risks and benefits of different childbirth methods can empower women to make informed decisions about their labor and delivery, ensuring that cesarean sections are reserved for situations where they are truly needed.
To reduce the likelihood of an unnecessary cesarean section, the article suggests that women avoid consenting to artificial induction unless medically necessary, as it can significantly increase the chances of requiring a cesarean. Common induction methods include cervical ripening, membrane stripping, membrane rupturing, and the administration of pitocin. The article notes that pitocin can lead to stronger and more painful contractions, often resulting in the need for epidural anesthesia. This can create a cycle of interventions that may culminate in a cesarean section. By understanding the potential cascade of interventions, women can work with their healthcare providers to develop a birth plan that minimizes unnecessary risks.
Another recommendation is to labor at home for as long as possible before going to the hospital, as early hospital admissions may lead to premature medical interventions. Studies have shown that the environment in which a woman labors can significantly impact the progression of labor, with the familiarity and comfort of home often leading to a more relaxed and natural process. It is also advised to decline continuous electronic fetal monitoring (EFM), which has not been shown to improve birth outcomes but may increase the likelihood of cesarean delivery due to concerns over fetal distress. Understanding the limitations of EFM and its impact on labor can help women make more informed choices about their monitoring preferences during childbirth.
The article concludes by advising women to choose their caregivers carefully, opting for those who are less likely to use unnecessary interventions, which can increase the likelihood of cesarean delivery. The presence of a doula or other labor support person has been shown to reduce the rate of interventions during labor, further lowering the chances of a cesarean section. Research suggests that continuous support during labor not only reduces the likelihood of cesarean delivery but also improves overall birth outcomes, including shorter labor duration and higher satisfaction with the birth experience. By selecting a care team aligned with their birth preferences, women can increase their chances of having a positive and empowering childbirth experience.
References
Contemporary cesarean delivery practice in the United States: http://www.ajog.org/article/S0002-9378(10)00838-0/abstract
High C-section rate may have something to do with impatience: http://articles.latimes.com/2010/aug/30/news/la-heb-cesarean-20100830
