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Preliminary data for 2003 indicated that 27.6% of all births in the United States resulted from cesarean deliveries, an increase of 6% from 2002 and the highest percentage ever reported in the United States. After declines during 19891996, the total cesarean rate and the primary cesarean rate (i.e., percentage of cesareans among women with no previous cesarean delivery; 19.1% in 2003) have increased each year. In addition, the rate of VBAC, which had increased during 19891996, decreased by 63% to 10.6% in 2003. Among women with previous cesarean deliveries, the likelihood that subsequent deliveries would be cesarean was approximately 90% in 2003.
Source: National Vital Statistics System, annual files, 19892003.
I fully recognize that most of these cesareans are totally necessary when they are done, but I am concerned that not enough is done to help women and their babies to be healthy before and during labor. I am also concerned that among the general public, there is a perception that a cesarean is the easy way to have a baby (especially a scheduled cesarean). Ask many of the readers of this blog who have been there (RoseMarie, recovering owl,) or especially those who have done it both ways (Elena?) and you will hear that in many cases, a cesarean is still a case of the mom sacrificing a bit of herself for the sake of her child (the reason that many moms in the 1940s were afraid to go to Catholic hospitals - the false idea that Catholic doctors would sacrifice the mother to save the baby).

9 Comments

I think that another reason for the high rates can be seen in the current malpractice atmosphere. Doctors are predisposed towards intervention when labor is not 'on schedule' in order to cover their butts and make sure that their insurance will pay any legal costs. And mothers are predisposed to trust that when their doctor recommends a c-section, he knows what he's doing.

I broached the subject with my doctor again last week about having a trial of labor and delivery insetad of a scheduled C and it looks like they're just not going to allow it. So my choices are to schedule the C, or do another homebirth midwife. Waiting to go into labor on my own probably isn't an option as everyone of my kidlets spent an extra 10 days or more past their due dates!!

If I were 10 years younger I'd go for the homebirth, but as I've got 5 other ones and went through the stillbirth experience I think I'll probably just politely protest and quote VBAC safety stats while they're strapping me to the operating room table.

I watch "A Baby Story" on TLC frequently. It seems to me the medical intervention rountinely given thwarts the natural birth process. My SIL is getting induced 2 weeks early for convenience (hers and OB's). She has had this done before, has had high intervention births, and is now convinced her body can't do labor naturally. My math tutor had a c-section after highly invasive medically regulated birth. Not only was she told she can't give birth regularly, she was told her breast tissue was defective, and she can't nurse. Her daughter had terrible reactions to formula, and now because of that she believes there is something wrong with her daughter. They don't know what it is, but it is allergy related. The same doctor told this lady's sister her breasts were too small, and therefore she couldn't nurse. This is pure evil. These doctors are physically and mentally torturing women, and insulting God and his wondrous creation. The pinnacle of hubris.

after 2 c-secs and 2 v-bacs i still contend that v-bac is the only way to go -- given a well informed choice.

i no longer have the option of v-bacs, but i will be forever grateful for the two i had.

I fully recognize that most of these cesareans are totally necessary when they are done,

I'm a little surprised to see you say that, especially thinking of "failure to progress" diagnoses. I can certainly see that more cesareans may fall into the highly preventable, yet prudent at the time, category, than the more trumped-up category. Just surprised at the "most," I guess.

I'm still not sure about how to classify my first cesarean, but I call it unnecessary. I'm very doubtful that good progress would have been made after that under the highly interventive circumstances, so it is the earlier decisions I cringe about much more than the actual c-section, but as the doctor said, it was a "you should have progressed 1 cm per hour" sort of thing which was not a "rescue." She wanted to avoid the rescue. I'd rather have used means to avoid needing the rescue, but they weren't really available to me by that point.

Smockmomma, why aren't you "allowed" to have any more VBACs? Was your last birth a VBAC or a C/S? I had 2 unplanned C/S and I truly thank God, my OB is supportive of VBA2C. While I disagree with blanket opposition to VBA2C, ruling it out when a woman has had a VB since her last C/S is what I really don't understand -- but I know they try to insist some women schedule after VBAC even with only one prior C/S :(

Um, even owls can get sleepy at 2:27 a.m. That last comment of mine could use some editing. Such as, "I'd rather haved used other means than surgery to avoid needing the rescue."

I had one---quite unnecessary-C section and have since had 8 VBACS.

I too was surprised to hear Alicea say most C secs were necessary by the time they were done. Maybe some are because of the stress to mother/baby from no food, too much medication, stressful environment. But I would think, a lot are not. Alicea,,,,why did you say this?

I had my C sec when young and recovered quickly. There was a day or so of pain afterwards and it was maybe a week before I was trotting up and down stairs with laundry ...rather than a day to a few hours as with a normal birth. But it is not that a C section is so bad, it is that having a normal birth is so good.

Was someone saying that some doctors only allow a woman to have ONE VBAC???? I had 8 babies vaginally after my C section.

Elena...I haven't had the sad experience of still birth, so I can't secondguess your decision..but I must say, YOU don't sound happy with it. If you can get an experienced homebrith midwife, I would say, Go for the birh you will really feel happy about! And smockmomma...yes WHY are they telling you you can't have another vaginal birth.?

Susan

It's not so much that some doctors limit a woman to one VBAC as that those who generally do not support VBACs may still try to convince a woman who has had a vaginal birth since her c-section(s) to schedule solely because of the prior section(s).

Ok, so I told you twice I had 8 vaginal deliveries after my C section. Ok, so I am proud of having 9 kids. And of getting from C section to home births....which mattered a lot to me. I know how it feels, in this one matter, not to be defeated. That is why my inclination is to say to others, Go for it, have the birth you want. Don't be foolhardy but don't listen to fearmongers....get the facts, and not from one source only. Try to contact some experienced homebirth midwives to discuss your situation with. Just don't give up too easily!
SFP

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This page contains a single entry by alicia published on February 3, 2005 4:38 AM.

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