The Myth of the Elective C-Section

I’m about a week late on this one, but check out my feature over at RH Reality Check on the myth of the elective c-section.

When the media covers the rising rate of c-section, it’s often ready to lay the blame at the feet of a woman we’re come to know well over the last few years — the busy career mom scheduling her delivery between important business deals, penciling in labor and delivery the way she pencils in a client meeting. As criticism of surgical birth mounts, the idea that mother-initiated c-sections are spurring an overall increase in the practice has only become more popular.

I go on to refute this idea, with the help of some great birth activists and advocates.

Does it do any harm when the media, doctors and others point to mother’s choice as the reason behind higher c-section rates? These advocates argue that it takes away attention from the how decisions related to pregnancy and childbirth are really made: often, under intense pressure from the woman’s physician.

Check the full piece out here.

C-sections on the rise in Canada too

While Canada is frequently touted as our more progressive and liberal neighbor to the north, things are not perfect for childbirth there either. The Society of Obstetricians and Gynecologists of Canada reports that more than 1 in 4 deliveries in Canada are c-sections.

“While the individual risk for a woman having a C-section is very small, the rising rate is certainly a concern,” society president Dr. Guylaine Lefebvre said in a release.

“We fear that there may be an emerging trend towards more scheduled childbirth and routine intervention. We need to be sure that C-sections are not driven by convenience, that interventions are medically indicated and that the safety of a woman and her baby are the driving factors in these decisions.

Between 1993 and 2006, Canada’s C-section rate grew to 26.3 per cent of all deliveries from 17.6 per cent. The increase is attributed an increase in the number of obese mothers, in which more pregnancy complications necessitating a C-section can arise, and older maternal ages.

Canada’s rate is still behind our 1 in 3 rate, but may not be far behind. They are also more supportive of midwives and out-of-hospital births.

Check out RH Reality Check on Monday for my feature on the myth of the elective c-section.

Thanks to Derek for the link!

April is Cesarean Awareness Month

Without even knowing it I posted about c-sections on the first day of Cesarean Awareness Month.

Thanks to all the awesome birth activist bloggers out there (and my fancy new google reader!) I found a lot of posts about this month’s theme. Here is one good round up of posts about it.

The International Cesarean Awareness Network is a good place to go for activism and advocacy around c-sections. Find a local chapter and get involved!

Playing the c-section guessing game

A new British study is out that correlates cervix length with likelihood of cesarean section.

Researchers in Britain say their study of more than 27,000 pregnancies found that women with the longest cervixes were more likely to need surgery to deliver their child.

Probably not a surprise, but I’m not a big fan of research like this. Number one, I don’t understand why having a long cervix might mean you couldn’t deliver vaginally. Number two, we need LESS c-sections, not more. In the US we already have a c-section rate surpassing 1 in 3, and the World Health Organization recommends 1 in 10. Number 3, is this kind of research going to give doctors another reason not to even allow women to try and deliver vaginally? I can just see it, sorry ma’am, your cervix is too long, we should just schedule a c-section because you’re probably going to need it anyway. What happened to correlation is not causation?

Lastly, read this piece from Bitch Magazine for more on way scientific studies are not always great science, or great journalism.

via Doulicia

More evidence against elective cesareans

I’m still waiting to see statistics on how common the elective cesarean trend really is, but in the meantime another study to add to the “reasons not to schedule” pile. A Danish study says that the risk of breathing problems is four times as high for babies who are delivered by scheduled c-sections (as compared to vaginal and emergency c-sections).

One explanation is that hormonal and physiological changes associated with labour are necessary for lungs to mature and that these changes may not be present in infants delivered by elective caesarean section. Gestational age at the time of elective caesarean section may also be important.

It makes sense when you think about the inaccuracy of measuring gestational age, and the just the common sense of not beginning a process before the body (and all the delicate physiological systems) have decided its time. Plus the added factor of who knows what really happens during labor and delivery that is good for moms and babies. But maybe by this point I am preaching to the choir.

The elective cesarean debate continues

Cara over at Curvature has a good post about an article which blames women’s vanity for the rate of elective cesareans. It’s an article from an Australian newspaper, but Cara brings up some good points, particularly that the idea that tons of women are running out and planning c-sections is false. While a small number of women are choosing (independently of their doctors recommendations) to plan c-sections, the majority of them are being encouraged to have c-sections (planned or unplanned) by their doctors. The jump in US c-section rates (almost 30% now) is not due to women’s choices, but to doctors decisions.

Check out Cara for more.

Post-partum plastic surgeries

This is timely, considering that I just posted about a site that is all about admiring post-pregnancy bodies, instead of surgically altering them.

The NYTimes has an article about “Mom Jobs” or post-pregnancy plastic surgery makeovers, with the goal of giving women their bodies “back.” What is our obsession with trying to avoid and evade change?

Aimed at mothers, it usually involves a trifecta: a breast lift with or without breast implants, a tummy tuck and some liposuction. The procedures are intended to hoist slackened skin as well as reduce stretch marks and pregnancy fat.

“The severe physical trauma of pregnancy, childbirth and breast-feeding can have profound negative effects that cause women to lose their hourglass figures,” he said. His practice, Marina Plastic Surgery Associates, maintains a Web site, amommymakeover.com, which describes the surgeries required to overhaul a postpregnancy body.

I don’t know about you all, but I’ve never had what could be described as an “hourglass” figure, and don’t particularly strive for one.

The article goes on to bring up the reasons why this trend could be problematic, including costs, stigmatizing mother’s bodies, and the risks associated with unnecessary surgeries.

Feministe brings up a good point though, that this is really only going to be an issue for the richest populations, since most women can’t afford a surgery that costs between $10,000 and $30,000 dollars. But I do think the statistics about the rise in plastic surgery are frightening, as well as the link to cesarean sections. Other countries with high plastic surgery cultures, like Brasil, also have extremely high c-section rates (almost 90% in some areas) and I don’t think that is a coincidence.

Thanks to Adam and Feministing for the link.

In case you needed another reason not to want a c-section

This one is scary, and unfortunately not from an episode of ER or Grey’s Anatomy.

A Florida woman is being awarded over 2 million dollars in damages after a doctor left a one foot by one foot surgical sponge in her uterus after a c-section. According to the woman, it was severe pain in the days following her c-section that brought her back to the hospital.

“I couldn’t walk,” she said. “I had to double over because the pain was horrendous.” When antibiotics did nothing to alleviate what doctors said was an infection, Dr. Joseph Becerra took an X-ray. The radiologist noticed a foreign object lodged in the 37-year-old’s abdomen, but it took days before Becerra removed the 1-foot by 1-foot surgical sponge that eventually damaged her uterus.

Here’s the even scarier part:

According to Florida’s Agency for Healthcare Administration, there were 88 surgeries in 2005 in hospitals statewide to remove objects left in patients from a previous operation.

And that’s just in Florida.

More on the C-section crisis

Jennifer Block, the author of Pushed, a look at the crisis in maternity care for a mainstream audience has a piece at the LA Times about the cesarean crisis.

Via Feministe.

CNN Reports: Five Ways to Avoid a C-section

Great short and to the point article at CNN today about 5 ways to avoid a c-section.

Here are their five ways:

  1. Don’t get induced unless medically necessary
  2. Labor at home until you’re approximately 3 centimeters dilated
  3. Choose your hospital, and your practitioner, carefully
  4. In the delivery room, ask questions if your practitioner says you need a C-section
  5. Get a doula (my personal favorite)

Check out the piece for more explanation about why each  step helps to deter c-sections.