Slicing Into Women
A cesarean section is a major surgery that is associated with risks, and women and their providers are taking this matter too lightly when choosing this route when delivering a newborn. There are many factors to blame the recent trend of rising C-sections being performed today. Just like everything in this economy, money is a factor when it comes to providers. Possible trendiness perhaps from posh mommies is to blame. It is interesting in a country like the United States and this day in age with all the medical advances and knowledge that women are opting for an evasive surgery instead of going the natural route. After all we seem to be hitting a trend of organic foods, cloth diapers, and chemical free cleaners, but the C-section rates continue to rise.
Cesarean section rates have doubled since 1996. Now recent stats have suggested that 1 in 3 newborns are delivered by cesarean section. One issue that has been correlated with this rise is inductions. Inductions account for 44% of the C-sections. (Rubin) Many women are scheduling their child's birth. However inductions do not mean that the baby is ready to be born. Babies are full term at 38- 40 weeks. Even then, depending on the doctor, full term may be viewed as 39- 40 weeks. Doing an induction early means the baby may not be ready and may have not even flipped, meaning a breech position. Breech position will call for a C-section if the doctor is unable to manually flip the baby. Inductions are too casual these days and are not explained well enough to patients what it means, they are associated with risks for baby and mom, and is very likely to end up in surgery.
C-sections are trending upwards because they are down played by providers, when in actuality it is a major surgery that can have complications. The trend can also be blamed on posh or trendy moms that think it is too much "work" to be in labor. The body was designed for natural vaginal labor and birth, not a slice into the abdomen. Women are jumping under the knife too quickly like it is a nose job, but it is not just their life at stake, there is also a helpless little newborn to think about. Surgery is for medical necessity not because it is "cool". A cesarean section should not be an elective surgery because a woman doesn't want push or because they want to preserve the looks of their vagina that is selfish and perhaps should be thought about before trying to conceive. C-sections were meant to save lives, the life of a mother or her soon to be child.
Money has been known to play a role in healthcare, as it does here too. Cesareans can cost six to seven times more money than a vaginal birth. A vaginal birth is a one or two day stay and a cesarean is about four to seven days, with no complications. Now also bring into play women who choose to induce and her provider goes along with it, now needs a C-section. There is now the cost of induction and trying to go vaginally but failed, then goes into a C-section. Not only can providers make more money by performing a C-section, it is also time efficient. C-sections are prepped by staff and the provider comes in slices and leaves, all on a schedule. Cesareans make it easier for staffing schedules, the hospital knows who is needed and when so no under or over staffing. Because the hospitals can staff accordingly this also saves them money, maximizing the amount they make on a surgery. Any business is out to make a profit, more money is better for hospitals too. Even non-profit hospitals want to make more money, and then they can put the money back into the hospital and the staff. Money can also be associated with this surgery in a different way that many people neglect to think about: malpractice. People can be overly eager to slap law suits on providers these days to make a buck, which could place fear into a provider. Providers may jump at giving an elected cesarean in fear of a malpractice suit. In addition if a provider has a slight feeling even that something could possible go wrong during labor; they may not want to take the risk of letting their patient go naturally.
There is also a myth that may have contributed to the recent rise over the years. Many women believe that if their first baby had to be delivered by cesarean section, then any babies they had after that would then have to be delivered by cesarean as well. This is simply not true. According to the American College of Obstetrics and Gynecology delivering vaginally after a cesarean, also known as VBAC, has a success rate of 80%, however only 10% of mothers are delivering VBAC. (Rubin) Another myth that is floating around is that the numbers of women who medically need cesareans are increasing, and there is no medical data at this point to back that up. (Corry)
Women are taking this matter to lightly and doctors may also be to blame. " In fact, one quarter of the Listening to Mothers survey participants who had cesareans reported that they had experienced pressure from a health professional to have a cesarean" (Corry) Basically for whatever reason, maybe personal or financial women are being talked into cesareans by their doctors, even when the mother-to-be is wanting otherwise. Health providers are professionals and women trust them with their life and their baby's life, so they are hoping their provider is making the right decision for them. However women should not settle with a provider "pushing" them into a cesarean or jumping into making a quick health decision. A woman can change providers anytime and if you get the feeling that the provider doesn't have your best interest in hand then seek a second opinion to be sure. Surgery as always is risky, and should be left in medically needed situations. Cesareans are not a casual thing that it seems to be treated today. There are many risks and recovery is much longer and intense than a vaginal delivery. A vaginal delivery will get a mom up and walking right away with no down time. With a cesarean, there is an incision which allows for no walking right after and no lifting. If you are a mom to other children at home, you may want to think twice about a C-section because you can't carry or lift anything or anyone. That can be impossible with a toddler running around. With a cesarean incision, it is necessary to hold a pillow or special device over the incision when sneezing or coughing so not to tear the stiches or glue. "Babies born by C-section may suffer from respiratory problems because of not being exposed to certain hormones during the birthing process." (Park) C-sections pose threats to mommy and baby. One big risk for mom is infection to several different sites: incision, uterus, and bladder. According to the American Pregnancy Association, 1 in 6 women need a blood transfusion. Hemorrhage is definitely not a risk to overlook. (Lydon) Cesareans can also cause injury to organs such as the bowel. Scarring is a down side to a cesarean, not just the outside where you can see it every day, but inside where there can be scar tissue that later can cause complications such as placenta previa or placenta abruption in future pregnancies. (Lyndon) Those are just some of many complications associated with a C-section for the mom. What about baby? Well baby can have premature birth weight if the gestational age was guessed incorrectly. There is also risk for fetal injury such as being cut during the incision. One to two babies are cut out of 100 during a cesarean procedure. (Lydon) Baby may not be able to breath or eat on their own, which is also a side effect of incorrect gestational age. Another complication is a low APGAR score which can be from the anesthesia, vaginal birth provides more stimulation for a baby, as for cesareans produce 50% lower APGAR scores than a vaginal delivery.
Most women are healthy enough to give birth naturally yet in the United States the Cesarean rate is about 1 in 3. There are many reasons why a woman should have a C-section, medical reasons. One reason is if the mom is carrying multiple babies, the position or risk for the babies may be too much and a C-section is medically needed to keep mom and babies safe and healthy. Certain health conditions like heart disease, HIV or some sexually transmitted diseases like herpes will not allow for a safe delivery for baby through the vaginal canal, or cause distress to either mother or baby. Position of the baby or the cord can be an issue, which can be life threatening for the little bundle of joy. Anytime the baby seems to be in distress and the heart rate starts dropping this is potentially fatal, and cause for alarm so an emergency C-section is the best and only option at this point. ("Cesarean birth (c-section)") Cesareans are not to be labeled evil but they do need to reserve for emergency situations and medically necessary situations like those examples above. "The National Institutes of Health (NIH) and American College of Obstetricians (ACOG) agree that a doctor's decision to perform a C-section at the request of a patient should be made on a case-by-case basis and be consistent with ethical principles. ACOG states that "if the physician believes that (cesarean) delivery promotes the overall health and welfare of the woman and her fetus more than vaginal birth, he or she is ethically justified in performing" a C-section. Both organizations also say that C-section should never be scheduled before a pregnancy is 39 weeks, or the lungs are mature, unless there is medical need." This quote is saying that really C-sections should be done on a patient to patient basis, no one case is alike. However, it is necessary to wait until the unborn child is at 39 weeks or full term. It is also stating it must be in the best interest of the mother and child to perform a cesarean instead of having the mother deliver vaginally.
This rise is clearly an issue because many hospitals across the United States have been trying to implement to guidelines to reduce the numbers of cesareans. Banner hospital, a group of hospitals were on the local news here in Arizona trying to reduce the numbers as well. Another hospital, Martinez Hospital near San Francisco has too mad the effort in reducing the amount of C-sections. The head their labor and delivery brought up a good point that vaginal delivery patients are more comfortable, and they leave to sooner with quicker recovery. Because of the Martinez Hospital and their effort to strive for the best quality care and reduce the use of a risky surgical procedure they have been acknowledged and given awards. You really know when something has become such an issue when hospitals begin to look at themselves and rethink what they are doing. One would argue that they lose money since vaginal births cost less, but fewer surgeries mean fewer fatalities. Another key point is that many times hospitals are given money by the government or health agencies for meeting or exceeding health guidelines, and with winning a prestigious award, it means much more than asking for a scalpel. At Oakwood Hospital and Medical Center in Michigan, they have taken the vow of trying to eliminate unnecessary C-sections. The hospital has now reported that newborns are now scoring higher in addition to fewer newborns needing the neonatal unit. "Even more encouraging are reports of better Apgar scores -- a measurement of a baby's health taken a few minutes after birth -- and fewer instances of infants requiring special care at the hospitals." (Anstett) What they are doing is proof that it is working and that it is safe and healthy plus natural to deliver vaginally, which should be the only option when there are no medical emergencies. If hospitals are willing to participate in this movement then education is key and there needs to be more of it.
Cesarean sections are a major surgery not to be taken lightly. It is a decision that deserves a great deal of thought. Mothers want what is best for their little babies, so that is why women need to become more educated about this procedure. Birthing is a natural process and unless it is life threatening for either baby or mom, a C-section is not necessary. Cesareans come with so many complications that can last from a few weeks to forever for mom, from the incision wound to a bowel problems or even a hysterectomy. The human body was designed for this process and that is what is best for mom and baby in most situations. Doctors should not make your health decisions based on anything other than your best interest and your baby's best interest. "Money is the root of all evil" as most of us have heard the expression; it certainly seems so when providers or hospitals are trying to perform more and more cesarean surgeries to fatten the pocket book. Today is the day that women need to take control of their health and their health care decision. We wait at the red stop light for our turn because it is safe even when there are no cars, we don't think to ourselves "I will just go it will be quick." So why is giving birth becoming too labor intensive for some women today? Women should not just opt for a C-section because it is the quick option. If it sounds too good to be true it probably is. This procedure comes with too many risks to not think twice, so getting lazy should not be an option.
