While we understand that some women are not able to have the vaginal births they hoped for, we encourage everyone to research and learn about all options available for the healthiest delivery of your little one. For many years, women have been successfully delivering their babies vaginally, though there are instances when a Cesarean Section (surgical procedure) is medically necessary for the safety of the mother and/or child. However, there is a troubling trend in the U.S. in recent years of an increased number of women delivering via c-section.
HealthGrades has recently reported that the number of c-section births is now at an all-time high. Between 2002 and 2009, the number of cesarean deliveries rose significantly, from 27 percent of births to 34 percent. This new report is based on information obtained from 19 U.S. states. Many mothers, soon-to-be mothers, and future mothers may be wondering why this number continues to increase so drastically. Have there been changes in health status or policies over the last decade that results in such a sudden increase?
According to the report, some of the reasons the number of cesarean deliveries are on the rise include:
- Convenience in delivery timing for the doctor or the mother
- Women giving birth later in life, which raises the risk of complications during pregnancy and delivery
- An increase in maternal risk factors, such as obesity and diabetes
- Increase in multiple births, sometimes due to the more frequent use of 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
While there are certainly other factors that can contribute to the need for a c-section, women are encouraged to be as knowledgeable of their choices as possible. This includes being selective in the process of finding a provider (OB and/or midwife), as well as researching the statistics of c-section rates in your hospital or birth center of interest. Asking questions of your provider regarding their experience, as well as having dialogue regarding the circumstances where a c-section will be necessary is important in lowering your risk. Additionally, researching and beginning discussions surrounding alternative methods of care can help to lower c-section risks.
What can providers and expectant mothers do to provide the opportunity for the lowest risk experience into motherhood without resulting in a surgical procedure? How can providers and expectant mothers work together so that prenatal care is improved, alternative methods are sought for mothers with risk factors, and the chance for c-sections are decreased? The reasons listed above included elements of fear, lack of knowledge, routine, pre-existing conditions, age, time, and convenience. While these items are definitely important factors to consider when researching birth options, they are not the only factors to consider. Risks of infection, healing time, immediate bonding, post-partum needs, and planning future pregnancies are important factors to consider also.
In addition, the report also highlighted that:
- 7 percent of women having babies in hospitals had a complication. If all hospitals performed at the level of the best-rated hospitals, 32 percent of these complications (141,869) might have been avoided.
- Of the 19 states included in the report, the highest rates of C-section deliveries were in Florida (38.6 percent) and New Jersey (38 percent). The lowest rate was in Utah (22.4 percent).
One may wonder why certain states have higher rates of c-sections than others. Is it attributed to the environment, social economic status, current health status of the mother-to-be, or health insurance options? Are there ethical or other fundamental factors contributing to the difference in data across states? Others may also be wondering how we can begin to talk about ways that our healthcare system can come to a medium where our levels of service and performance can increase so that our risk for complications decreases. If best-rated hospitals are seeing lower numbers of complications during pregnancy and delivery, then how can we begin to standardize resources so that other facilities are able to achieve the same outcomes?
There are so many questions that can be asked in regards to this increase and more components to finding where the increase is stemming from. However, what is important to remember is that a healthy birth for both mother and baby is important not only to that moment, but the future births the mother may experience. C-sections may be necessary depending on the circumstance. The support of both mother and her provider working together in order to decrease risks are fundamental in providing more women with the vaginal birth that many hope for.
Written by Adrienne Hunter.
HealthGrades Report Finds U.S. Cesarean Section Rate Continues Rise to Historic High: 34%