There's something very weird going on that I need some women's perspective in understanding. I just happened across a statistic that informs me that in 2005, about 35% of American women delivered via Cesarean Section. 30 years earlier the rate was about 5%.
I have no clue as to why American women are increasingly having c-sections, but my instinct tells me that it's related to the sexual revolution, a set of social changes I find increasingly dubious. So I'm poking around and here is what I find.
Nearly half of obstetricians in Canada say a woman should have the right to choose a caesarean section when there is no medical reason to warrant one.
The finding comes from a nationwide survey of maternity care providers that found many obstetricians appear to support the wide use of technology, despite a push by their own professional body to "normalize" childbirth and reduce Canada's rising C-section rate.
Forty years ago in Canada, five per cent of babies were delivered by caesarean. Today the rate is 28 per cent nationally, and more than 30 per cent in B.C. and P.E.I. More than 78,000 C-sections were performed in Canada last year.
What are some reasons that would mean I would need a cesarean?
Prolapsed cord (where the cord comes down before the baby), placenta abruptio (where the placenta separates before the birth), placenta previa (where the placenta partially or completely covers the cervix), fetal malpresentation (transverse lie, breech (breech can sometimes be managed by External Version, exercises or a vaginal breech birth), or asynclitic position), cephalopelvic disproportion (CPD, meaning that the head is too large to fit through the pelvis. This can also be over diagnosed, it can be caused by maternal positioning either from restraint to bed, lack of mobility or anesthetics.), maternal medical conditions (active herpes lesion, severe hypertension, diabetes, etc. (please note that these conditions do not ALWAYS mean a cesarean.)), fetal distress (This is a hot topic with the recent studies indicating that continuous electronic fetal monitoring increases the cesarean rate and does not show a relative increase in better outcomes. Discuss with your care provider how they define fetal distress and what steps are used to remedy the situation before a cesarean.), maternal exhaustion, and repeat cesarean, these are the main reasons for cesareans.
Matthews & Zadak
This article uses the US debate over elective Cesarean section to re-consider some of the more contentious issues raised in feminist debates about childbirth. Three waves of feminist commentary and critique in the United States are analysed in light of the ongoing debate over whether women should be able to choose Cesarean for non-medical reasons. I argue that the alternative birth movement's essentialist and occasionally moralistic rhetoric is problematic, and the idea that some women's preference for high-tech obstetrics is the result of a passive 'socialization' into 'dominant values' is theoretically inadequate. On the other hand, the invocation of women's choice and appreciation of high-tech childbirth serves as a weak foundation for a feminist perspective on childbirth. By limiting their analysis to the rhetorical and discursive nature and functions of 'the medical' and 'the natural', poststructuralist critics of the alternative birth movement obscure the connection of these discourses to practices that have very different consequences for maternal and infant health and, most importantly, for the consumption of health care resources.
The alternative birth movement is a consumer reaction to paternalistic and mechanistic medical obstetrical practices which developed in the United States early in this century. Alternative birth settings developed as single labor-delivery-recovery rooms in the hospital or as free-standing birth centers. Both alternatives offer family-centered, home-like, low technological maternity care. In order to overcome physician resistance to non-traditional maternity care, alternative birth center policies eliminate all women who are expected to have a complicated pregnancy or delivery. Physician resistance to alternative birthing is publicly based on the issue of maternal and infant safety. Additional issues, however, are that physicians fear economic competition and resist loss of control over obstetric practice. This paper (1) traces the historical antecedents and social factors leading to the alternative birth movement, (2) describes the types of alternative birthing methods, and (3) describes ways in which the obstetrical community has maintained and rationalized dominance over the birthing process.
The best answer I could find comes from Childbirthconnection.org which I artlessly reproduce in full:
Reasons for the Rising Cesarean Section RateThe following interconnected factors appear to be pushing the cesarean rate upward.
Low priority of enhancing women's own abilities to give birth
Care that supports physiologic labor, such as providing continuous support during labor through a doula or other companion and using hands-to-belly movements to turn a breech (buttocks- or feet-first) baby to a head-first position, reduces the likelihood of a cesarean section. The decision to switch to cesarean is often made when caregivers could use watchful waiting, positioning and movement, comfort measures, oral nourishment and other approaches to facilitating labor progress. The cesarean section rate could be greatly lowered through such care.
Side effects of common labor interventions
Current research suggests that some labor interventions make a c-section more likely. For example, labor induction among first-time mothers when the cervix is not soft and ready to open appears to increase the likelihood of cesarean birth. Continuous electronic fetal monitoring has been associated with greater likelihood of a cesarean. Having an epidural early in labor or without a high-dose boost of synthetic oxytocin ("Pitocin") seems to increase the likelihood of a c-section.
Refusal to offer the informed choice of vaginal birth
Many health professionals and/or hospitals are unwilling to offer the informed choice of vaginal birth to women in certain circumstances. The Listening to Mothers survey found that many women with a previous cesarean would have liked the option of a vaginal birth after cesarean (VBAC) but did not have it because health professionals and/or hospitals were unwilling (Declercq et al. 2006a). Nine out of ten women with a previous cesarean section are having repeat cesareans in the current environment. Similarly, few women with a fetus in a breech position have the option to plan a vaginal birth.
Casual attitudes about surgery and cesarean sections in particular
Our society is more tolerant than ever of surgical procedures, even when not medically needed. This is reflected in the comfort level that many health professionals, insurance plans, hospital administrators and women themselves have with cesarean trends.
Limited awareness of harms that are more likely with cesarean section
Cesarean section is a major surgical procedure that increases the likelihood of many types of harm for mothers and babies in comparison with vaginal birth. Short-term harms for mothers include increased risk of infection, surgical injury, blood clots, emergency hysterectomy, intense and longer-lasting pain, going back into the hospital and poor overall functioning. Babies born by cesarean section are more likely to have surgical cuts, breathing problems, difficulty getting breastfeeding going, and asthma in childhood and beyond. Perhaps due to the common surgical side effect of "adhesion" formation, cesarean mothers are more likely to have ongoing pelvic pain, to experience bowel blockage, to be injured during future surgery, and to have future infertility. Of special concern after cesarean are various serious conditions for mothers and babies that are more likely in future pregnancies, including ectopic pregnancy, placenta previa, placenta accreta, placental abruption, and uterine rupture (Childbirth Connection 2006).
Providers' fears of malpractice claims and lawsuits
Given the way that our legal, liability insurance, and health insurance systems work, caregivers may feel that performing a cesarean reduces their risk of being sued or losing a lawsuit, even when vaginal birth is optimal care.
Incentives to practice in a manner that is efficient for providers
Many health professionals are feeling squeezed by tightened payments for services and increasing practice expenses. The flat "global fee" method of paying for childbirth does not provide any extra pay for providers who patiently support a longer vaginal birth. Some payment schedules pay more for cesarean than vaginal birth. A planned cesarean section is an especially efficient way for professionals to organize hospital work, office work and personal life. Average hospital charges are much greater for cesarean than vaginal birth, and may offer hospitals greater scope for profit.
All of these factors contribute to a current national cesarean section rate of over 30%, despite evidence that a rate of 5% to 10% would be optimal.
Are American women that stupid? Given this information, the decline of marriage and the rise of abortions since the American sexual revolution, I would say that on the whole our nation has radically degenerated on the very basics of human survival. Good Lord!
But let us never forget in these days of 'health care debate' the final paragraph. The incentives that encourage this surgical procedure increase its market share. Here is something I think all conservatives should make an absolute stand on. Defund elective Cesareans.