I posted this article on Facebook, but thought I’d put it here too. This was sent to me by Parenting Weekly. It’s an article from the San Francisco Chronicle, talking about how C-Section rates are higher in CA at a for-profit hospital than a nonprofit one, even when comparing hospitals who serve the same demographic in the same town.
You can read it and decide if you want to disregard it or not. When I posted this on Facebook, people began encouraging me to watch “The Business of Being Born” (available for instant viewing if you have Netflix), a documentary made by Ricki Lake (remember her?) when she started looking into why people choose midwives over hospitals. She was so convinced by her research that she decided to have her second child at home.
I am not saying that there aren’t valid reasons to have a C-Section. Doctors use this procedure all the time to save lives, and I’m grateful that modern medicine has found a way to turn otherwise deadly birth situations into a safe experience. I have friends who would not be here, were it not for this practice. So please don’t misunderstand me.
But our culture doesn’t seem to realize that birth is natural and normal, not a sickness. It isn’t ALWAYS an emergency. Why, then, is the national C-Section rate at 31.8%, vs. ? Did 1 in 3 women die in childbirth before doctors figured out how to perform this surgery? Was childbirth really more deadly than war? Plagues?
This also doesn’t explain why there is only an 11.1% transfer rate to the hospital of mothers who begin their care at my birth center (10% of which are first time moms who are not progressing). Less than 5% of these turn into C-Sections.
Are people just not aware of the possible complications of a C-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 breastfeeding, 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).
One of my good friends is no longer able to have children because her first C-Section was so botched that her body went into labor 9 weeks early with her second baby. When they went in to remove him, they said that her uterus was practically transparent near the first incision. Her body had gone into labor early in order to save her life. She and her husband had always dreamt of a big family– now, they will only have 2.
3 of Michael’s high school students just had C-Sections. Their doctors met with them ahead of time and explained that since they were so young, their hips couldn’t possibly accommodate a normal birth, so they should go ahead and schedule a C-Section ahead of time.
The woman I used to babysit for was livid about her first birth– the doctor at Baylor had also told her that her hips were too small to give birth to what they estimated to be a nine pound baby growing within her. They convinced her that a C-Section was the only way to be safe. After the surgery, they discovered that the baby was only 6 pounds. Simple mistake on their part (a charitable read), but now surgery has been her only option for her other two (despite the fact that a V-BAC– vaginal birth after cesarean– succeeds 9 out of 10 times, there is only one doctor in the entire DFW area who is willing to risk it).
A woman listed in this article talks about how her first c-section has now rendered her infertile. She, too, was told she was having a baby too big to fit through her cervix. A baby who turned out to be 5 pounds 12 oz.
What is going on, America? I’m not trying to artificially find a whipping boy for this one– big bad doctors, corporations, what have you. But am I wrong to see this as a problem?
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Becks says
While I totally agree with you that unnecessary C-sections are bad, it’s easy to get a little TOO impassioned about their evils. Yes, birth is a natural event, but it’s about the most dangerous “natural” event that exists. Before the advent of modern medicine, any birth that wasn’t a perfect low risk birth was a birth where the mother died, or the baby died, or the mother was horribly disfigured. Victims of traumatic birth were often rendered completely incontinent, which was thought be a sign of a witch: these women were ostracized from their communities, branded, drowned, or burned at the stake.
And if you look at things from a Biblical perspective, childbirth is the thing that is cursed by God when Eve sins in the garden. There are better births and there are worse births, but I don’t really think there are any births that are free of pain or danger. C-sections are probably overused, and of course there is a risk of complications in any medical procedure, but I really can’t say that something that saves lives is a “bad” birth. It’s not an ideal birth, but it’s just not a BAD birth.
My C-section saved my life, and it saved my son’s life. If I had lived even 100 years ago, the life we have now together wouldn’t exist. Nate would be alone; James and I would be dead. I would have WAY preferred to deliver James vaginally, but I would much, much rather be alive! And if I had to choose between C-sections being over-performed and under-performed, I would certainly choose over-performed!
I think that in the good birth/bad birth debate people have lost perspective: A “natural” vaginal, low-risk birth in a birth center, with the option to transfer to a hospital should things not go as planned, it a luxury and a blessing! That God has blessed you with a healthy, low-risk pregnancy and a smooth low-risk delivery (most probably) means that you are most blessed among women! Given all of time and history, God in his grace has given you the blessing of the best possible birth experience, but it’s just not an experience that everyone gets to have. My birth experience was not the best possible experience by any means, but that doesn’t means that a C-section is a bad birth. From my point of view, it was a GREAT birth, because it meant life for me and my son, when a natural birth would have resulted in death. How can that not be a good birth?
Kelly says
I really was trying to make it clear that I’m responding to a culture who would elect to have a C-Section for no medical reason whatsoever. Courtney, Christine and Amanda Voss/Unruh wouldn’t be here if it weren’t for the procedure, so I’m obviously very grateful for it and think it has an important place. I would never call a necessary C-Section a “bad birth”, just like I wouldn’t call it a bad birth if a woman hemorrhaged post-delivery and needed surgery to keep her alive. It accomplished the purpose of bringing another human being into the world. With such a great privilege always comes a great sacrifice.
So, I guess my infuriation is with those who have more knowledge (doctors) convincing those with less to do something, just because it saves time, protects them against law suits, etc. There is no reason a healthy 16 year old should be convinced to have a C-Section, just because. Small women give birth all the time. Just because she can’t see down the road, at the future where she may want to have more children but may not be able to because of the side-effects of a decision she made, doesn’t mean that the doctors should take advantage of that naivete.
Becks says
Yeah, I think I was mostly responding to the “better birth” crowd, not so much to you 🙂
I hope next time around I will be able to have a VBAC, especially given how late in the pregnancy I had the C-section, and what an excellent job my OB did on the surgery. There are also 2 hospitals in the area that perform VBACs, so here’s hoping 🙂
I agree with you about the unnecessary C-sections, but I also get really irritated when natural birth advocates (of which I would be first in line, if life had given me that) feel like they have to bash other kinds of births to prove their point. I totally agree that more women, and more doctors, should take a holistic non-crisis attitude towards births, but not at the expense of the women who actually need medical intervention during birth.
Kelly says
Like I said in my post, I’ve heard that most VBACS are successful, although with a good friend of ours it wasn’t. For her third child, she’s just going to schedule the C-Section. But she did try. Funny enough, the doctor who was helping her is the only doctor in Dallas who is willing to even attempt a VBAC. This is also the same doctor I will be transferred to at Baylor if something goes wrong at the Birth Center.
I actually get just as frustrated with natural birth advocates who criminalize all hospitals and doctors. Different people were trained under different schools of thought, but that doesn’t make them evil. My very first appt. at the birth center, there was a lady in the next room arguing with the other midwife. She had tested positive for gestational diabetes, had very high blood pressure, and her baby had tested positive for down syndrome. The midwife was trying to tell her as gently as possible that she needed medical intervention, and the lady was furious, wondering why they were writing her off and “selling her out” to the doctors, getting in the way of her perfect natural birth. That, to me, said it all!
courtney says
yes, this topic can become heated *very* quickly. i will be the first one to stand up and praise modern medicine for working hard and quickly to get me out when my mom’s life and our lives were in danger 27 years ago. Thank God for those doctors and their wisdom. What, to me, is frustrating about the whole scenario is the way they seem to set people up for failure. Lie a woman on her back (the most excruciating position EVER), encourage her to get an epidural, encourage pitocin to speed up contractions (since the epidural slowed them down), watch baby go into distress because of the pitocin, and then need to do a c-section to get the baby out. it begs the question, would the baby’s life be in danger had they not set the mom up for a difficult birth experience? i can say from experience that starting off labor not on my back put me in control of how labor went. if i had to be on my back, i would need drugs.
secondly, i know people who were unable to have ‘natural’ vaginal births feel that they are constantly under attack and need to defend against us ‘natural birth advocates’. however, i feel like those of us birth center birthers or home-birthers are more in a place of disenfranchisement. i mean, my insurance won’t even talk to me about a home birth, even though the success rates are better at home than in hospitals. why do i scare people in the supermarket or at piano lessons when i tell them i’m having a home birth? why am i afraid to mention it to my apartment manager, in case she says she won’t let us? people seem to think we’re bizarre for wanting to manage our own labor and delivery…even accusing us of not caring for our babies (what if something were to go wrong???) without looking at the facts and numbers and success stories at home vs the hospitals. i’m sorry if you feel under attack at times from us ‘natural-ites’ but, to be honest, i think more people agree with you than with me. because of that, you get to have the birth you’re comfortable with while i have to fight for it, pay for it, and go through scrutiny from almost everyone i meet…just because i want to have him at home.
i shall now end my rant. 🙂