Should We Be Concerned about Rising C-Sections?

March 27, 2006

One of the responses to my recent post on bed rest and pregnancy reminded me of a recent debate I read in Brain, Child Magazine: “Are Elective C-sections Anyone’s Business?”

The debate, a regular feature in the magazine, is not available online. But here is a synopsis with each writer’s strongest point. Arguing in the affirmative is Nola Hamilton, a caterer:

Of course, sometimes C-sections are medically necessary, and having one is much better than risking harm to mother and child, but all things being equal and low risk, a vaginal birth presents fewer risks to both mother and child…The March of Dimes reports that a C-section will increase a mother’s risk of uterine infection, excess bleeding, and blood clots; it will also increase the baby’s risk of being born premature (since the due date could have been miscalculated), and the anesthesia can make the baby sluggish. The risks are small, but why take them at all if you don’t have to?

Marlee Ryson, a stay-at-home mother, disagrees. She says women can make their own choice in how they deliver their babies:

No, elective C-section is not the most “natural” choice for giving birth. But neither is using pain medication, fetal heart monitors, birthing chairs, hot tubs, or hospitals, for that matter. Unless you’re willing to argue that a woman shouldn’t have access to those choices either, it makes little sense to wind yourself up about whether or not she chooses to have her baby by C-section.

Here are the facts: The World Health Organization has recommended a C-section rate of no higher than 15 percent. (I am assuming it’s because of the risks and costs related to the surgery.) But the rate for the operation has climbed to 29 percent in the United States, according to WHO.

Get ready for some contradictory information. The American College of Obstetricians and Gynecologists has said it is ethical for doctors to provide medically unnecessary C-sections and that “the risks associated with C-section relative to the risks of vaginal delivery are unclear, and the lack of data indicates that it is not ‘ethically necessary to initiate discussion regarding the relative risks and benefits of elective (caesarean) birth versus vaginal delivery with every pregnant patient.'”

Excuse me? If my doctor offers me a C-section, she better tell me all risks involved and, ahem, the slight fact that it carries a longer recovery time than vaginal birth. I am hardly the only person critical of elective C-Sections, which by the way, are now more common than emergency C-sections, according to the debate in Brain, Child.

Celebrities have been scorned for going under the knife rather than risk stretch marks on their bellies. I have had at least one friend tell me she wanted a C-section to avoid a stretched-out vagina. Another acquaintance of mine — an attorney — had the operation so the birth wouldn’t conflict with her work schedule. She also chose to bottle-feed the baby formula rather than nurse.

Sure, it offends my own sensibilities. But, ultimately, I agree with Ryson. Unless it becomes some national crisis, in which women die on the operating table, I don’t think it’s any of our business what other women do.