Choosing Cesarean Birth

This article caught my eye this morning as I was scrolling through the NPR health news feed and I wanted to share it with you all. In class, we have briefly discussed health outcomes of cesarean section births, but I am not sure if we have talked very much about elective cesarean section births. As someone who is passionate about natural childbirth, this issue really interests me. An article from ACOG explains that elective cesarean, or Cesarean delivery on maternal request, is prelabor cesarean delivery on maternal request in the absence of any maternal or fetal indications (ACOG, 2013). However, the aspect of elective cesarean sections that I am most interested in regards providers who either:

a) allow women to electively schedule cesarean section births despite the evidence that claims poorer outcomes for both mothers a babies (potential risks include a longer maternal hospital stay, an increased risk of respiratory problems for the infant, and greater complications in subsequent pregnancies, including uterine rupture, placental implantation problems, and the need for hysterectomy ACOG 2013)

 

or

b) do not facilitate adequate education to women about the benefits of vaginal delivery, especially if the case of women who may desire a VBAC if the option was provided

The NPR article discusses a recent report that claims approximately 9% of births covered by medicaid are elective cesarean sections. However, because of the potential negative outcomes of elective cesarean deliveries some states (2) are now refusing to pay for elected cesareans while others are finding other ways to discourage this practice.

What do you all think about providers allowing elective cesarean section births? What are some reasons you all think women, and providers, might prefer elective cesarean sections? And, how do you all think this might (or might not) be primarily an “American” problem?

http://www.npr.org/blogs/health/2014/12/08/369378083/despite-decline-elective-early-births-remain-a-medicaid-problem

http://www.childbirthconnection.org/article.asp?ck=10456

Cesarean delivery on maternal request. Committee Opinion No. 559. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013:121;904–7. http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Cesarean-Delivery-on-Maternal-Request

1 thought on “Choosing Cesarean Birth

  1. Hey Molly,

    Interesting article! I’m also in favor of natural child birth. Nevertheless, I’ve heard that some women choose C-Sections because they feel it’s “cleaner” and do not want to “mess up” any of their genitalia in a vaginal birth. But of course, a lot of these ideas are misguided — so it may simply come down to education. C-Sections are very expensive, so people in poorer countries would not have the ability to freely select a method as an American would, for sure. I am against the idea of casually electing for surgery, even if it’s a c-section, but I do not think it can be absolutely banned without repercussions. I think strong discouragement of the practice is more appropriate and will be more conducive to actual practice. It’s kind of like the breastfeeding issue. All the literature tells us breastfeeding is best, but people still elect to use alternative feeds. Healthcare providers must be careful not to enter themselves into a power struggle with patients. All we can do is advocate, educate, and respect the choices made by clients, even if we ultimately disagree. Great post!

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