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Underground > Laboratory >

'Unnecessary' Caesarean Sections

Ganesh

08:31 / 13.08.01

I was vaguely aware that elective (ie. on non-emergency grounds) Caesarean section operations were becoming more and more popular - and this week's Observer obligingly ran a special feature, supplying me with the appropriate statistics.

Seems the proportion of women undergoing Caesarean section as a means of delivery has been steadily climbing since the 1950s, but has leapt up, in recent years, to 20% of total births in the UK (no idea how many US women pick this option). There's been a spate of high-profile 'celebrity Caesareans' too - Madonna (although hers were 'emergency', I think), Victoria Beckham, Zoe Ball, Patsy Kensit - and, amongst middle-class 'career women', it almost seems to have become the method of choice.

Pros: allows a relatively 'quick & easy' labour; reduced risk of neonatal birth trauma; timing of delivery can be predicted; no vaginal tearing; mother 'keeps figure'.

Cons: increased mortality/morbidity risk for mother and neonate; possible complications of anaesthetic agent and abdominal surgery; subsequent births more likely to require Caesarean; scar.

Feminists seem divided on this one. It can be argued that women have the right to choose how and when they give birth, with as little pain as medically possible. On the other hand, Naomi Wolff argues the 'right to undergo labour' and suggests that women are increasingly being warned off 'normal' vaginal delivery with scare stories of the pain of giving birth.

There are also resource implications. Caesarean delivery is more expensive than other options and, if the popularity of this method continues to grow, the NHS may be forced to 'ration' availability, or limit Caesarean sections to emergencies. Private obstetricians, on the other hand, are only too happy to carry them out, as they get paid proportionately more than for a vaginal delivery.

Thought? The New Black? A Feminist Issue?

16:56 / 13.08.01

Seems like it would collate closely with the rising age of maternity in the post-housewife era.
No data to back that up, of course.

It's also part of that nasty trend for doctors to eliminate all biological risk by doping up patients and cutting them open. I wonder how the rise of C-sections maps against the rate of still-births or deaths/injuries from "complicated deliveries."

Ganesh

09:19 / 14.08.01

I'm talking primarily about elective Caesareans, so I'm not sure whether it relates directly to either older mothers or complicated deliveries (both of whom would probably influence the rate of emergency Caesareans more - in a non-private health system, anyway).

I'm not sure it's a result of those nasty intrusive doctors either. 'Biological risk' is hardly eliminated by performing Caesareans electively; the mortality risk is actually two to five times greater (from an admittedly small baseline of one in 25,000 or so).

09:19 / 14.08.01

I don't think it 'keeps your figure' - it's the big baby in there stretching things that causes your shape to change, not the way it comes out, surely?
My friend, who is a midwife, says most C-sections are done for real medical reasons and the 'elective' issue is being blown out of proportion. Vaginal delivery is fraught with dangers - in her words, "sometimes I look at the words 'vaginal' and 'delivery' and wonder how the human race has survived this long". And of course, before C-sections and modern medicine, lots of women and lots of babies didn't survive.
I know that in her clinic they encourage people to deliver naturally because it makes the next pregnancy easier and it's easier to recover from.
So - I'm sure there are some women who are choosing it, and some doctors going for the 'easy' option but I don't know that it's as prevalent as people think. My friend is working in New Zealand but she's actually Scottish and practiced in Glasgow for years.

15:42 / 14.08.01

I know for example that all of my aunt's children we're born via C-section, something that she wanted for herself. She was also fairly heavy though so I'm not sure if that had anything to do with it.

My mom's a special care nurse in a neonatal department and has seen just about everything that can happen. She brings up C-sections a decent amount of the time, so it definitely points to an greater awareness and or greater use of the procedure. I can ask her for more info about it.

Being a man, I guess it's hard for me to not have a 3rd person perspective on the issue, but I think, if you don't need one, you shouldn't have one. I can see it as somewhat of an escapist act from delivering the child, a natural and generally quick recovery procedure.

I know someone who had a similar procedure to remove an ovarian cyst and she could walk stairs or drive a car for a month. So C-sections don't seem too easy either. Plus the drugs out now are pretty good and depending on where you go, the care could be great, if you go to the right place.

My mother delivered me and my brother and sister (twins) naturally without any drugs. My sister who was delivered second, started in breech, but the doctor shifted the baby outside of the womb with his hands and directed her out. Even though, her care was probably some of the best around, and she walked in knowing personally what was involved, I give her props for doing it that way. A good mom.

15:51 / 14.08.01

quote:Originally posted by Ganesh:
I'm not sure it's a result of those nasty intrusive doctors either. 'Biological risk' is hardly eliminated by performing Caesareans electively; the mortality risk is actually two to five times greater (from an admittedly small baseline of one in 25,000 or so).

What I was wondering was more along the lines of doctors having better prenatal scanning equipment, which in turn points up potential risks, which leads to them strongly suggesting a woman have a C-section. I mean, as long as she's conscious - even if she's had an epidural and is in the throes of labor - then she can "elect" to have the baby via C-section.
My girlfriend's had two, and I think something like this happened for the first. The second was more... complicated.

17:47 / 14.08.01

Netbanshee, surely a good 'Mom' is one who loves her children and brings them up to the best of her ability? A C-section won't harm the child in any way, as far as I'm aware - if anything, the birth is much easier on the baby.
So the decision to 'elect' for a caesarian might have all sorts of adverse health effects on the mother but so long as she knows all that, surely it's up to her?
I'm uncomfortable with what seems to be a "good mothers go through pain" attitude - why, for god's sake? The only reason for other people to stick their nose in is if it affects the baby or if it costs money on the National Health and isn't necessary.

The Return Of Rothkoid

19:48 / 14.08.01

quote:Originally posted by Ariadne:
I'm uncomfortable with what seems to be a "good mothers go through pain" Agreed. A good friend of mine has just had a baby boy, and while she was planning on going the natural birth route, due to some complications (she has MS, for a start) she had to have a c-section. I'm sure she felt pain either way, but if she'd persisted with the original plan - at home, au natrel - she probably would've died. Fuck that noise. She'll be a kick-ass mother anyway; I don't think the level of pain or resistance to anaesthesia determines how good a parent she's going to be to that little boy.

I'm guessing that c-section only becomes a problem if the number of people choosing to have it who may not have needed it end up compromising the health of those who actually do need it.

02:45 / 15.08.01

Wasn't suggesting anything about the meaning or process of birth relating to motherhood. Simply doesn't make sense. Is a sensitive topic though...

I can see that the shivers are natural before child-birth and it isn't easy to go through with. My friend fought with the idea of childbirth, the fear of pain during it but ultimately had the kid and got through it (fairly well too). Yet cutting through an abdominal wall seems a whole lot more to deal with than the natural way, especially when offered instead of required.

But at the same time, childbirth is a strange subject because people feel so strong to it. I mean naturally its easy to understand, a birth = life and all the things that go with it. Plus I'll never feel something growing inside of me for that period of time. But at the same time, I can't help but think that all mammals can generally go through with this biological process and that its natural and nothing more. We're just able to do it better with our tools when deer for instance, have none. This subject worthy of a post or discussion?

06:55 / 15.08.01

I'm not sure of my ground here, but from what I've read, humans have evolved somewhat haphazardly and the baby's head is generally too big for natural birth to be easy - much more so than in other mammals. I think it might be because human babies gestate slightly longer? Does anyone know the facts here? That's just what I've read and/or heard.
I'll look it up if I get a second.

18:57 / 15.08.01

I'll look into it to...might have some available resources (2 immediate family members way in the healthcare system). People have certainly grown in size over the last 100 years or so, all you have to do is look at the size of furniture and doorways, etc. that are in colonial or historical homes. Wonder if this reflects in birthsize? Maybe 100 years from now, C-Sections will be a requirement...