Cesarean birth

...now browsing by tag


Are Cesareans the Lazy Way Out?

Thursday, May 10th, 2012

The process of giving birth has certainly evolved over the years.  Women can now opt for an assortment of painkillers, choose to do a home birth, and even substitute doctors for midwives.  The most recent trend though, seems to be cesarean deliveries.  Instead of enduring hours of labor, being coached by the doctor, and toughing out a natural, vaginal birth, babies are getting the quick way out.  Is this increase because of concerns for the mother’s or child’s health, or simply because obstetricians are looking for the lazy way out?

Right now, one out of every three births happens through cesareanIn 1965, only 4.5% of births were cesareans.  Why the big increase?  Unfortunately, it’s not a result of medical need.  Instead, 29% of Obstetricians polled in a survey said, “they were performing more Caesareans because they feared lawsuits.”  (Some other physicians, myself included, happen to be of the mindset that it is more about convenience, on both the parent and physician side, than anything else. It takes serious stamina to stand by and coach a woman through thirty hours of difficult labor. And I do it because I love my job. I am a warhorse, and I am there for my patients.) Because they’re concerned about being held responsible for potential harm to the baby from vaginal labor and deliveries, they would rather opt for cesarean deliveries.  While this kind of labor may be quicker, it is by no means safer.  A cesarean is an invasive surgery that is actually more likely than a vaginal birth to pose a risk for complications that might, “put the mother back in the hospital and the infant in an intensive-care unit.”  Some hospitals are not giving moms all the information.  Instead, they offer the cesarean as a casual choice in order to skip providing long-term labor support, to get through the labor as quickly as possible, and to avoid malpractice claims.  Cesareans are also much more expensive, consequently, making hospitals more money.  While there are women who do need cesareans for valid medical reasons such as breech for first-time Mom’s, high-order multiple births in one delivery, cephalopelvic disproportion (the baby’s too large for Mom’s pelvis) or eminent danger to the mother (such as hemorrhage) or fetus (sudden abnormal heart rate), these do not make up nearly enough of the more than 30% cesarean rate.  That means that the majority of cesareans are happening because obstetricians are choosing them, not mothers.  If Mother Nature wanted our babes to be born by Cesarean, she would have put a zipper on our abdomens.  The consequence of this increase in Cesarean births (some by maternal request) is the increase in maternal death and Cesarean hysterectomies in subsequent pregnancies due to hemorrhage caused by abnormal placental location and uterine rupture.

This is why it’s so important to become as informed as possible about child birth before making any decisions.  Make sure you have a caring, ethical obstetrician who is willing to give you all the information you need to make the safest choice for you and your child.  If they recommend a cesarean, ask them about their reasons and whether or not it is medically necessary.  Remember, it is your body, your baby, and your choice.

— Yvonne S. Thornton, M. D., M. P. H.

In came Beyoncé and the security guards. Out went the hospital’s common sense—and common decency.

Friday, January 13th, 2012

As an OB-GYN who has delivered thousands of babies—including several with rich and famous parents—I’m scratching my head over the insanity at Lenox Hill Hospital in New York City surrounding the birth of Beyoncé’s baby.

Here’s a sampling of what went on, according to The New York Times:

The familiar area outside the neonatal unit had been transformed: partitions had been put up, the maternity ward windows were completely covered, and even the hospitals’ security cameras had been taped over with paper. Guards with Secret Service-style earpieces roamed the floor.

“We were told we could walk no further,” Ms. Nash-Coulon said Monday. And when she and her husband, Neil, demanded an explanation, she added, the guard claimed, unconvincingly, “ ‘Well, they’re handling hazardous materials,’ ” even as a large group of people screened from view were passing through the main hallway he had declared off-limits.

Let me make this perfectly clear: The hospital had no right to bar other patients from having free access to their babies.  Worse, from a safety perspective, doctors were prevented from visiting their own patients on rounds, because of this so-called “security.”

Someone in the hospital decided that the celebrity of a hip-hop artist was sufficient to ignore medical necessity and common decency. Not a good message to send to sick people.

Beyond that, I’m alarmed to learn that the baby was born by Cesarean, as so many celebrity babies are today. I could be mistaken, but I doubt that Beyoncé’s OB-GYN warned her of the risks before treating little Blue Ivy’s birth like just another item on the to-do list. The risks are real: a dramatic increase in maternal deaths due to hemorrhage and infection; more babies ending up in the neonatal intensive care units after Cesarean births because of respiratory distress.

If she’d been my patient, I’d have told her what I tell other mothers-to-be: if God wanted women to have Cesareans, he would have put a zipper in the pubic area.

– Yvonne S. Thornton, MD, MPH