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 cesarean.  In 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.