C-Sections in US Are at All-Time High

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You need to read between the lines.

 

 

http://www.truthout.org/issues_05/111605WA.shtml

 

 

C-Sections in US Are at All-Time High

By Mike Stobbe

The Associated Press

 

Wednesday 16 November 2005

 

Atlanta - The rate of Caesarean sections in the US has climbed to

an all-time high, despite efforts by public health authorities to

bring down the number of such deliveries, the government said Tuesday.

 

Nearly 1.2 million C-sections were performed in 2004, accounting

for 29.1 percent of all births that year, the National Center for

Health Statistics reported. That is up from 27.5 percent in 2003 and

20.7 in 1996.

 

The increase is attributed to fears of malpractice lawsuits if a

vaginal delivery goes wrong, the preferences of mothers and

physicians, and the risks of attempting vaginal births after Caesareans.

 

The C-section rate increased for all births, even those that

involved healthy, first-time pregnancies with a full-term, single

child. In 2000, the government announced a national public health goal

of reducing the C-section rate for such births to 15 percent by 2010,

but the actual rate now is about 24 percent and rising.

 

The government also reported that more than a half-million infants

were born preterm - at less than 37 weeks' gestation - in 2004, which

is another record. And the proportion of infants with a low birth

weight rose to 8.1 percent in 2004, from 7.9 percent the year before.

 

Increases in multiple-fetus pregnancies and in pre-term C-sections

seem to help explain the preterm and low birth weight numbers, said

Joyce Martin, an epidemiologist who co-wrote the report.

 

A C-section is major surgery: A doctor cuts open a women's abdomen

to retrieve the baby. The risks include infection and, in rare cases,

death, and recovery time is longer than with a vaginal delivery.

Doctors often perform a Caesarean when the fetus lacks oxygen or is in

some other kind of life-threatening distress.

 

For decades, C-sections were done in only a small fraction of

births. In 1970, the national rate was 5 percent. Then it rose,

surpassing 20 percent by the mid-1980s.

 

Experts say many factors drove the rate: Mothers increasingly

preferred the convenience of C-sections, which could be scheduled.

Technological innovations let doctors better see problems before birth.

 

The trend temporarily reversed in the early 1990s, partly because

HMOs pressured doctors to curtail unnecessary procedures. But by the

late 1990s, health insurers had cut back their C-section control efforts.

 

Also, doctors became worried by studies that showed that women who

deliver vaginally after having a C-section earlier suffer a ruptured

uterus - a potentially lethal complication for both mother and child -

in about 1 percent of such cases.

 

Some hospitals have banned vaginal deliveries after C-section, or

VBAC, said Tonya Jamois, president of the International Cesarean

Awareness Network, an advocacy organization.

 

" Women are struggling to avoid unnecessary surgery, but the

medical system has abandoned them. For many, they have to submit to

major surgery in order to get medical care, " she said.

 

The VBAC rate has dropped to 9.2 percent of births after a

previous Caesarean in 2004, compared with 28.3 percent in 1996.

 

The rate of Caesareans among women who have not previously had one

has shot up, climbing to 20.6 percent of such births in 2004, compared

with 19.1 percent in 2003 and 14.6 in 1996.

 

Dr. Sarah Kilpatrick, head of a practice committee for the

American College of Obstetricians and Gynecologists, said that 20

years ago, virtually no women asked for C-sections. But nowadays, she

said, " the public gets the sense that it's like a zipper - they open

you and then close you back up. "

 

Some women believe they have a lower chance of becoming

incontinent if they opt for a C-section, though the evidence to

support that is not complete, Kilpatrick said.

 

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