A cesarean birth is an operation that results in a baby being brought into the world through an incision in the mother’s abdomen and uterus. Because of the inherent risks involved, cesareans were originally performed only in emergency situations. Now, however, cesareans are the most frequently performed surgery in the United States. In 2009 (the last year for which statistics are available from the Centers for Disease Control), nearly one and a half million pregnant mothers giving birth via cesarean. That’s about one in every three pregnant moms who birthed her baby through cesarean surgery.
The high cesarean rate is part of a trend that began in the mid-90s: The U. S. has posted record high cesarean rates every year since 1996, a concern to the American College of Obstetricians and Gynecologists (ACOG), which concedes that while the number of cesarean births is increasing, the outcomes for mothers and babies isn’t improving.
By comparison, in 1970, the cesarean rate in the United States was just 5%. The six-fold increase in cesareans over the last four decades has been attributed to a number of factors:
- An increase in the number of multiple pregnancies because of advances in fertility treatments
- Older women are becoming pregnant, increasing the risk of certain pregnancy-related complications
- More women are overweight during pregnancy which can cause complications
- Doctors say that mothers are requesting cesareans more often for convenience. In 2007, ACOG issued new guidelines for how physicians should handle elective cesareans.
- ACOG has loosened its guidelines on VBACs (Vaginal Births After Cesarean)
- Obstetricians are concerned about liability issues
The World Health Organization states that when the cesarean birth rate is higher than 15%, it imposes more risks than benefits to mothers and babies. Sometimes a cesarean is truly medically-necessary. In a patient education pamphlet, ACOG lists the following as reasons for a cesarean, many of which occur in a very small number of pregnancies or labors:
- Breech presentation
- Poor fetal heart rate
- Uterine rupture
- Prolapsed umbilical cord
- Placental abruption
- Placenta previa
- Failure to progress
- Cephalo-pelvic disproportion
Cesareans are Risky Business
Any surgery is risky, and cesareans, considered major abdominal surgery, are no exception. With a cesarean, it’s not one but two people who are put at risk by the surgery.
The Centers for Disease Control states that “Cesarean delivery involves major abdominal surgery, and is associated with higher rates of surgical complications and maternal rehospitalization, as well as with complications requiring neonatal intensive care unit admission. In addition to health and safety risks for mothers and newborns, hospital charges for a cesarean delivery are almost double those for a vaginal delivery, imposing significant costs.”