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Pros and Cons of C-sections

The rate of cesarean sections (C-sections) in the United States has increased significantly since 1996. The percentage of C-sections was 32.8 percent in 2010, meaning that about one-third of mothers gave birth by C-section. Since then, the C-section rate has remained stable or declined slightly. For example, the C-section rate in Pennsylvania decreased by 3 percent between 2009 and 2012.

What accounts for the long-term increase in this method of giving birth? Some have said that fear of liability is an important reason. The reasoning is that doctors perform C-sections because they fear being held liable for a birth injury. However, numerous studies have shown that this accounts for only a small percentage of the increase.

Other Reasons for Increase in C-Section Rate

According to one source, the increase in C-section rates is the result of a combination of factors that include:

  • Lack of attentive care provided to women during labor
  • Side effects of common labor interventions, especially labor induction
  • >Automatically scheduling women for repeat C-sections even when there is no medical reason
  • Acceptance of surgical solutions to medical events and problems
  • Limited awareness of the risks of C-sections
  • Pressure for medical staff to be more efficient, which can lead to performing a C-section just to speed things along because labor is not progressing fast enough

C-sections have saved the lives of countless mothers and babies, but there are downsides that can outweigh the risks associated with a vaginal delivery.

Risks of C-Sections

The risks of having a C-section include

  • Breathing problems in the baby
  • Surgical injuries that include nicks and cuts on the baby's skin
  • Inflammation and infection in the mother's uterus and at the incision site
  • Increased bleeding and even hemorrhage, requiring a transfusion
  • Reactions to anesthetic
  • Blood clots
  • Surgical injuries to other internal organs

Given these risks, why would a mother or a doctor choose to undergo or perform a C-section? Reasons range from wanting to avoid vaginal tears that require stitches to wanting to avoid abdominal scars. If the mother has an infection such as herpes or HIV/AIDS, having a C-section can reduce the chances of transmitting the condition to the baby. Mothers with high blood pressure, diabetes or other health conditions may be unable to tolerate the physical stress of giving birth.

Reasons for C-Sections

Most C-sections are the result of complications during labor and delivery. These include:

  • A baby becoming stuck in the birth canal
  • A breech baby
  • Labor stopping
  • Fetal distress as shown on a monitor strip
  • A prolapsed umbilical cord
  • Birth defects that change the shape of the baby's head and extremities

Some of these reasons for performing C-sections can sometimes be addressed by other means. For example, a baby stuck in the birth canal may be freed by manual rotation or by having the mother change position. A labor that has stopped or is slowing may be corrected by having the mother walk around.

When a C-section Is Needed, Act Quickly

However, some C-sections are the result of true medical emergencies and must be performed quickly to save the baby. A prolapsed umbilical cord can result in oxygen deprivation or the baby's death. In such instances, a C-section must be performed quickly. Other signs of fetal distress should be addressed quickly after trying noninvasive corrections such as walking around or changing position.

Although the medical community continues to try to reduce the number of C-sections performed in the United States, it is important to remember that C-sections can and do save lives. Failure to monitor labor and delivery for signs that things are not going well can cause birth injury for the baby and ruptures and tears in the mother's reproductive system. This makes it critical for doctors and nurses to be able to evaluate each mother's situation and progress, analyze the risks and benefits of a C-section, and act quickly if intervention is indicated.

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