State's C-section rate reaches all-time high
By Stephen Smith, Globe staff
One out of three infants born in Massachusetts in 2006 were delivered by Caesarean section, the highest proportion ever, according to a state report released today that charts a dramatic rise in surgical deliveries in the past decade.
In 1997, barely 20 percent of Bay State babies were born via C-section, placing the state slightly below the national average. By 2006, the rate had risen to 33.4 percent, a level that now eclipses the national figure.
"I'm concerned about this trend because there is some risk associated with having Caesaran sections in terms of infection and other complications," said Dr. JudyAnn Bigby, the state's secretary of health and human services. "We don't want women to be exposed to these risks unnecessarily."
In an interview, Bigby attributed the increase to an array of factors that reflect broader trends in healthcare.
For one, women are giving birth later in life, when complications are more common and C-sections may thus be viewed as medically necessary. Increasing obesity rates are another potential cause, Bigby said, with obese mothers more prone to difficulties during pregnancy and delivery. And obstetricians' fears of lawsuits may be fueling some of the increase, she said, with doctors opting for Caesarans over vaginal deliveries because of a perception that they are less risky.
The findings on C-section rates are part of a larger annual report on births in Massachusetts. That study also found that racial gaps in infant mortality rates persist in the state, with African-American babies more than two-and-a-half times more likely to die before their first birthday than white infants. Black babies are twice as likely as Hispanic newborns to die before the age of 1.
The report also found that gestational diabetes among expectant mothers rose steadily from 2000 to 2006, with nearly 4 percent of women developing the condition during their pregnancies. Asian women were the most likely to be diagnosed with gestational diabetes.
Hmmm.
I'd like to know what the %increase of use of epidurals during labor for the same time period is. Also, what percentage of women who received epidurals during labor had unplanned c-sections vs. what percentage of women who did not receive epidurals had unplanned c-sections.
Could there be a correlation? I would think so, but would love to see those numbers.
I would rather see what the correlation is between induced labor and c-sections. I think it is more often a case of a woman being induced to either appease the mother or the doctor rather than the use of an epidural that has led to sucn an alarmingly high rate of c-sections.
I'd like to see the stats on elective c's versus "medically necessary" c's. I just had a vba2c, and I'm so glad that I didn't 'schedule' a c. If any doctor told me a c was safer, I'd run like the wind...
This is a pretty complicated issue. Both comments above would be interesting to explore. I also think that women who have had prior sections are opting for repeats rather than VBAC. So are their doctors. The liability issues are huge. Then there is a real issue of women scheduling their sections and avoiding labor all together. If they only knew how complicated a section can actually be!
I've seen epidurals work to relax people by reducing pain, and allowing them to move along to deliver just as often as it can slow labor. It has to be used judiciously as a very effective tool. I can only hope the rate will come back down, but some facilities have rates much higher than 33%!
Too many women are consenting to inductions and c-sections without being told of the risks of complications. I was induced early for a "big baby" which I know now led to my unwanted c-section. Two years later I had a VBAC with a baby the same size as my first in just two hours. It's a cascade of interventions where inductions, epidurals, and other interventions lead to c-sections. OBs are trained to control labor and women are taught to fear childbirth. Women need to educate themselves and realize that doctors aren't making decisions in the best interest of mother and baby but instead for fear of liability. The healthcare system is broken letting insurance companies control doctors' decision-making. I can't wait to see the new documentary "The Business of Being Born". FINALLY the most important human natural process is being addresses.
It is true that a C-section could be complicated. But, when it isn't, it spares the mother all kinds of unpleasant experiences. There is no ripping, tearing or stretching with a C-section. No need for an episiotomy, no bladder control issues and no painful sex down the road.
I honestly don't understand why women should sacrifice their comfort just to have a baby. Why should we have painful sex later because we had to be cut during labor? Why should we endure pain if we don't have to? There is just no need.
Men certainly don't have to make these sacrifices, and they get the very same baby.
And I definitely don't buy the fact that the pain of labor bonds you to the baby - real bonding occurs when the mother and baby spend time together.
There is ripping and tearing involved with a c-section. That's what a c-section is, major abdominal surgery that requires cutting.
If you are refering to tears in the vaginal floor, most of them are relatively minor. (they are definitely more minor than episiotomies). In the vast majority of cases, there is no "need" for an episiotomy. In over 80% of cases, the woman doesn't "have" to have an episiotomies. The problem is Ob/gyns who think they can cut women up as they please.The rhetoric that episiotomies are better and safer than regular tears is a lie. Besides, a lot of tearing can be prevented by changing positions (not flat on the back) and supporting the perineum with hot oil.
Giving birth itself doesn't cause those complications. The way we give birth does. For example, pushing when the woman doesn't feel the urge and pushing against gravity cause more pain and are more likely to harm the pelvic floor.
I say, have a home birth.
We must put an end to these practices!
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