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The Under-publicized Risks Of Caesarean Sections
Posted by Dr. Ben Kim on Feb 24, 2007
About ten years ago, I devoted several months of my evening hours researching the ins and outs of C-section deliveries. I was stunned to discover that in some cases, C-section deliveries are encouraged because they are more profitable and convenient for doctors to perform, even though C-sections are clearly more dangerous than natural vaginal deliveries that take place in a supportive environment.
At that time, I vowed to share what I had learned about the risks of C-sections and the possible motivations behind promoting them with as many expectant parents as possible. Although I have stuck to this vow while in private practice for the past ten years, it has been discouraging to see the rate of C-section deliveries continuously climb over the years.
According to recently released data, in Canada, the number of C-section births rose from 5.2 percent in 1969 to 25.6 per cent of the annual total in 2003. That's a quarter of all deliveries in Canada being carried out by major surgery with major risks in 2003. The worst part of this statistic is that some patients are led to believe that C-section deliveries carry few risks and actually offer many advantages to healthy mothers.
To be fair, there is some evidence in the medical literature that indicates that a planned C-section delivery may provide the following benefits:
- Reduced risk of the mother experiencing pelvic disorders, the most common of which are urinary incontinence, fecal incontinence, and pelvic organ prolapse
- Reduced risk of having an unexplained stillbirth or having the baby experience health problems related to:
- Cord prolapse
- Breech presentation that doesn't respond positively to manual manipulation
- Abnormalities with heart rate
- Inflammation and possible infection of the membranes that surround the fetus (chorioamnionitis)
But these potential benefits are, in my opinion, far outweighed by the potential risks of unnecessary C-section deliveries.
A major new study published in this month's issue of the Canadian Medical Association Journal warns that C-section deliveries may be three time more dangerous for healthy mothers than natural vaginal deliveries. The study indicates that the most common health risks for women who undergo a C-section delivery are:
- Myocardial infarction (heart attack)
- Development of dangerous blood clots
- Need for hysterectomy
Other studies have shown that planned caesarean deliveries are associated with an increased risk of death or health complications in the newborn. Two recent studies published in Obstetrics & Gynecology (2006) and the American Journal of Obstetrics and Gynecology (2005) found that full-term babies whose mothers chose to have a C-section before experiencing labour were at higher risk for the following:
- Neonatal respiratory problems
- Persistent pulmonary hypertension
- Delayed neurologic adaptation
- Neonatal intensive care admission
- Delayed establishment of breastfeeding
With increasing numbers of women choosing C-sections without a clear medical need, these under-publicized risks of C-section deliveries need - well, more publicity.
As Dr. Robert Liston, a lead author of the most recent study cited above, has said, "Look, caesarean section is not just like falling off a log. There are health issues that result from the operation, significantly more so than a planned vaginal delivery."
Expectant mothers need to know that there are serious risks to choosing to have a C-section. Ideally, such a choice should not be made because of a busy schedule, vanity-related issues like fear of weight gain, or the desire to avoid pain associated with childbirth.
For support and more information on this topic, I give my highest recommendation to the following books:
Ina May's Guide to Childbirth - Excellent for those seeking support for a natural childbirth.
Women's Bodies, Women's Wisdom: Creating Physical and Emotional Health and Healing - Provides useful information on a variety of women's health issues.
Reclaiming Our Health: Exploding the Medical Myth and Embracing the Sources of True Healing - One of the best books I have ever read in this arena.
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