Fifteen to 30 percent of births are done by cesarean today. The rise in cesarean deliveries is attributable to a variety of reasons. The United States used to have poor infant mortality statistics — we ranked sixteenth among the developed Western countries. But our surgeons were fantastic, and instead of focusing on preventive measures, they did more cesareans to improve an infant’s chances of surviving delivery. In 1988, the cesarean rate was up to 25 percent.
When electronic fetal monitors came on the scene in the 1970s, it was easier than ever before to detect fetal problems. Therefore, babies whose distress might not have been evident until birth were identified and designated for cesarean birth.
Some doctors fear being sued for malpractice if there are any problems with the mother or child after birth. Instead of learning alternate methods of dealing with complications, or perhaps because they aren’t willing to take chances, some doctors will do a cesarean if there is the slightest chance of a birth complication. Many parents would also rather have the surgery than risk a complication.
Today, preventive measures are becoming a more important part of the prenatal experience. The cesarean rate, though the highest of any country, has lowered from its all-time high. Improved anesthesia such as the epidural and the advent of better antibiotics make today’s cesareans the safest ever.
In fact, in many complicated labors, a cesarean is considered safer than a vaginal delivery. These complications include premature babies weighing less than 3 pounds 5 ounces and some difficult presentations , such as transverse or brow or face first. Researchers have also documented a higher incidence of brain damage and cerebral palsy in infants who underwent long labors or high- forceps deliveries.
Doctors are only now recognizing that having a previous cesarean does not mean you will automatically need one again. Many cesareans were done for no reason other than that the mother had a cesarean with another delivery, and that was a valid reason, since the uterine incision carried a risk of rupturing during labor.
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