By Terry A Rondberg, DC
Because of increased dangers and risks to the mother and baby, cesarean procedures (C-sections) are supposed to be reserved for cases in which normal births may be impossible or dangerous. Yet, according to a research report published in the British Medical Journal, the United States has seen a steep rise in cesareans to women with no reported medical risk.
Researchers analyzed information on four million births per year between 1991 and 2001, identifying mothers with no medical risk or labor and delivery complications noted on the birth certificate. From this group of
mothers, they examined those cases where mothers had a first-time cesarean.
Results showed that cesarean rates increased by 67% among these mothers. First-time mothers aged 34 and over were the most likely to have a ‘no indicated risk’ cesarean, with almost 1 in 5 giving birth by cesarean in
Cesarean births also rose steeply for ‘no indicated risk’ mothers under 30, increasing by 58% between 1991 and 2001. For first-time mothers over 40, the odds of having a ‘no indicated risk’ cesarean were over 5 times that for mothers aged 20-24.
In the U.S., 24 % of births are cesarean — double the rate of many European countries. The World Health Organization says no country’s C-section rate should be higher than 10 to 15 percent.
Undergoing cesareans where there is no reported medical indication raises serious questions, say the authors, not least for younger mothers who plan to have further children. Previous research has indicated that women who have vaginal birth after having cesarean deliveries are at increased risk for maternal morbidity and such serious complications as uterine rupture, endometriosis, transfusion or newborns who suffer brain injury from lack of oxygen.
According to the International Cesarean Awareness Network, “a cesarean section is major abdominal surgery with all that entails. The surgery itself, as opposed to medical problems that might lead to a cesarean increases the risk of maternal death, hysterectomy, hemorrhage, infection, blood clots, damage to blood vessels, urinary bladder and other organs, postpartum depression, post traumatic stress syndrome, and rehospitalization for complications. Potential chronic complications from scar tissue adhesions include pelvic pain, bowel problems, and pain during sexual intercourse. Scar tissue makes subsequent cesareans more difficult to perform, increasing the risk of injury to other organs as well as placenta previa, placenta accreta, infertility, ectopic pregnancy, uterine rupture in subsequent pregnancies and the risk of chronic problems from adhesions.
There are also risks to the baby such as respiratory distress syndrome, prematurity, lower birth weights, jaundice, lower APGAR scores (APGAR is the means of assessing the health status of a newborn), and finally in 1 to 9 percent of cases the baby is scarred or even maimed by the scalpel.”
Other studies show that women are 5 to 7 times more likely to die when undergoing a C-section, and are at greater risk for bladder or uterus problems, hemorrhage, infection and hysterectomy. Some mothers experience long-term side effects such as hip pain, bowel problems and pain during sex.
SOURCES: “Rise in ‘no indicated risk’ primary caesareans in the United States,”
1991-2001: cross sectional analysis, British Medical Journal, November 19, 2004
“Caesareans Have Drawbacks for Future Pregnancies,” British Medical Journal / International Cesarean Awareness Network, online FAQ