Cesarean section, or C-section, is found to be one of the commonly performed major surgeries in the United States. Instead of implying the natural way of delivering babies vaginally, hospitals in the U.S prefer and deliver 1 out of 3 babies through C-section. The crucial point to note here is that half of these C-section deliveries are not medically necessary.
Even if a patient is at low risk of complications during the time of delivery, many hospitals or doctors decide to carry out a C-section only due to the labor taking too long. A statement by Neel Shah, M.D., an assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School pointed out “the hospital a mother walks into to deliver her baby, and how busy it is,” as the biggest risk factor for C-section.
The latest report by Consumer Reports indicated that more than 1,300 hospitals in the U.S correlate with Shah’s statement. Although, there can be a considerable difference in C-section rates for low-risk deliveries amongst different hospitals. Lauren Friedman of the Consumer Reports also quoted, “Your biggest risk of having an unnecessary C-section could actually be the hospital where you choose to give birth.”
Under some circumstances, C-sections become completely necessary to save lives but low-risk pregnancies can undergo vaginal delivery and do not necessarily require C-section. Women that are pregnant with twins, triplets, or multiples, have diabetes or high blood pressure or are overweight, may find C-sections necessary for delivering their babies.
There are various risks and complications associated with C-section that can be harmful to the mother and the baby. There is a 90 percent chance of the mother having her second baby with another C-section if she delivered her first one with it as well. Each C-section can cause increased risk of complications such as infection, hemorrhage, and post-partum depression for the mother.
Childbirth Connection along with other leading organizations that included The American Congress of Obstetricians and Gynecologists, American College of Nurse-Midwives Association of Women’s Health, Obstetric and Neonatal Nurses, March of Dimes and Society for Maternal-Fetal Medicine created a report that addressed various maternity issues of the recent time. Overuse of C-sections in low-risk women was one of the important topics they discussed.
An article by Fit Pregnancy summarized their report as follows, “They determined not only are we doing too many unnecessary C-sections, they’re causing harm to mothers and babies. What’s more, it’s not just high-risk mothers who are having surgery. We often hear the argument that older mothers and mothers with health problems are the main contributors to our rising C-section rate.
This report demonstrates that in reality, we’ve been doing more C-sections on women at low and high risk for complications, with and without prior C-sections, in preterm and term pregnancies, across all ages, races, and ethnicities.”
The report by Childbirth Connection also revealed a number of factors how a C-section can be harmful to the mother and ranked them on a scale from very small to very large. These included:
- Maternal death
- Cardiac arrest
- Urgent hysterectomy
- Thromboembolic events (blood clots)
- Anesthetic complications
- Major infection
- Rare, life-threatening complications including amniotic fluid embolism or uterine artery pseudoaneurysm
- Wound infections
- Wound disruption
- Increased length of hospital stay
- Hospital readmission
- Problems with physical recovery including general health, bodily pain, extreme tiredness, sleep problems, bowel problems, ability to carry out daily activities, and ability to perform strenuous activities
- Chronic pelvic pain
It also mentioned the physical effects that might happen to a baby delivered through C-section. These included:
- Neonatal mortality
- Respiratory distress syndrome
- Pulmonary hypertension
- Not breastfeeding
With such high rates of C-section and the risks/complication associated with it, hospitals across the U.S. are determined to reduce unnecessary Caesareans. Women with their choice of which hospital to choose from can further assist in reducing their risk of delivering through C-sections. Journal Birth conducted a study that found out half of the women prefer to travel to a farther hospital of 20 miles to deliver their baby at a hospital that showed a lower C-section rate.
Director of the Consumer Reports Health Ratings Center, Doris Peter, Ph.D., detailed, “Women understand that the quality of care differs depending on the hospital they pick, and this study shows that it is possible for women, if properly armed with data, to vote with their feet and send a signal to the medical community by choosing—if possible—a hospital with a lower C-section rate.”