Jul 26, 2009 3:17 pm US/Central
Caesarean Sections: The Easy Way Out?
C-Section Births Were Skyrocketing In Early 1980s, And Experts Wanted To Know Why
CHICAGO (CBS) ―
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The number of Caesarean section births was skyrocketing in the early 1980s, and experts wanted to know why.
CBS
In recent years, the number of women who choose Caesarean sections has skyrocketed in the U.S. and around the world.
Between 1996 and 2006, they climbed from 21 percent to 31 percent in the United States, according to statistics in The Guardian. And all this comes as the medical community insists that traditional vaginal births, not C-sections, are the safest way for first-time mothers to deliver.
Some experts say the jump is because women think Caesarean sections are easier, and are less likely to bring about complications such as urinary incontinence. Others blame doctors who fear being sued if there are problems during a vaginal delivery, and thus are quick to order Caesareans.
But while mothers may be choosing C-section to avoid complications, researchers have found that they may be causing more. Earlier this year, a team of researchers discovered that kidney failure, respiratory distress syndrome, shock and ventilator use jumped more than 20 percent from 1998 and 1999 to 2004 and 2005. Rates for pulmonary embolism jumped 52 percent in that period, and blood transfusions jumped 92 percent, the Guardian reported.
While the goal of the study was not to determine the cause, researchers said more frequent C-sections seemed to be contributing factors, the Guardian said.
But while the concerns are alarming, they're definitely nothing new.
Part I: Introduction
The number of Caesarean sections more than tripled in the decade from 1972 to 1982, and obstetricians were telling mothers that they were the only safe option.
At Gottlieb Memorial Hospital in Berwyn, nurses said it was likely that every fourth woman in a given group would have major surgery just to have her baby.
On July 26, 1982, Don Craig explored what the trend toward Caesarean births says about the medical profession, and what it means for babies and mothers, in this CBS 2 special report, "The Easy Way Out?"
Part II: Facts And Figures
Caesarean sections go back thousands of years, but originally, they were only used on dead or dying mothers. But during the 19th century, surgical practices improved, and a few women began to survive Caesareans. By the 1930s, the operation was safe enough that 2 percent of all births in the United States were by Caesarean section. The rate jumped to almost 5 percent in World War II.
The percentage remained pretty much the same until the late 1960s, and then began a dramatic rise. It jumped from 1 in every 20 women in 1970 to one in every 6 in 1980. And as noted above, they have only been on the rise since then.
Why did the rate jump in the latter 20th century? Certainly, there were legitimate reasons; C-sections were considered medically advisable for breach babies, premature babies, babies too big for a mother's pelvis, or babies born to mothers with medical conditions.
But there were other factors leading doctors to perform Caesarean sections that weren't medically necessary. What were those factors? Did convenience, fear of malpractice or even greed play a greater role in the spike in C-sections than solid medical evidence, or what's best to mother and baby? In this segment, some experts suggest some answers.
Part III: A Social And Economic Perspective
At Gottlieb Memorial Hospital in Melrose Park in 1982, most of the working- and middle-class mothers who came to deliver babies were considered low-risk for complications. Expectant mothers could, and did, receive prenatal care, and took classes during pregnancy.
But a large percentage of women there gave birth by Caesarean.
By contrast, at the University of Chicago Lying-In Hospital, many mothers came from areas of high unemployment and poverty. More than two thirds were high-risk for complications, and many had received no prenatal care. But most mothers delivered their babies in the normal, vaginal way.
These trends defied logic, but they were widespread. In 1980, the average Caesarean rate in the Chicago area was 16 percent. Far more hospitals in middle-class or affluent areas were performing Caesareans than in poorer ones.
What did all this mean? Were the poor not receiving the Caesarean sections they needed, or were the wealthy receiving unnecessary Caesareans because they could afford them?
Also, what should we expect as a standard Caesarean percentage? And how can mothers avoid unnecessary Caesareans and make sure the necessary ones are less traumatic? There are answers to these questions in this next segment.
(© MMIX, CBS Broadcasting Inc. All Rights Reserved.)
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