C-Sections and VBACS
The C-section rate has risen dramatically
in the U.S. averaging as many as 25% of all births. Whereas
many women are led to beliveve that c-sections may be safer
than natural, vaginal deliveries and planned births are more
convenient, there is much evidence in the literature to indicate
otherwise.The following studies are provided to increase
your awareness about the risks of c-section and the links
below will lead you to extensive resources on the subject.
Soaring C-section Rates Cause for Alarm
Cesarean section rates are off the charts and women are being duped into thinking
that this is all right; in fact they are being enticed to consider c-sections
on demand based upon questionable promises.
A woman considering cesarean section should be told that, compared to vaginal
birth, she has an increased risk of infection, hemorrhage, damage to abdominal
and urinary tract organs, and complications from anesthesia/narcotics. She
needs to know that the incidence of drug resistant infections is increasing
and blood transfusions can lead to life threatening complications. She should
also be told that she will probably not be allowed to attempt a vaginal birth
in the future, and that the risk of complications from cesarean section increase
with each subsequent surgery. Recent studies note higher rehospitalization
and draw a direct link between chronic pelvic pain and cesarean section. These
complications can ultimately limit her ability to have the number of children
she desires.
The American College of Nurse-Midwives
Cesarean Section Increase: Cause for Concern
In Great Britian, the number of women giving birth by c-section increased once
again in 2001. Hospitals in England and Scotland now have a 22% rate and wales
and Northern Ireland is up to 24%
The New Zealand Ministry of Health is concerned that a growing proportion of
c-sections in the country is done for the convenience of the mother and/ or
physicianIndividuals and organizations are speaking out against these “social
cesareans.” National maternity manager Barbara Browne says, “The health sector
needs to support women around the time of childbirth to help them feel strong.” The
C-section rate in New Zealand has risen from 12% in 1988 to 20% in 2001. The
WHO estimates that the rate of C-section should be between 5 and 15% of all
births.
Mode of delivery and asthma -- is there a connection?
The results of this study in Finland suggests that caesarean section delivery
may be associated with an increased prevalence of atopic asthma.
Kero J, Gissler M, Gronlund MM, Kero P, KoskinenP, Hemminki E, Isolauri E Mode
of delivery and asthma -- is there a connection? Pediatr
Res. 2002 (Jul); 52 (1): 6-11
C-Sections may up risk of asthma.
Natural childbirth may prevent a baby from developing asthma later in life,
according to a just-published report.
Investigators followed 1,953 Finnish subjects from their birth in 1966 to their
third decade of life in 1997. The 5.3% of subjects who were delivered via Cesarean
section were three times more likely to have developed asthma by age 31, compared
with subjects delivered vaginally. However, delivery method did not influence
risk of other allergic disorders.
Xu B, Pekkanen J, Hartikainen AL, Jarvelin MR Caesarean
section and risk of asthma and allergy in adulthood J
Allergy Clin Immunol. 2001 (Apr); 107 (4): 732-733
Babies delivered by elective cesarean have an increased risk of neonatal
respiratory distress syndrome (RDS), a life-threatening condition and other
respiratory problems that may require NICU care.
Levine EM, Ghai V, Barton JJ, Strom CM Mode of delivery and
risk of respiratory diseases in newborns Obstet Gynecol 2001; 97
(3): 439-442
Neonatal respiratory distress syndrome (RDS) is an important complication
of elective repeat cesarean section. Awaiting the onset of spontaneous labor
to determine the timing of repeat cesarean section in women at term is an
effective way to preventing iatrogenic neonatal RDS.
Bowers SK, MacDonald HM, Shapiro ED Prevention
of iatrogenic neonatal respiratory distress syndrome: Elective repeat cesarean
section and spontaneous labor Am J Obstet Gynecol 1982
(May 15); 143 (2): 186-9
Iatrogenic RDS continues to occur in the setting of elective repeat cesarean
delivery and is associated with a failure to adhere to clinical protocols.
Parilla BV, Dooley SL, Jansen RD, and Socol ML Iatrogenic
respiratory distress syndrome following elective repeat cesarean delivery Obstet
Gynecol. 1993 Mar;81(3):392-395
Neonatal respiratory morbidity and mode of delivery at term: influence of
timing of elective caesarean section.
Morrison JJ, Rennie JM, Milton PJ Neonatal
respiratory morbidity and mode of delivery at term: influence of timing of
elective caesarean section Br J Obstet Gynaecol. 1995 Feb;102(2):101-106
Influence of labor and route of delivery on the frequency of respiratory
morbidity in term neonates.
Hales KA, Morgan MA, Thurnau GR Influence
of labor and route of delivery on the frequency of respiratory morbidity in
term neonates Int J Gynaecol Obstet. 1993 Oct;43(1):35-40
Neonatal respiratory distress is a major complication of elective Cesarean
section. Awaiting the onset of labor appears to be beneficial in preventing
neonatal RDS for term neonates delivered by elective Cesarean section.
Yang JY, Fang LJ, Tsou Yau KI Labor
pain before elective cesarean section reduces neonatal respiratory distress Zhonghua
Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1997 Jan-Feb;38(1):38-43
Study Links C-Sections, Stillbirths
Procedure May Put Subsequent Pregnancies at Risk, Study Says
Having a Caesarean
delivery may increase the risk of having a stillbirth in a second pregnancy,
researchers said. Doctors at the Rosie Hospital in Cambridge, England, who
studied data on 120,000 births in Scotland between 1992 and 1998, found that
stillbirths were higher among women who had previously had a child by Caesarean
section.
"Delivery by Caesarean section in the first
pregnancy could increase the risk of unexplained
stillbirth in the second," Gordon Smith, who headed the research
team, said Friday in a report in The Lancet medical journal. "Our
best estimate is that for every 1,000 women with a previous
Caesarean section, there will be one additional stillbirth
in comparison if they hadn't had a previous Caesarean section," he
added in an interview.
Doctors are not sure why the surgery increases the risk of
stillbirth but they suspect that repairing the uterus after
the surgery could affect the function of the placenta, which
nourishes the fetus, in a future pregnancy. Scarred tissue
also works less well than unscarred tissue.
"This is a factor
that women should take into account when deciding to have a Caesarean section," Smith
said. "Our results are of relevance for women considering
Caesarean delivery who are planning future pregnancies."
Reuters Friday, November
28, 2003; Page A16 LONDON, Nov. 27
Additional Info
There is so much information available for women to read so they become informed
about the rising frequency, risks to themselves and their babies, etc. Here
are some links which offer the best compilation of information.
International Cesarean
Awareness Network
ICAN's Links Pages
ICAN's Choices
in ChildBirth
Additional Articles of Interest:
C-Sections:
Are they Really a Safe Option?
Midwifery
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