Assumption: It would be beneficial to lower cesarean rates in the US.
This study, published in the Obstetrics & Gynecology journal this month enumerates the reasons cesarean delivery can have negative consequences in mothers: “increasing incidence of placenta accreta associated with multiple uterine scars requiring the need for emergency cesarean hysterectomy, blood transfusion, and maternal mortality due to obstetric hemorrhage” and babies: “elective repeat cesarean deliveries performed before 39 completed weeks of gestation have demonstrated increased respiratory and other adverse neonatal outcomes.” Most importantly, with the rising cesarean rate, there has *not* been improvement in neonatal morbidity or maternal health. Cesarean delivery does have its place, but physicians are encouraged to avoid surgery unless there are true medical indications.
Much is made these days of decreasing the cesarean rate, but many women seem to prefer surgery to a vaginal delivery. Many women feel that a vaginal delivery presents more of a risk than a cesarean and that cesarean deliveries are the safer route. This study shows that this is not necessarily the case. I am glad that we have the option of delivering our babies surgically and that the surgery is usually safe. But I am afraid that we have overused surgery and have begun using it at times when the risk does not outweigh the benefits. As with any surgical procedure, there are risks to a cesarean birth and I believe they should only be used when truly medically necessary.