Cesarean Rates

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.


My Views:
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.

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