U.S. rate of caesareans exceeds WHO standards
Because of increased dangers and risks to the mother
and baby, caesarean procedures (C-sections) are supposed to be reserved for
cases in which normal births may be impossible or dangerous. Yet, according
to a research report published in the British Medical Journal, the United
States has seen a steep rise in caesareans to women with no reported medical
risk.
Researchers analyzed information on four million births per year between
1991 and 2001, identifying mothers with no medical risk or labor and
delivery complications noted on the birth certificate. From this group of
mothers, they examined those cases where mothers had a first-time caesarean.
Results showed that caesarean rates increased by 67% among these mothers.
First-time mothers aged 34 and over were the most likely to have a 'no
indicated risk' caesarean, with almost 1 in 5 giving birth by caesarean in
2001.
Caesarean births also rose steeply for 'no indicated risk' mothers under 30,
increasing by 58% between 1991 and 2001. For first-time mothers over 40, the
odds of having a 'no indicated risk' caesarean were over 5 times that for
mothers aged 20-24.
In the U.S., 24 % of births are caesarean -- double the
rate of many European countries. The World Health Organization says no
country’s C-section rate should be higher than 10 to 15 percent.
Undergoing caesareans where there is no reported
medical indication raises serious questions, say the authors, not least for
younger mothers who plan to have further children. Previous research has
indicated that women who have vaginal birth after having caesarean
deliveries are at increased risk for maternal morbidity and such serious
complications as uterine rupture, endometriosis, transfusion or newborns who
suffer brain injury from lack of oxygen.
According to the International Cesarean Awareness
Network, “a cesarean section is major abdominal surgery with all that
entails. The surgery itself, as opposed to medical problems that might lead
to a cesarean increases the risk of maternal death, hysterectomy,
hemorrhage, infection, blood clots, damage to blood vessels, urinary bladder
and other organs, postpartum depression, post traumatic stress syndrome, and
rehospitalization for complications. Potential chronic complications from
scar tissue adhesions include pelvic pain, bowel problems, and pain during
sexual intercourse. Scar tissue makes subsequent cesareans more difficult to
perform, increasing the risk of injury to other organs as well as placenta
previa, placenta accreta, infertility, ectopic pregnancy, uterine rupture in
subsequent pregnancies and the risk of chronic problems from adhesions.
There are also risks to the baby such as respiratory distress syndrome,
prematurity, lower birth weights, jaundice, lower APGAR scores (APGAR is the
means of assessing the health status of a newborn), and finally in 1 to 9
percent of cases the baby is scarred or even maimed by the scalpel.”
Other studies show that women are 5 to 7 times more
likely to die when undergoing a C-section, and are at greater risk for
bladder or uterus problems, hemorrhage, infection and hysterectomy. Some
mothers experience long-term side effects such as hip pain, bowel problems
and pain during sex.
SOURCES: “Rise in ‘no indicated risk’ primary caesareans in
the United States,
1991-2001: cross sectional analysis, British Medical Journal,
November 19, 2004
Caesareans Have Drawbacks for Future Pregnancies,
British Medical Journal, 14 January 2004.
International Cesarean Awareness Network, online FAQ
