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One-third of first-time mothers having cesareans

A study published in this month’s American Journal of Obstetrics & Gynecology has made headlines, including the Los Angeles Times.  Results of the study show that 1 in 3 new moms are giving birth surgically:

Overall, cesarean deliveries account for about a third of births in the U.S. While much attention has recently focused on women having repeat C-sections, researchers with the National Institutes of Health found that nearly one third of first-time moms delivered by cesarean.

Although several potential reasons were cited, including increased maternal weight and age, one factor stood out. From another article in the LA Times:

The study, released Monday by the Eunice Kennedy Shriver National Institute of Child Health & Human Development, found C-section rates were twice as high after induction of labor compared with women undergoing spontaneous labor. Labor is often induced to speed up labor and delivery.

“Our study cannot directly say induction causes C-section, but it does provide some clue that either people may not be patient enough or something is going on that we’re not really sure about,” said the lead author, Dr. Jun Zhang.

The researchers note that lack of patience may be at issue:

The study showed, not surprisingly, that the major reason for undergoing a cesarean was due to the woman having a prior C-section. Still, almost half of the cesareans that took place after labor had started were due to “failure to progress,” and the study suggests that doctors aren’t acknowledging that labor takes time and doesn’t follow a predictable pattern in women, especially first-time mothers. A high proportion of these C-sections were performed before the women’s cervix had dilated to six centimeters, which is still considered an early stage of labor, and among women who had been in active labor for only two or three hours.

“As long as the maternal and fetal health are doing well in labor, they can wait longer and perhaps decrease the cesarean rate,” said Dr. S. Katherine Laughon, a co-author of the study.

Solutions? What ICAN has advocated for a long, long time:

For C-section rates to fall, more first-time mothers need to delivery vaginally, Zhang said, and more patients should undergo a trial of labor for VBAC, as was recommended recently by the American College of Obstetricians and Gynecologists.

2 Comments

  1. Heather says:

    I think it is not only the impatience of doctors, which is clearly a factor, but also the impatience of many women themselves. I cannot count the number of women I have met who are “tired of being pregnant” or “just can’t wait to meet my baby,” who ask for an induction or jump at the chance when offered. Interesting to note the correlation between induction and increased c-section rates.

  2. Anna says:

    I am a Doula and an educated woman and still ended up having a c-section that may have been unnecessary. I agreed to being induced 1 week after my due date. I was in an area that was completely unsupportive of natural childbirth (what do you mean they said when I mention it, natural childbirth is anything that’s not a caesarean right?, they said.) The key piece of information that led me to agree to an induction was my baby’s heart rate on an NST. I still cant find information that tells me whether the Dr.’s advice was good or reactionary. While I don’t trust that my Dr. made good decisions for me, I trust that I did all I could to keep my family safe and healthy to the best of my ability within the environment I was subjected to. The ENVIRONMENT needs to change in order for women to realize and understand that their bodies can do this. Doctors need to be telling women that their bodies are MADE for birth. That barring rare complications they will do all the work. That interventions (all of them including an epidural) should be used with the utmost care and less interference will benefit them and their baby.