Word: cesarean
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...hospital and request major abdominal surgery than it is to give birth as nature intended. Jessica Barton knows this all too well. At 33, the curriculum developer in Santa Barbara, Calif., is expecting her second child in June. But since her first child ended up being delivered by cesarean section, she can't find an obstetrician in her county who will let her even try to push this go-round. And she could locate only one doctor in nearby Ventura County who allows the option of vaginal birth after cesarean (VBAC). But what if he's not on call...
Much ado has been made recently of women who choose to have cesareans, but little attention has been paid to the vast number of moms who are forced to have them. More than 9 out of 10 births following a C-section are now surgical deliveries, proving that "once a cesarean, always a cesarean"--an axiom thought to be outmoded in the 1990s--is alive and kicking. Indeed, the International Cesarean Awareness Network (ICAN), a grass-roots group, recently called 2,850 hospitals that have labor and delivery wards and found that 28% of them don't allow VBACs...
After 1980, when the National Institutes of Health (NIH) held a conference on skyrocketing cesarean rates, more women began having VBACs. By 1996, they accounted for 28% of births among C-section veterans, and in 2000, the Federal Government issued its Healthy People 2010 report proposing a target VBAC rate of 37%. Yet as of 2006, only about 8% of births were VBACs, and the numbers continue to fall--even though 73% of women who go this route successfully deliver without needing an emergency cesarean...
Multiples, as opposed to singletons, are more likely to be born premature (the more fetuses, the earlier labor occurs). The risk of miscarriage is higher. Cesarean sections are utilized more frequently. Gestational diabetes, hypertension and preeclampsia can all occur. Multiple births can also create potential long-term health implications for the children, like cerebral palsy. In the short term, in many multiple-birth situations, newborns are at greater risk of birth complications and death, though notably, all eight of the kids born to "Octomom" Nadya Suleman earlier this year survived...
...data will likely have the most impact on discussions between doctors and women who are planning a repeat elective cesarean. Although most obstetricians are disinclined to schedule c-sections prior to 39 weeks, they still feel pressured by their patients to do so. The new study ought to shift the substance of that dialogue, the authors hope. "This will be one more piece of useful information in any discussion about deciding when to schedule that delivery," says Tita, ideally in favor of the babies...