Gimme a C
Is choosing a Cesarean for a nonmedical reason wise?
In fact, in 2003, The New England Journal of Medicine cited five studies that linked higher incontinence rates to vaginal deliveries than to C-sections. But while two concluded that the problem is best prevented when a Cesarean delivery is performed before labor begins, some critics of elective C-sections point out that the risk of incontinence wasn’t reduced enough to justify the procedure.
Danger down the line?
Having a C-section—either emergency or scheduled—may pose a small but increased risk to a baby in a subsequent pregnancy, a new British study suggests. Cambridge University research found that when a woman had a previous C-section, the risk of unexplained stillbirth in a second pregnancy increased with each week past 34 weeks. While the risk was twice as high among women who had C-sections than among other women, it was still low—less than one in 1,000 births. Still, if a woman is planning to have more than one child, it’s a factor to be considered.
Growdon says that ideally a physician will discuss a woman’s personal and medical history and any worries she has about labor, which typically brings up the issue. “In the final analysis, after discussing the possible complications, pain management and extra days in the hospital, the patient has autonomy, and the doctor can either perform a requested C-section or refer her to another physician,” Growdon says. “But doctors do have an ethical obligation to discuss the risks and benefits.”
Fighting for “normal birth”
Lamaze International recently launched a worldwide campaign to promote what it calls normal birth. The goals include allowing labor to begin on its own; permitting women to move around during labor and to give birth in nonsupine (e.g., squatting, side-lying) positions; and avoiding routine interventions, including medically unnecessary C-sections.