A Today Show Delivery

2.5.10: Making Scheduled C-Sections Look A Little Too Easy?


The Today Show ran a segment Tuesday morning about a scheduled c-section, live from the operating room. First time parents allowed a film crew and Dr. Nancy Snyderman, chief medical editor for the show, to tag along while their baby was born. As I watched, I was filled with mixed emotions. No matter how many times I’ve seen it, I’m still thrilled when a new baby arrives. I love that moment when someone calls out, “It’s a boy! Or it’s a girl!” I love when Dad tears up, relieved that his wife and child are safe. I love hearing the baby’s name announced and finding out how much he/she weighs. Birth is fabulous and I love it every time.

I expect that’s what the Today Show was aiming for. This c-section was part of a series called, Today Goes Inside the OR. They wanted to show what a well-produced, c-section looks like; how normal it is, how it still contains all the elements of a beautiful birth and how easy it is on mom, dad, baby and delivery staff. How neat, clean and painless it is. The baby didn’t even have any blood on him. He was an absolutely gorgeous baby boy.

And yet, the other set of emotions I felt was all about frustration. I’m frustrated at how normalized c-sections have become. Seriously guys, where’s the segment about how scheduled c-sections on first time mothers are a big part of the ever-increasing c-section rate—a contributing factor in why the US ranks 30th in the world for infant mortality 30th! We suck. Yet, most women are still unaware of the risks. They’re still unaware that the reason why their doctor is recommending one has as much to do with malpractice insurance as it does patient safety.

Dr. Snyderman said this mother was scheduled for c-section because she was having a “big baby.” She didn’t mention any other factors in Mom’s medical history that played into the decision to deliver surgically. It’s extremely common that “big baby” is all the indication doctors need to go to the OR without giving labor and vaginal birth a try. It’s assumed a vaginal birth will fail so why bother. Just go to the OR. It’s easier on everybody.

I’ve seen it happen countless times that the presumed “big baby” turned out to be average weight; even small. Then it’s “Oops, well, it’s probably for the best, right?” Except for those mothers and babies who suffer complications and those mothers (most) who will have to have repeat c-sections for any future babies.

The common ways to estimate a baby’s size before birth are by ultrasound and abdominal measurement. Ultrasounds are frequently wrong by a pound or two. Abdominal measurement can also be inaccurate depending on how much fluff Mom has on her tummy.

The Today Show’s healthy baby boy weighed in at ten pounds on the dot. What bothers me is the assumption that women can’t have big babies vaginally anymore. I’ve seen countless ten-pounders delivered vaginally by first time mothers. Sure, it’s tough (labor always is) but it’s possible and even normal.

Dr. Snyderman asked the surgeon how many babies are born by c-section these days. The surgeon answered “somewhere between 25 and 30%.” Seriously, doctor? Where are you getting your statistics? That’s a very low-ball estimate. The Centers for Disease Control announced the preliminary 2007 stats for c-section rates way back in March and once again, it’s higher than ever at 31.8%. Massachusetts, (where this morning’s delivery took place at Beth Israel Deaconess Medical Center in Boston) has a c-section rate of 33.5%. I called the medical center to ask what their current c-section rate was and was told no one was available to give me that statistic.

Dr. Snyderman also asked the surgeon if Mom would be able to deliver future children vaginally, since the uterine incision was made horizontally instead of vertically. The surgeon said, “Absolutely,” as if getting a Vaginal Birth After Cesarean is a piece of cake these days. It’s not. The majority of doctors and hospitals won’t do them.

While I think the Today Show did a lovely job showing that birth is a joyous event no matter how the baby is delivered, I really hope they round this out by providing another segment on why America needs to take a serious look at scheduled cesarean sections. Or how about a segment called “Inside the NICU” about scheduled c-section babies accidentally born prematurely or about the increased risks of complications all c-section babies face. And maybe a segment on normal vaginal birth.

C-sections are beautiful births too. The one we saw on TV was almost too easy though, almost slick. I worry about the millions of women out there who will be deciding what to do when their doctor says, “Let’s schedule your c-section because I think this is going to be a big baby.” Sometimes, mothers die during routine c-sections. It happened at Beth Israel Deaconess Medical Center during a routine c-section a couple years ago.

Jeanne Faulkner, R.N., lives in Portland, Oregon with her husband and five children. Got a question for Jeanne? E-mail it to labornurse@fitpregnancy.com and it may be answered in a future blog post.

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