Who Needs Cesareans?

by Asheya on November 30, 2011

Often on natural birth advocacy sites, or discussion boards, cesareans are considered negative.  Some of this is certainly healthy~Canadian cesarean rates vary by region, but overall are at approximately 26% and rising.  This rate is high, particularly when we consider that subsets of maternity care providers can produce the same, low rates of maternal and infant death and injury without resorting to a cesarean section in 26% of cases.  Health Canada and the Society of Obstetricians and Gynecologists of Canada (SOGC) advocate lower rates.  The International Cesarean Awareness Network (ICAN) provides tips on avoiding a cesarean section, and Lamaze International outlines the risks of cesarean section for mother and baby.
However, some of the discussion surrounding these high surgical rates veers towards unhealthy when it goes unacknowledged how fortunate we are to live in a time and a place with efficient and equal access to cesarean surgery.  Who needs cesareans?  Babies in distress, and women in danger.  The majority of women and babies in Canada traverse through birth just fine, but a small percentage will not, if nature runs its course.

 Universally acknowledged reasons for cesareans include;
-Prolapsed cord
-Placenta previa
-Maternal HIV+
-Maternal active herpes outbreak (particularly first outbreak)
-Baby is in persistent transverse position
-The baby has a persistent, unresolved, abnormal heart rate (fetal distress)

Thankfully we have cesareans for these cases, otherwise a significant percentage of women and infants in the above situations would die or be injured.  Cesarean surgery has been refined and techniques developed to make it safer than at any time in history to have a surgical birth.  In particular, the development of spinal anesthesia and the now widespread use of lower transverse uterine incision have made this surgery safer.  This week and next we will be looking in depth at cesarean birth, and to start, it is important to state that cesareans save lives.  And we are very grateful they exist.

{ 1 comment… read it below or add one }

FabulousMamaChronicles December 1, 2011 at 5:57 am

I am thankful that the life-saving surgery is a safe option for women today but I am also concerned how the rising rates are in part due to medical teams defecting to the surgery prematurely because of lack of evidence-based care in dealing with manageable birth issues like breech birth and failure to progress. Never mind how often the problem is created by unecessary interventions in the birth in the first place. Already I know a handful of women who've had cesareans births and the reasonings they have given me for the surgery has often been due to ignorance about the physiological needs of a natural birth. I grieve for what these women and infants experience as a result. Women certainly need to be aware of what really warrants a cesarean surgery and to protect themselves against this outcome if within their power. If the rates are then reduced, then more women would not suffer from PPD due to their surgeries because they would actually be necessary and not simply be paraded as being such.

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