In America We Are Forcing Women to Have C-Sections

KS002-1Joy Szabo got some bad news when she was seven months pregnant.

Because she had had a previous C-section, the hospital where she was planning to deliver would not let her have a vaginal birth with her fourth child.

Szabo’s story is written up on CNN’s Website (if you watch TV, you may have seen it on CNN as well): “Mom fights, gets the delivery she wants.”

But the title of the article is misleading. The hospital and the doctor did not change their policy after the Szabos insisted. Instead, Szabo and her husband had to move six hours away to Phoenix, Arizona (they live in Page) three weeks before the baby was due in order to go to a hospital that would let her deliver her baby vaginally.

I am so grateful to women like Szabo who refuse to let American doctors dictate what is best for them. But I’m sickened to think of all the women in this country who are being forced or coerced into having unnecessary C-sections.

Though a C-section can sometimes be a lifesaving measure, the vast majority of the time it is totally unnecessary. Yet almost one third of women in America are having C-sections.

The high C-section rate in this country is unacceptable, unfair, and unhealthy.

Some people in the medical establishment argue that a VBAC (Vaginal Birth After Cesarean), which is what Szabo wanted, is dangerous because of the increased risk of the uterus rupturing.

Yet hundreds of thousands of women have VBACs with no complications at all, in the hospital, in birthing centers, at home, and even at home unassisted. After explaining the different risks, doctors who attend hospital births need to let women and their families decide for themselves.

Instead, the medical establishment is trying to mandate C-sections. A C-section is a major surgery that is much more risky than vaginal labor and delivery and much harder to recover from. C-sections can lead to chronic pelvic pain, hemorrhage, blood clots, infection, and even maternal death.

If that’s not enough, most people don’t know that there is a new kind of surgery for stitching up the uterus that might be partially to blame for the increased risks associated with VBACS.

Called the “Misgav-Ladach method” or “single-layer suturing,” in this surgery the uterus is stitched up in a single layer instead of in two layers. According to Ina May Gaskin, two-layer suturing has been the standard of care for more than 75 years.

Single-layer suturing has been associated with placenta percreta, a once extremely rare condition where the placenta grows over the uterine scar and can sometimes grow into other organs like the bladder, as well. Single-layer suturing has also has been associated with unprecedented bleeding, failure to heal, and other post C-section complications.

Gaskin cites a study in Montreal of 2,142 women that found that single-layer suturing comes with a four-times higher risk of uterine rupture than double-layer method (Ina May’s Guide to Childbirth, page 284).

But HMOS and hospitals save money on the single-layer method because it is faster for the doctors and reduces the time a surgeon needs to spend in the operating room.

Is doctor convenience and HMO costs really how we make health care decisions for laboring women in our country?

Unfortunately the answer is yes.

It is impossible that one third of American women actually need C-sections.

Joy Szabo did not.

She delivered a healthy baby boy on December 5th after an uncomplicated labor.

Should two of these six pregnant women really need a C-section?

Should two of these six pregnant women really need a C-section?

Photos courtesy of Jenny Johnson.

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17 thoughts on “In America We Are Forcing Women to Have C-Sections”

  1. Wow. Thanks for this, Jennifer. I didn’t know about single layer suturing.

    Seems like much of contemporary medical procedure is born out of fear. . .

  2. Jennifer–really well done, as always. I ended up having a c section–even after months of prenatal yoga, even after Bradley classes, even after hypnobirthing classes. It ended up that my baby was stubbornly breech. We tried everything to turn her–chiropractic, hypnotherapy, inversions, pool swimming,even energy healing. I mean everything. Then I faced a tough decision. There was not a physician or midwife in my area willing to deliver a breech baby. Not one. My only choice would be to travel someone –perhaps as far as Ina May herself. I wasn’t willing to do that, and I didn’t want to go to the one place I knew of locally — basically an Amish farm — to birth her either. So I resigned myself to the C section and just made the best of it that I could. I understand that there is a slightly higher risk, but we’re talking statistics that are so slight that it really ought to be the mother’s decision and not the doctor’s. The problem is that doctors are not even trained to deliver breech babies anymore, which probably raises the risk some more. It’s a sad situation the whole maternity business. No one forces someone with back pain or even heart disease to undergo surgery. They always have choices–options. But people are forcing pregnant women to do it every day.
    .-= Alisa Bowman´s last blog ..Why Parenthood is Worth It =-.

  3. It’s crazy to think that docs won’t let women have their birth they want because of methods they use that make it more dangerous. Such a shame.

  4. The really sad thing, Alisa, is that delivering a breech baby is completely standard and there is no real medical reason for doctors not to deliver them. But as you said, doctors are not trained in doing so. There are home birth midwives where we live — in Oregon — who WILL deliver breech babies.

    Also, it’s VERY COMMON for a baby to turn DURING LABOR. In the pregnancy issue of Mothering there’s a story written by a first-time father of his and his wife’s birth. Their baby was transverse when labor started (which is considered a death sentence today) and came out healthy and happy head first. Until I read that story, I didn’t realize that it was possible to birth a live baby who is presenting transverse at the beginning of labor.

    Thank you, Alisa, for sharing your experience here.

  5. My first was one of those really long labor, some complications, then forced emergency c section deals. After that, I wanted to try vbac but they were very afraid my son was too big and it would be bad. They estimated (with US) that he was 9lbs 10oz and delivered me by csection when he was 36 weeks. I agreed because he also happened to get into a frank breach position. (backwards and folded in half, feet by each ear). To be honest, this son of mine still manages to get himself in positions that I cannot figure out. By third one a vbac wasn’t even an option for me (i was told). Recovering from a csection is so difficult. When I hear that a friend has had one I grab my tummy and wince. Maybe my third could have been vbac afterall? Not sure. She’s here, she’s healthy, I’m over it. But it’s still a shame overall.

    I do remember the OB making a snide comment to the intern about stitching me. She was taking too long and the covering OB (who i didn’t know) said, “yeah, sure, no problem. I’ve got all day.” That comment has been with me ever since.
    .-= Claudine´s last blog ..Someday, You

  6. Thanks for the informative post. I am concerned not only about what the medical professions is doing, but the societal “trend” where young women say–I don’t want to have to go through all that–just knock me out and cut me open.” That was my d-i-l’s attitude, and nothing I said could change her mind because all of her friends and mother’s friends had chosen C-sections. It puzzles me. I hope like the trend against breast feeding in the fifties that it will circle back to natural birth.
    .-= Vera Marie Badertscher´s last blog ..Travel Tuesday San Diego Part II =-.

  7. Thank you, Jennifer, for tackling such a painful topic. When I was pregnant with my first child I was hospitalized at 33 weeks with an abruption. I found that not all hospitals treated this sort of situation the same way, and it was only by changing hospitals (2 times) that we were able to avoid interventions which would have greatly increased the chance of a premature baby born by c-section. In the end he was born in a beautiful out-of-hospital birth at term (though the labor was a long one that might have resulted in a c-section in a hospital). Not all women realize there are options, and sadly, the options are harder to find these days. I feel infuriated about the rising rate of c-section births in the U.S. since I have been living abroad where the standard of care is different and natural birth is the norm.
    .-= Christine ´s last blog ..Pine cone tree craft =-.

  8. We do so much to undermine women’s confidence in their bodies on so many levels, as this demonstrates.

    I am for women controlling their reproductive choices so I had to swallow A LOT when a friend did choose a c-sec. I only jump at her now when she insists she made the safer choice. And I feel entitled to correct her 🙂
    .-= Sarah Buttenwieser´s last blog ..Parenting Equations, Grocery Expeditions, & Slippery Slopes =-.

  9. I agree with the comments here that doctors often aren’t the only ones pushing c-sections, whether “elective” or not. It seems like the scheduled c-section has become an accepted norm, convenience over listening to your body. If I recall correctly, the AAP (or it may have been ACOG) came out with revised guidelines this year saying that babies really do need to stay in utero as long as possible–that even electively delivering a week or two early might pose health risks to the baby.
    .-= ReadyMom´s last blog ..THE best bread you’ll ever make =-.

  10. So frightening. My mother was told she’d need a c-section because she was very tall and thin. Uh, we all came flying out. And then, when I was pregnant, my doc was saying a c-section would be easier and less stressful and I was like, no way!! Luckily, baby girl finally came after 2 hours of pushing. My SIL had a very successful vbac. I just don’t understand why doctors want to perform these surgeries so often.
    .-= Almost Slowfood´s last blog ..Entertaining: Jelly Cake =-.

  11. I agree with you 100% about the C-section rate being too high. And that, from a mother who had both of her children via C-section. My first was discovered to be breech after I’d been in labor for hours already. My second was an attempted VBAC – a valiant attempt, if I do say so myself – that ended in an emergency C-section because baby had the cord wrapped around his neck. Do I wish I could have had a traditional birth? You bet. But in at least the second case, the C-section saved my son’s life. The surgery is a valuable tool, but in my opinion should be used only when absolutely necessary.
    .-= Kris Bordessa´s last blog ..Coconut Bay Resort & Spa =-.

  12. My son was born by C-section and had some learning and developmental issues. I ended up taking him when he was nine to a sensory integration therapist. She evaluated him and gave us exercises to do that made a huge difference. Daily bedwetting cleared up in a week, and reading and other challenges improved a lot. The therapist told me that the squeezing of the baby through the birth canal is designed to “wake up” the nervous system, and that children born by C-section often have challenges related to missing out on that. So there is one more reason to avoid C-sections whenever possible.

  13. Re: The Single-Layer Suture Issue – When you look at all of the studies done on this (not just the one) the picture is much less black & white. Apparently single-layer was less complications from infection than double-layer does. And you can imagine that an infected incision is it’s own uterine rupture risk. While the jury is out on whether the number of layers makes a difference, it’s starting to look like the real incision issue may have to do with 1) what material the surgeon used to do the suturing and 2) the surgeon’s skill. See this link for more info: Otherwise, this article is a big Hell Yay! Thanks for writing about how women get strong-armed into the OR unnesessarily!

  14. Oh, this kind of thing drives me nuts. We have health-care people telling us that demanding special care is what’s driving UP the cost of healthcare. Then we get sub-par care (with single-later suturing) that then leads to a future of riskier AND more expensive sub-par care (unnecessary c-section). When will it end???
    .-= Stephanie – Wasabimon´s last blog ..Food Blogger Spotlight: Matt Armendariz =-.

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