32.8% cesarean rate in the USA

[Sarah Ricks]

It seems like woman's health issues have come up a lot in this presidential election. But I feel like one issue has been ignored our 32.8% cesarean rate. Our cesarean rate being high doesn't save more lives. The US has a very high infant/mother mortality rate, one of the highest in the developed world. My big question is why and what can we do about our grossly high cesarean rate and has either of our presidential candidates said anything about this Issue?

[Sarah Ricks]

I'm one of the 32.8%. With my first birth I was labeled failure to progress. My water had broke but I was making very little progress after 25 hours. They started pushing intervention more and more even though I and my baby were in no danger and in prefect health. At 36 hour my dreams of natural child birth were gone. I was cut open and didn't even get to hold my baby until after I was out of recovery. Once again we both had no health problems other than them saying 'failure to progress. My son is now 2 health and happy but I still carry a lot of what ifs with my first birth. I'm now 4 months pregnant. This time I'm going to a midwife clinic that specializes in VBAC. After talking with my midwives and OB and them going over my medical file they have said they really didn't see a real medical reason for my cesarean. This time around my midwives and OB are giving me a 86% chance of natural delivery.

[rnra]

Infant mortality is not the ideal statistic to cite if you're interested in how infants do with the care provided while their mother is pregnant and gives birth.  Infant mortality is primarily a measure of pediatric care, not obstetric.  It measures death from birth to one year of age.  Neonatal mortality is more accurate for a reflection of care provided during birth.  It measures death from birth to 28 days.  The very best statistic for the area you mention is perinatal mortality.  Perinatal mortality adds late stillbirths to the neonatal mortality statistics.  The problem with these statistics is that, although they seem straightforward, many countries measure them in different ways.  This makes comparison difficult.  Some countries exclude babies who are born very prematurely or with very low birth weights, which artificially improves their statistical reports.  

[fayebond]

I feel your frusteration, but it has been somewhat addressed, I think, by the way the main two candidates are putting forth thier healthcare ideas.  I think the CS rate is as high as it is in part because women don't have enough information about what is a real reason for CS and whats not, and partly because insurance is so complicated, OBs have to be proactive in protecting themsleves since they can't be sure a CS is NOT required until they get into the slicing.  Romeny's idea is to let each state basically call the shots, which would require alot more discussion,  convincing of voters ( again with more information) and clarification of insurance requirements/benefits.  Obama's plan is to stick with the unread bill we recently passed, the the 100,000 pages of clarification (which is NEVER going to be read by any average person ever).  The way I see it, Obama is happy to have gotten a bill passed, regardless of what it says.  At least Romeny's veiw would give me a chance to understand my healthcare options better, and if other women are given the chance to weigh in on this before it becomes an actual bill, we have the chance to influnce the CS rate for the better too.  Obama says its already done with yay, moving on.    

Best wishes on your upcoming birth!  I'm going for my fist VBAC too, and my midwives also agree that my CS was unnecessary.  Its frusterating and encouraging at the same time to know that my odds of getting a normal birth are high, but not as high as if I hadn't been with that particular CP the first time around.