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Discussion Starter · #1 ·
New Study: Cesareans cause 2 to 4 times more maternal deaths than vaginal<br>
births<br><br>
Dear Friends,<br><br>
ACOG has posted a news release “Weighing the Pros and Cons of Cesarean<br>
Delivery” at: <a href="http://www.acog.com/from_home/publications/press_releases/nr07" target="_blank">http://www.acog.com/from_home/public..._releases/nr07</a><br>
which most importantly mentions a large study showing that cesareans<br>
definitely cause 2 to 4 times as many women to die in childbirth as vaginal<br>
births.<br><br>
Discussion of this study is very low key and pretty much buried in the news<br>
release. It is an important study on mortality risks: “Pregnancy-Related<br>
Death and Health Care Services” (Margaret Harper, MD et al. Obst & Gyn Aug.<br>
2003 Vol. 102 No. 2 pp 273-278). This is “a population-based, case-control<br>
study from North Carolina for the 7-year period 1992-1998” that looked at<br>
pregnancy-related and pregnancy-associated deaths, using death certificate<br>
codes and linked to birth and death files. The authors looked at many<br>
factors – demographics, medical risk factor, pre-term delivery, use of<br>
prenatal care and health care services, etc. – including mode of delivery,<br>
to determine what factors were associated with maternal mortality. Mode of<br>
birth (cesarean or vaginal) was the most significant factor related to<br>
maternal mortality, although use of prenatal care also had an effect. The<br>
study found that “the pregnancy-related mortality rate among women with<br>
cesarean deliveries was 35.9 deaths per 100,000 cesarean deliveries with a<br>
live-birth outcome” compared to 9.8 deaths per 100,000 vaginal deliveries<br>
without complications. The mortality rate for the population presumed to<br>
have had “elective cesareans” (they were repeat cesareans) was 18.4 per<br>
100,000 cesarean deliveries. Therefore, they conclude that “cesarean<br>
delivery is probably neither less than two nor more than four times more<br>
hazardous than vaginal delivery.”<br><br>
You can read the entire study by clicking on “another study” in the ACOG<br>
press release, or go directly to<br><a href="http://www.acog.com/from_home/publications/green_journal/wrapper.cfm?documen" target="_blank">http://www.acog.com/from_home/public...er.cfm?documen</a><br>
t=2003/ong14505fla.htm.
 

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thanks for posting that. i don't think most people realize how risky a c-section really is. not the women here, these are some seriously informed women, but i have a friend who thinks her c-section was wonderful and will do it again, and another board that i lurk at has several women expecting their first baby who WANT c-sections, don't even want to go into labor and think people who have vaginal births are crazy and drug-free births are stupid. which would be why i lurk and don't post. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/rolleyes.gif" style="border:0px solid;" title="rolleyes">:
 

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Thanks for posting that...can you see if you can fix the link? I can't get it to work nor can I copy and paste it.
 

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I doubt that Cesarians CAUSE 2-4 times more maternal deaths. Look at who has Csecs: women (and fetuses) who might die if they don't have one. I suspect that some of those women die even with the life-saving surgery and THAT'S what is causing the increase in maternal mortality, NOT (usually, though sometimes) the surgery itself. This is not to say that there are WAY too many Cesarian births in the U.S (mostly because of docs' fears of lawsuits). I'm just saying that they save more lives than they take, on the average. I would wager that even with scheduled C-births, there may be reasons for doing it that save lives. Let's say a woman had some health condition that makes it difficult to labor or to push out a baby. She and the baby might very likely die if she labored and attempted to birth vaginally. This health condition might also make the surgery more difficult for her and put her at greater risk than the average woman, thus leading to a higher death rate for C-births. Or, take an emergency Cesarian, let's say that a woman was about to die during a vaginal birth, her baby was delivered alive surgically, and then the mother died, thus leading to a higher death rate for C-births. Correlation does NOT prove causation. The title of that study would be more accurate if it read: 2-4 times more maternal death occur during Cesarian births than vaginal births.<br><br>
I was recently musing over the high C-birth and low nursing rates in the U.S., and it occured to me that the human race would never have survived this long if 1/4 of women were unable to birth vaginally and 1/3 of women were unable to nurse.<br><br>
No, I'm not contradicting myself. I'm saying the conclusions of the study are flawed.
 

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Discussion Starter · #5 ·
That many more women are dying during C-sections. The vast majority of C-sections in this country are not performed to save a womans or even a babies life. A minimum of 3 out of 5 C-sections in the country are unneccasary. If we reduced the C-section rate significantly fewer women would be dying in childbirth.<br><br>
Many other countries have between a 5 and 10% Cesarean rate AND also have lower infant AND maternal mortality statistics. Less moms and babies are dying in those countries than here. Maternal deaths are currently rising, as are the # of C-sections done, pre-maturity, etc. WE currently rate #27 in infant mortality and #16 in maternal mortality and have a record high 26.1% C-section rate.<br><br>
Women lose much more blood during C-section and they also have thier organs taken out of thier body shooting up the opportuntiy for infection. No one would argue that the rare woman who has a placental abruption or other life threatening event occur during birth should get a C-section and fast, but there is no excuse for 26.1% of women birthing through surgery with all of its risks and an increased possibility of death. Remember this is super conservative ACOG stating this that the risk is no less than 2 times and no more than 4 times higher that a woman will die during a C-section than a natural birth, they aren't just saying it off base or without ALOT of evidence, this isn't very popular in thier neck of the woods.
 

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Thank you weesej, you took the words right off my monitor! I was just going to respond to Juile128's post in the same way! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up"> You're absolutely right!
 

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Sorry, I don't buy it. There is too much skew from women and babies who need them to state as a fact that the C-secs are the cause of all the deaths. CORRELATION DOES NOT PROVE CAUSATION! During a discussion in statistics class, our teacher correlated the price of peanut butter with the suicide rate. Does this mean that low peanut butter prices CAUSED a high suicide rate? Of course not.<br><br>
I would love to see the study showing that scheduled Cesarians of otherwise healthy mothers CAUSED 2-4x more deaths than vaginal births. I doubt there is even one.
 

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Right, but if you read the study, it says that the researchers looked at all things - maternal complications, health and prenatal care, medical risk factor....the study simply concludes that all things taken into account, c-sections do cause more maternal deaths than vaginal births. Which has been proven over and over and over by many reputable sources.<br>
Don't believe it, that's fine..(it is a shocking figure and can be hard to believe) but I am sure if someone as conservative, well-funded and public as the ACOG proves the results with a long-term study, they probably have researched it pretty extensively.<br>
I took a statistics class, too...and you're right: correlation doesn't prove causation. However, these things were taken into consideration while researching...<br><br>
Thanks again, weesej, for posting the study! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up"> Things like this need more attention than they are receiving in the media!
 

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404 - File Not Found<br>
The file you requested is not available on The American College of Obstetricians and Gynecologists' Web server (<a href="http://www.acog.org" target="_blank">http://www.acog.org</a>). However, we invite you to explore our site for other useful information.
 

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Here are those links:<br><br><a href="http://www.acog.org/from_home/publications/press_releases/nr07-31-03-3.cfm?printerFriendly=yes" target="_blank">Weighing the pros and cons of cesarean delivery</a><br><br><a href="http://www.acog.org/from_home/publications/green_journal/wrapper.cfm?document=2003/ong14505fla.htm" target="_blank">Pregnancy-Related Death and Health Care Services</a><br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Researchers conclude that the number of pregnancy-related deaths could be reduced by removing barriers to and actively promoting the need for routine prenatal care services as well as lowering the number of cesarean deliveries.</td>
</tr></table></div>
 

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A neighbor's sister was induced Thursday night and by early Friday morning was prepped for an emergency c-section. She quickly began to hemorrage and was determined to have DIC. She has had five surgeries since Friday including a full hysterectomy. She is currently lin ICU on a vent and on dialysis because her kidneys have failed.<br><br>
I live in a community where induction is the norm. When I approached my due date, some women indicated that my "natural" approach was putting my unborn baby at risk. They had not read Henci Goer's "A Thinking Woman's Guide..."<br><br>
I can be grateful to live in a country with access to excellent medical attention if I need it, I just wish that more people had access to information that ***might*** prevent them from needing it. Does that make sense??<br><br>
I have no idea what has caused this poor woman's dire condition related to the birth of her third child, my heart just breaks for their family and especially that little baby. Perhaps this is due to my "extreme" interest in this topic, but I can't help but feel that this situation could have been avoided had it not been for the induction.<br><br>
Of course this is a moot point ... all we can do is light a candle and pray.<br><br>
If anyone has update research to share on maternal mortality or any follow-up studies to the one referenced in this thread, I would be interested to know of them.<br><br>
thank you.
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">The mortality rate for the population presumed to<br>
have had “elective cesareans” (they were repeat cesareans) was 18.4 per 100,000 cesarean deliveries.</td>
</tr></table></div>
I thought this was the bit that indicated that scheduled, non-emergency cesareans have a mortality rate twice that of vaginal birth.
 

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Well...<br><br>
I agree that some cesereans save lives. there are real reasons for doing the, (placenta previa, abruption, true fetal distress-which is quite rare) However, there are risks of any person having major abdominal surgery...DIC(which is one of the worst), blood clots, anaphylactic reaction to meds...infection leading to sepsis and death...and more...ceserean surgery is surgery. Anesthesia itself has risk. Spinals have risk. And Julie-when you have an 'elective surgery'like i did for my infertility...you sure as heck sign a sheet that states that you the patient understand that death is a risk...no surgeon is deluded about that. You can find the stats on the risks of surgery on healthy people-just go look for them.<br><br>
One of the main problems...is the idea that medicine can manage births..interfering and inducing the birth process when it should just be left alone. These inductions when moms are not ready to be in labor lead to many surgeries...big surprise. So those are mostly completely uneccessary surgeries-and they carry the same risk factors as any other surgery.<br><br>
Thank you for posting the ACOG info. I hope that women can read it and make up their own minds...I don't know why people get so defensive about the idea that there is risk associated with ceserean...
 

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Thank you so much for posting these links. I started a thread a while back about cesareans and my refusal to have one...hypothetically speaking, and other moms jumped all over me. They got really upset by my statement that cesareans caused more deaths that vaginal births. I wish I had this study to show them. I hope they see it and maybe the discussion can continue.<br><br>
I think this country is in a terrible place when it comes to our birthing choices. It's like women have just turned off their intuitive parts of their brains and gagged themselves. Why or why don't more women speak up...ask questions...care more about their bodies and babies. Why would you CHOOSE to go under the knife?
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>weesej</strong></div>
<div style="font-style:italic;">That many more women are dying during C-sections. The vast majority of C-sections in this country are not performed to save a womans or even a babies life. A minimum of 3 out of 5 C-sections in the country are unneccasary. If we reduced the C-section rate significantly fewer women would be dying in childbirth.<br><br>
Many other countries have between a 5 and 10% Cesarean rate AND also have lower infant AND maternal mortality statistics. Less moms and babies are dying in those countries than here. Maternal deaths are currently rising, as are the # of C-sections done, pre-maturity, etc. WE currently rate #27 in infant mortality and #16 in maternal mortality and have a record high 26.1% C-section rate.<br><br>
Women lose much more blood during C-section and they also have thier organs taken out of thier body shooting up the opportuntiy for infection. No one would argue that the rare woman who has a placental abruption or other life threatening event occur during birth should get a C-section and fast, but there is no excuse for 26.1% of women birthing through surgery with all of its risks and an increased possibility of death. Remember this is super conservative ACOG stating this that the risk is no less than 2 times and no more than 4 times higher that a woman will die during a C-section than a natural birth, they aren't just saying it off base or without ALOT of evidence, this isn't very popular in thier neck of the woods.</div>
</td>
</tr></table></div>
Exactly.
 

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Thank you for posting the article.<br><br>
Since the ACOG realizes that a c/s CAN & DOES cause deaths, what are they gonna do about it? So far all they have done is put more restrictions on vbacs. They obviously know the seriousness of c/s so why aren't they encouraging more vbacs? Hm, makes one think.
 

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Question:<br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>navessa</strong></div>
<div style="font-style:italic;">Thank you for posting the article.<br><br>
Since the ACOG realizes that a c/s CAN & DOES cause deaths, what are they gonna do about it? So far all they have done is put more restrictions on vbacs. They obviously know the seriousness of c/s so why aren't they encouraging more vbacs? Hm, makes one think.</div>
</td>
</tr></table></div>
Answer:<br><br>
$$$$$<br><br><br><br><br>
Sorry -- feeling cranky today...<br><br>
Great articles!
 

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OT--Vanessa, it's about time you showed up around here. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/wink1.gif" style="border:0px solid;" title="wink1">
 

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Carollyn, glad someone said it <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/wink1.gif" style="border:0px solid;" title="wink1">. Since I haven't posted much here yet, I thought I would be polite, <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> . But regarding vbacs, sometimes it is hard to be nice especially when "they" aren't nice about my decisions. Next time, I won't bite my tongue too hard, lol.<br><br>
KKmama, HI! I have been lurking for awhile. Nice to "see" you around here.
 

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Let me start by saying I am not trying to be a smarta$$ (sorry, couldn't think of a better way to word it). I just really wonder about where that leaves my odds as far as death goes. I have had three medically necessary c-sections and one elective. I have also delivered vaginally once.
 
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