Cesarean Birth Statistics

[iknowitsmadbutiwantit]

Hi.
I am not currently pregnant (unfortunately)(dd and ds already), but my sister is and we have had some interesting conversations recently. One of these concerned the alarming figures I read somewhere that 1 in 4 women in America have cesareans. Imagine our suprise, when we checked out the national birth statistics in Great Britain! A 25% cesarean rate is not uncommon in this country either! My local hospital, Colchester General, has cesarean statistics of 25 - 28% depending on where you research. I personally know of someone who was told she would have to have a cesarean if the maternity ward was short staffed!
Do these figures worry anyone else? or is it just us? Id be interested to hear other peoples opinions. x

it definitely worries me, when dd was born, i was the only woman that night NOT to have a cesarean! this WAS because of bed shortages, i overheard midwives saying something along the lines of 'if she (not me, another woman) takes any longer we will have to send her down or we will have no beds and there's women waiting' i took 7.5 hours, i'm glad this was acceptable for them!

Seem to remember years ago a discussion on cs rates in the US and a ob/gyn saying that American women choose csections to "keep their honeymoon passages fresh"!! (if my memory serves me well)!
His point being that they did not want to suffer internal injuries that would affect their future sex lives, as they regarded this more important than having a "natural birth" with its attendant (possible) long term effects.

I had one of each and very clearly dictated to by circumstances: the caesarian was because of difficulties, the vaginal was because that baby was coping, no pressure either way.

Just checked caeasarian rate of my local hospital and it's the lowest in the region despite being a large teaching hospital where lots of difficult cases get sent. Sounds like they're doing something right then.

QT - yes my sister's friend was left for 60 hours in agony before she was given a cs and her husband had to get VERY assertive. All she is grateful for is that her baby is not brain damaged and she did not suffer any virginal damage. However, it has taken her longer to recover because she was in such an exhausted state before the op. On the other hand my sister had a planned cs (big baby 11lbs+) and was fine after 2 weeks! Said that it was easier to recover from cs than from the op to remove her appendix.

I think when you look at the CS rates of an individual hospital, and compare it to national averages, there are LOTS of factors to take into account. And frustratingly, some of them may be difficult/impossible to access to the casual enquirer.

Average age of mothers makes a big difference, for example, as the CS rate tends to be a fair bit higher for women in their late 30s than their late teens. That varies a lot from area to area. I think putting it all down to lack of maternity staff won't give you the full picture.

Totally anecdotally, along the same lines as QTPie and Gailforce1 - my friend gave birth 4 weeks ago to her 1st. She had a very protracted labour (3 days), when slow progress stalled. (she wasn't given an epidural, was fairly mobile, was given syntocin, it was just one of those things). She was finally given an emergency CS when her baby's heartrate slowed dramatically.

She had a birth de-briefing last week as she felt quite traumatised by some aspects of it - particularly the fact that during the last 12 hours, when she stopped dilating at all, and was totally exhausted and in massive pain, no one came and discussed the possibility of a CS. She believes, and so did the midwife going through her notes, that it should have been carried out earlier.

The midwife doing the de-briefing told her 'off the record' that while she couldn't speak for an individual consultant, the hospital was under 'huge pressure' to bring down its CS rates atm, and she thought this was a factor. This has left my friend very angry - she feels she would have had a better overall experience and a much better recovery if hospital policy had been less 'anti-CS'.

I think that a 1 in 4 c-section rate is terrible. The world health organisation think that 1 in 10 women should have C- sections.

However the hospital needs to look at what is getting women into that sort of situation of needing assisted birth/ C- section in the FIRST place. What is needed is PROPER one to one care for women in labour from a qualfied midwife. There are plenty of unemployed midwives. The issue is just money.

Better emotional support would reduce the need for epidurals and spot major problems quickly. It might also prevent women developing post traumatic stres if they do have a traumatic time. There is nothing worst than a woman being in intense pain and feeling alone.

The CS rate in the USA does not surprise me at all. Midwives are very uncommon in North America (approximately only 8% of births are attended by midwives) and the majority of babies are delivered by OB/Gyn's. You normally have a OB/Gyn from the time you become sexually active and they care for you through your pregnancies as well as your caring for all your female health (smear tests etc). Midwives are far more pro-natural birth than the majority OB/Gyn's. If there is any inherent risk, then mothers are given CS's for the safety of the mother and the child. In addition to this VBAC's are rarely offered and actually forbidden in many hospitals. OB/Gyn's are not willing to take the risk particularly when litigation is high and often successful when something goes wrong.

Provided that mother and baby are healthy and happy I don't see a problem either way.

Yep, agree QTPie.

"Provided that mother and baby are healthy and happy I don't see a problem either way."

The problems are:

Cost. The NHS is already being asked to make massive cut backs.

There is a risk of secondary infertility with C- sections.

Bad labour experiences can blight early motherhood.

My mother is a retired midwife. She tells me that in the 1960s C-sections were extremely rare. Admittally mothers are a lot older than in the past, but what else has changed?

Well I had to c-sections and I am happy that my hospital did not put statistics first. I would be more concerned by the level of induction or assisted birth.

Reallytired

Cost?? Seriously?? Cost should come before anything else?? Health and happiness of mother and baby should ALWAYS come first not cost.

There are risks with VBAC as well; Uterine rupture, infection of the uterine lining, lack of option to the infant brain, infant death, etc.

Any decision for a woman should be a fully informed choice between her and her doctor. No woman should feel pressured to do anything either way.

Yes, in the 1960's CS's were extremely rare and infant mortality was much higher! We have advanced in medical technology to make things safer for all.

Here in the south of Italy the figures are between 40 and 60% c sections.

I am definitely in a minority among my friends not to have had one, and in fact, throughout my pregnancy was convinced I would be having one because it's simply what everyone does here.

Apparently Italy has been slated by the WHO for it. It is especially prevalent in the south. (I believe, from talking to others on here, that Greece is the same)

Birth and pregnancy in general here are very very medicalised.

C-sections are not risk free. It is naivety to think so. It is major surgery with all the complications that entails.

In the 1960s there was decent midwifery care. In fact the C-section rate was far lower in 1980s. Infant or maternal death was rare in both the 1980s and 1960s. I'm refering to the past 40 years, not 400 years ago. We have had excellent universal maternity care in this country for roughly 50 years.

"Health and happiness of mother and baby should ALWAYS come first not cost."

What about the health and happiness of cancer patients? What about mental health of elderly men or the treatment of people with learning diffciutlies.

Sometimes mothers get very ego centric. I shall be mean and say as country we can afford the rising numbers of c-sections.

I am sure that there are many mothers who would have mental health issues whatever their birth experience was like. It would be interesting to see if there is more or less postnatal depression than in the past.

What shocked me more was that the hospital I was due to give birth to my first in (v large central London) performed C-Sections on half of all first time mums (this was in 2006).

This was despite their official total figures of about 22% of all births.

I think this says a lot about time constraints put on labours as first labours are usually longer.

Reallytired

I never stated that CS's were risk free. There are risks with all births. I said that the choice should be an informed one between a woman and her doctor.

Infant mortality is still incredibly high in countries that do not offer the medical back-up of CS's. i.e. Angola, Sierra Leone, Liberia, Niger. Birth rates were also much lower in the 80's then the 60's.

I never mentioned anything about others with medical issues receiving care??? You are running into another issue.

Time and time again you read the boards on here and elsewhere about horrendous natural birth expericences. I would say that the majority of mothers that have a planned CS (as opposed to a emergent CS) have good birth experience.

Do you honestly think every woman should be offered an elective c-section? Is that what women really want? Do you really think an elective C-section is a soft option?

It would be interesting to see how many women would choose to have a major operation which disables them for up to six weeks. Natural childbirth is painful, but the pain disappears afterwards. After a C-section the pain is on going. The poor mother can't even pick up her baby

Also the pain of natural childbirth gets grossly over exaggerated. It makes good TV to have a woman lying on her back screaming her head off.

Childbirth is not fun, but its certainly managable and there are good pain relief options.

I find it sad that there are time constraints on how long a woman is in labour. Women should be allowed to take their time if they want to.

Reallytired what has changed is better medical diagnosis, ultrasound etc.

My (and millions of others') placenta previa would not have been diagnosed in the 60s, and we would have died in childbirth. I mention previa because that's what I have experience in, I'm sure there's lots of other complications that are easily surmountable with a section.

I think an awful lot of women who have suffered prolonged difficult labours and traumatic instrumental deliveries would disagree that the pain of natural childbirth is overated, and that the pain disappears afterwards.

Shaz10, you are wrong. The 1980s or 1960s were not cave men times. You would not have died, if you had given birth in the UK.

My mother who had a long career in midwifery only experienced twice having a woman die during or after childbirth.

One sad case was a lady in Zambia (1970s) who had advanced maleria. The combination of giving birth and being sick was just too much. The other case was in 1990s in a UK hospital. The poor lady had advanced cancer and had decided against abortion.

Childbirth is not as dangerous as some people make out, otherwise the human race would be extinct.

I had a prolonged second tsage labour and subsequent forceps/episiotomy delivery and I am SO grateful that I have been told I can have A C section this time around. I suffered split stictches, an abcess on said split, re-hospitalisation for this and 2.5 yrs of pain and being unable to have sex and my gp telling me everything was "normal" as far as he could see.

Just an idea but haven't babies got much bigger since the 1960's? I may be wroong but this was certainly a factor in my pregnancy (DS was 9lb 70z at birth)

Reallytired

I think that a natural birth for most mothers with their first child is the best and most preffered option. However, in saying this there are always alot of factors determining the safety of a natural birth. All of those factors should be discussed with a woman and her doctor and a decision should be made.

There are alot of women that choose to have a CS after discussing various risk factors, pregnancy problems, etc with their doctor. I am one of them! The pain of a CS varies for women and the majority recovery quickly and well. It is also utter nonsense that you cannot pick up your baby, I had no problems with this.

There are also many women who have natural births that suffer for months or years after that birth; 2nd and 3rd degree tears, prolapsed uterus, loss of sensation, etc. There are risks with ALL births.

I think size of babies is definitely a factor. My DS was 9lb 6oz, I was only about 9 stone at the time and had to have an emcs after he turned transverse 19 hours in. There was frankly no way he was coming out sideways, so I turned into one of those statistics despite starting out in a birth pool and doing the first 10 hours drug free then just some G&A for the rest. Of course I might as well have just had the spinal from the get-go as it turned out. I definitely don't think a c-section is an easy option given that mine landed me in high dependency due to a big bleed. Nor does it leave you honeymoon fresh (ik) pregnancy and hours of pushing for nowt put paid to that!
But after being a real anti-c section type I am now so thankful I live now and not 200 years ago!

poppet I was small too- about 7stone 9lbs before pregnancy and people could not believe Id produced my DS at 9lb7oz as a first pregnancy. I did not have GD or anything like that had been terribly worried how big this second would get to - until I was told I can now have C section - The only reason i did not get one 1st time round was it was "too late" byn the time they realsied there was a prob THANK GOD FOR C SECTIONS!