Have C-sections Become a Means of Convenience for Busy Doctors?

7:12 AM

 With recent stories in the news, like the CNN story "Mom Defies Doctor, Has Baby Her Way," I have begun to wonder if the vast increase in the number of cesareans done in this country each year is due almost entirely to the fact that doctors are just too busy to be bothered with waiting for a vaginal birth to progress. With labor lasting anywhere from a few hours to a few days in some cases, that is precious time that doctors could be utilizing elsewhere.

In the CNN story referenced above, a woman named Aneka (last name withheld) was pronounced irresponsible by her obstetrician when she failed to show up for her scheduled C-section. Aneka, the was given a cesarean after 10 hours of labor with her first child nine year prior when the doctor pronounced it was not "progressing" as she would like. From that point forward, doctors insisted that she have C-sections for the birth of her two other children because of her first cesarean.

When Aneka became pregnant with her fourth child, she started researching her options and was frustrated to find that no one wanted to allow her to have a vaginal birth. Eventually, she found a midwife who delivered her fourth baby (a healthy 9 pound 6 ounce boy) at home without issue.

As a mother of four and a woman who had a cesarean with my first child, I know first hand that it is possible to deliver vaginally after one. My oldest son was born via C-section when I was in labor and it was discovered he was breach. I had an emergency C-section and it was quite possibly the worst experience of my life, as I was put to sleep, missed the birth of my son and had a long recovery period.

When I became pregnant with my second son, I became determined to have a natural vaginal birth. At that point, both hospital and just about every doctor in the area were still allowing VBAC and I delivered him after naturally after only a few hours in labor. By the time I became pregnant with my third son, only one hospital was still allowing C-sections and my choice in doctors was becoming smaller. I again gave birth naturally with no complications.

The search became much harder when I became pregnant with my fourth son. I could only find one local doctor who would allow a V-BAC and accept me as a patient and the local hospital allowed me to have one, but has since stopped allowing them.

In a statement released by the American College of Obstetricians and Gynecologists earlier this year, they talked about issuing less restrictive guidelines for VBACs. In 1970, the percent of births that resulted in a C-section was a mere 5%, in 2007, that number jumped to 31% and continues to grow. In a society that is so driven by pro-choice movements in so many aspects of life, why are women not given the choice of what to do with their bodies in this most natural instance? Are their risks associated with VBACs, yes. There are also a wide range of possible risks associated with having a cesarean as well.

What do you think? Have C-sections become a convenience for doctors today?

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  1. Yes, they have. My doctors never asked me if I wanted to try to deliver my twins without a c-section. With my next 2 pregnancies, it was just assumed that I would have c-sections as well. I didn't know then what I know now, but I definitely wish I had been given all the options. I hate that I will never get to experience a natural birth.

  2. I think it depends -- my doctor wouldn't discuss a c-section with me (a procedure I actually wanted) b/c she prefers vaginal delivery and will only do a c-section if medically necessary. Turns out, it became medically necessary with my son b/c of his dropping heart rate. Now that I'm pregnant again, I know that I can have a VBAC with her and it's probably something she'll suggest. Not sure yet if I want to do it or not.

  3. Have you seen "the business of being born?" I haven't seen it, but heard that it addresses this very issue. I am pro natural childbirth as much as possible (but not as far as a homebirth, that scares me) and I definitely felt like my OB wanted to induce me when I hit my due date, but he respected my decision and I went 5 days over.

    I think I read once, though, that Drs are using a weaker kind of stitch on c-sections now that really does make a VBAC a little riskier. Not sure if that's true or not.

  4. I don't keep up much with topics like this - and have to say this article surprised me!

    When my daughter was born 14 years ago, I begged the doctor for a C-Section - I was in so much pain, and I'm only 4'9" so very petite. My doctor was very encouraging and told me I could do it without, I did require an episiotomy, but gave birth naturally.

    The expense of a c-section is so much more to the hospital, insurance and the parents, to save some time to do it that way seems in poor judgment to me right across the board.

  5. Thanks for the feedback ladies. It is great to hear different opinions. While my C-section was medically necessary and I have no qualms about having it done, I would have had a big problem with being told that I could not choose a VBAC. The risk of a rupture is less than 1 percent and surely the risks that you face with a cesarean are much higher than that.

    Rachel, it is nice to hear from someone who was actually told no to a C-section at first. The problem comes in when more and more doctors are refusing to allow women the option of a VBAC at all.

  6. Yes, I believe they have. I also believe they're using them as a tool to prevent malpractice lawsuits because of the complications that can come from VBAC's or even vaginal deliveries in general.

    Personally, I've never had a c-section, they scare the hell out of me to be quite honest. Either way you go, complications are possible so birth should be about the safety of the baby, followed by the needs of the mother, followed by the wants of the doctor.

  7. I've heard a little bit about this and I can't help but think that from a doctor's perspective, C-sections are easier, take less time, and cost more. It's a win-win for them.

  8. C-sections scare me too. My sister had to have an emergency c-section with her first child 21 years ago, and refused to have a repeat c-section with her second when they tried to tell her she had to. She had 4 easy vaginal births (and one was a home birth) after her c-section.

  9. I didn't have a C with the birth of my daughter, but I was amazed when I was preg of the number of people scheduling Cs just b/c. I don't know enough about VABC, but I don't think a Dr should pressure you one way or another unless it is TRUELY medically necessary. Much like antibiotics, I think Cs are over prescribed.

  10. My children were born in the early 1970's when C-sections were rarely done. I never heard of anyone having difficulties delivering their babies back then.

    I have known several young women these days who have pressured their doctors into either inducing labor or doing a c-section birth, because they wanted their babies born NOW! In two cases, they even demanded that their doctors do this.

    I was appalled! Pregnancy and childbirth are natural functions of our bodies, and labor happens naturally when it is supposed to, if we let it.

    I really think that the higher incidence of children having neurological problems now is a direct result of being rushed into birth, whether it is by the doctor who wants to schedule their days, or by the mother who is just wanting to not be pregnant anymore. C-Sections should be done only when there is a real risk to mother or child.

  11. I had 1 vaginal and 1 emergency c-section and 1 scheduled c section.

    I think they like to share the high risks of vaginal delivery after csection and its scares most into just going with it.

    BUT I must say that I do see a lot of women take the VBAC option. Great post

  12. I think C-sections have become a means of convenience for Moms. I had to have an emergency C with my son, but the doctor did everything she could to prevent that, and counseled us ahead of time on all the reasons natural birth is preferred.

  13. I had what turned out to be a terrible doctor. I did not know, that he had delivered only 1 other baby before me. I know what can happen to children during difficult deliveries, so I had told him, if anything happened I wanted a C section in no uncertain terms. He refused to give me one. I ended up having 4 doctors and 10 nurses in the room with me. My son's apgar scale was 1 and 3. He had a stroke, and I believe still suffers the effects years later. This terrible, incompetent doctor has since went on to head a teaching medical school. I wish I could have had one.

  14. Debbie, I am terribly sorry to hear that your doctor did not do what was best for your baby! My article was more referring to C-Sections that are forced on women after having had a previous cesarean, without giving them the option of a VBAC.

    Obviously in your case, I believe a C-section should have been done. I certainly understand that cesareans have a place, especially in the birth of my first son, but I don't think it is impossible to believe that women can have normal healthy vaginal deliveries after having a previous cesarean.

    Thank-you all for sharing your thoughts and again Debbie, I am terribly sorry you have to go through what you did.

  15. You have to find the right doctor. I found the most wonderful doctor. She makes the birth experience very comfortable and doesn't do anything I don't want to do. I even gave birth to my twins vaginally. You have to be vocal. If I had a doctor do one thing wrong I was done with them. You don't have to put up with anything you don't want to. I went through a lot of doctors before I found my current one. I am looking forward to the birth of my 6th child next year.



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