Sex Stories: Questioning C-section Overuse

The C-section has long been heralded for its ability to save the lives of mothers and babies who may go into distress or encounter other medical complications during the birth experience. The surgery is one of many measures that has contributed to an overall decrease in maternal deaths. And of course busy moms-to-be appreciate that they can schedule their delivery.

Yet for nearly as long, the natural birth movement has argued that many C-sections are unnecessary and that they can cause a variety of future health problems for both mom and baby.

Who is right? Well a new report from Consumer Reports may have the answer.

In short, the report shows that many C-sections are being done for all the wrong reasons.

The non-profit looked at over 1,500 hospitals in 22 states. The researchers focused on C-sections done for women considered low-risk. They report shows that rates vary drastically from hospital to hospital, even among those in similar geographic areas with similar patient populations; and many C-sections were performed unnecessarily, whether out of habit, a desire to be efficient, or a fear of being sued. Perhaps even more unsettling, a hospital’s C-section rate is difficult to find, meaning that many parents-to-be are making important decisions about their birth experience with incomplete information. Two-thirds of the hospitals reviewed earned Consumer Reports‘ lowest or second lowest rating.

Some of the variation seen is not all that unexpected. For example, hospitals in southern states have higher rates than those on the West Coast. This could correspond with the South’s higher rates of chronic diseases like diabetes and hypertension, both of which can lead to complications during pregnancy and delivery that may endanger the life of mom or baby. Nevertheless, most of the variation is random, even when controlling for factors such as:

the percentage of patients on Medicaid
the number of births
the number of neonatal intensive care units beds.

This randomness speaks to vast differences in hospitals’ views on C-sections and their attitudes towards birth, pregnancy, and even their obstetrics providers.

Of course, the ultimate question is, why does this matter? Regardless of what popular media may say, C-sections are still major surgeries. Women have longer hospital stays and recoveries as well as a higher risk of both short- and long-term complications like infection and chronic discomfort at the incision site, respectively. All of these factors mean that C-sections tend to cost more than vaginal births. Additionally, women who’ve had one C-section often are encouraged to deliver future children in the same way despite the fact that the risk of complications increases with each additional surgery. It should be noted, however, that vaginal birth after Caesarean (VBAC) has gained much support from the medical community in recent years and is becoming an increasingly popular option. Vaginal birth may also benefit babies. They have a lower risk of breathing problems, are more likely to breastfeed, and may be less prone to chronic ailments like asthma an allergies.

The report also adds important data and publicity to new guidelines from the American Congress of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine. The recommendations, released in March of this year, debunk the outdated myth that labor should be induced or a C-section performed if labor is going on “too long.” In fact, this myth may contribute to the high rates of C-sections because inducing labor before a women’s body is ready to deliver may led to complications. Additionally, the recommendations also put to bed the idea that C-sections should be the go-to delivery method for large babies, identifying 11 pounds as the marker for when surgical interventions may be necessary.

Ultimately, there needs to be more transparency around C-sections and larger shifts within the medical field to address healthcare providers’ fears about meeting quotas or getting sued. Because at the end of the day, C-section overuse doesn’t benefit providers or patients.

Other Sexual Health News this Week

Coalition Issues Call-to-Action to Increase Shockingly Low Uptake of Sexual Health Services
The National Coalition for Sexual Health (NCSH), which consists of nearly 40 leading health and medical organizations, issued a call-to-action to increase the shockingly low uptake of essential sexual health care services in America, and launched a new guide and website to help Americans get the services they need.

See related: Taking Charge Of Your Sexual Health—How Preventive Services Can Protect Your Health (HuffPost Live)
With featured guests Dr. Edward W. Hook III, M.D., of University of Alabama at Birmingham, and Dr. E.W. Emanuel, M.D., MBA, an Og/Gyn at Kaiser Mid-Atlantic.

Some Parents Angry About Graphic Sex Education Book (USA Today)

White House Will Announce Measures to Combat Sexual Assault on Campus (Los Angeles Times)

Vatican Details Efforts to Combat Sexual Abuse (The Times-Picayune)

How a Single Low-Level Election Could Change Same Sex Marriage in the South (Think Progress)

Military Sexual Assault Victims May Get Amnesty for Minor Crimes (US News)

Three new organizations hope to make gender identity a protected classification in their anti-discrimination policies. These include Virginia Tech University, the University of Georgia, and the city of Spokane.

No LGBT Representation in NC as Gay Candidates Take a Beating in Primary (LGBTQ Nation)

Louisiana Senate Committee Passes Omnibus Anti-Abortion Bill (RH Reality Check)

Syphilis Cases Increase Among U.S. Gay and Bisexual Men: CDC (Reuters)