Number of Caesarean Deliveries at a High
The number of women in the United States giving birth by caesarean section has reached an all-time high, with nearly one-quarter of babies now being delivered by the surgical procedure, according to government statistics being released this week.
Continuing a steady retreat from the “natural childbirth” trend, the caesarean section rate jumped 7% in 2001, reaching 24.4% of all live births -- the highest rate since the government started collecting the statistics in 1989.
The reasons for the rise, and whether it’s good or bad for women and their babies, are the subject of an intense debate that has been raging at medical conferences, in medical journals, in doctors’ offices and at birthing centers. It’s an unusually emotional debate, especially when it comes to women who want a “C-section” for their first baby -- even when a regular delivery poses no obvious danger.
“I think there is rationality on both sides of the debate,” said Judith Walzer Leavitt, a professor of medical history and women’s studies at the University of Wisconsin Medical School. “But there’s also some things that ... we might look on as less scientific -- like training and experience, like religious beliefs and mind-sets, like political issues of the day.”
Some experts see the surging caesarean rate as a welcome development. Medical authorities in the 1980s and 1990s had campaigned to reduce the number of such deliveries. Doctors particularly targeted the practice of routinely performing caesareans on any woman who had had one before. Repeat caesareans were derided as often unnecessary, and as subjecting women to costly and potentially dangerous surgery and a long recovery.
But before long, problems began to emerge.
“Fetuses died. Mothers died. Mothers’ uteruses ruptured,” said Michael F. Greene, director of maternal and fetal medicine at Massachusetts General Hospital in Boston. “As the reports of these disasters started to appear in the medical literature, obstetricians became much more cautious.”
By 1996, the caesarean rate started creeping up. Last year, the number of women who had vaginal deliveries after a previous C-section plummeted 20%, dropping to a low of 16.5%, according to preliminary data from the National Center for Health Statistics. The final numbers, being released Wednesday, are not expected to vary significantly.
