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Cesarean sections are being carried out more frequently than ever before. According to a report by the International Childbirth Educators Association’s Cesarean-Options Committee (1997), “In the past 20 years, Cesarean-section rates have quintupled in the United States, to 23.8% [of all births] in 1989, and nearly quadrupled in Canada, to 18.3% in 1987-8.” The rate is one in three for high-risk pregnancies (women giving birth after age 35 are currently considered to be subject to high-risk pregnancy). The main reason for this change is that the operation has become much safer than it used to be. Improvements in anesthetics have lowered the risk, especially since a planned Cesarean can now be done with an epidural rather than general anesthetic.
The development of the low, transverse “bikini cut” incision also made the operation safer and more acceptable, and decreased the risk for women who may want to have a later birth the normal way. The number of Cesareans has increased in recent years for reasons that include:
- Doctors are better able these days to detect babies in distress who need to be delivered this way.
- It reduces the use of forceps, which can carry its own risks.
- It is considered a safe surgery.
- Having had a Cesarean can predispose a woman for another in a subsequent pregnancy.
- The most common reason cited for a Cesarean is that the baby’s head is too big to pass through the pelvis, but other reasons include:
- The mother suffers from a disease, such as diabetes or chronic high blood pressure.
- The uterus does not contract properly, even with stimulation.
- There are signs of fetal distress.
- The placenta is wrongly positioned (placenta previa).
The mother’s age is also taken into account, because it is anticipated that older mothers will have more difficult labors, and the baby may be more “precious,” especially if the woman has suffered infertility or miscarriages or may not conceive again. In these circumstances a doctor may prefer to do a Cesarean than take any risk for the baby’s well-being:
“The attending staff never mentioned my age at all. They didn’t make me feel old. It was only at the end, when they discovered she was breech, that it suddenly came up, because they wanted me to have a Cesarean. They said, ‘Well, it’s your first baby, it’s breech, you’ve had infertility problems and you’re 40. This might be your only baby, so you want to be sure that nothing goes wrong.’”
