Sadly, labor seems to be a necessary evil
Bookworm on Sep 04 2006 at 8:40 pm | Filed under: Health
Many years ago, when I was in about seven months along with my first pregnancy, I begged my OB for a C-Section. I didn’t need one, but I’d had surgery before, and figured better the pain I knew than the scary and unfamiliar pain of labor. She refused my request, telling me that it’s good for babies to go through the labor process. If she hadn’t been a brilliant, hip, delightful, young woman, I might have accused her of misogyny, especially by the time I entered my twentieth hour of labor. As it was, I survived labor and had one healthy baby, followed a couple of years (and twenty hours of labor) later, by a second health baby. And it turns out my OB was right:
A recent study of nearly six million births has found that the risk of death to newborns delivered by voluntary Caesarean section is much higher than previously believed.
Researchers have found that the neonatal mortality rate for Caesarean delivery among low-risk women is 1.77 deaths per 1,000 live births, while the rate for vaginal delivery is 0.62 deaths per 1,000. Their findings were published in this month’s issue of Birth: Issues in Perinatal Care.
The percentage of Caesarean births in the United States increased to 29.1 percent in 2004 from 20.7 percent in 1996, according to background information in the report.
Mortality in Caesarean deliveries has consistently been about 1½ times that of vaginal delivery, but it had been assumed that the difference was due to the higher risk profile of mothers who undergo the operation.
This study, according to the authors, is the first to examine the risk of Caesarean delivery among low-risk mothers who have no known medical reason for the operation.
Congenital malformations were the leading cause of neonatal death regardless of the type of delivery. But the risk in first Caesarean deliveries persisted even when deaths from congenital malformation were excluded from the calculation.
Intrauterine hypoxia — lack of oxygen — can be both a reason for performing a Caesarean section and a cause of death, but even eliminating those deaths left a neonatal mortality rate for Caesarean deliveries in the cases studied at more than twice that for vaginal births.
“Neonatal deaths are rare for low-risk women — on the order of about one death per 1,000 live births — but even after we adjusted for socioeconomic and medical risk factors, the difference persisted,” said Marian F. MacDorman, a statistician with the Centers for Disease Control and Prevention and the lead author of the study.
“This is nothing to get people really alarmed, but it is of concern given that we’re seeing a rapid increase in Caesarean births to women with no risks,” Dr. MacDorman said.
Part of the reason for the increased mortality may be that labor, unpleasant as it sometimes is for the mother, is beneficial to the baby in releasing hormones that promote healthy lung function. The physical compression of the baby during labor is also useful in removing fluid from the lungs and helping the baby prepare to breathe air.
The researchers suggest that other risks of Caesarean delivery, like possible cuts to the baby during the operation or delayed establishment of breast-feeding, may also contribute to the increased death rate. (Bolded emphasis mine.)
Email This Post To A Friend
7 Responses to “Sadly, labor seems to be a necessary evil”
Leave a Reply
You must be logged in to post a comment.
Lawyers…. Lawyers, lawyers, lawyers.
… by voluntary Caesarean section … What does this mean? Aren’t they all voluntary?
One of the biggest sources of problems we’re experiencing in our country today is organized labor–from the teacher’s union blocking education reform or the ability to fire incompetent teachers to the massive amount of money spent by unions in CA to defeat Prop. 75 (which ironically would have required members of CA public employee unions to give permission before their dues are spent for political purposes.) The bottom line is that organized labor must be stopped!
What’s that you say–labor in childbirth? Oh.
Never mind!
No, they are not all voluntary! Many are done for medical necessity. My girls both came by emergency c-section (one with cord around neck, other had fetal distress). I had not wanted c-sections, but it was definitely in the best interests of the babies to have had those c-sections. Now I am pregnant with my third, and will probably have to have a 3rd c-section, since I have already had two (malpractice insurance). It’s a real bummer. Maybe this 3rd one will be considered “voluntary”, but it won’t be because I prefer it!
I think by “voluntary”, erp might have been suggesting that no one can be forced into a c-section. And in fact, I know one woman who was so insistent on natural birth that she refused a c-section for a breach birth. The result was that the baby came out okay, but the woman can no longer have other children. I guess it was also a natural form of birth control!
As it is, though, more and more women, for convenience or to avoid the undoubted pain of childbirth are opting for scheduled c-sections. For a long time, people thought the only risk of a scheduled c-section was the risk that’s inherent in any surgery. It didn’t occur to anyone that there was a positive benefit to the travails of labor!
Glad to hear you had a good, ethical OB, BW — so many of them, nowadays, are penciling-in needless c-sections so Friday’s golf game will not have to be rescheduled.
I misread what was meant by voluntary. I was thinking it was similar to spontaneous, as in miscarriages. Here’s another testimonial to medical ethics taken perhaps too far. My daughter was in labor for 24 hours and at the end of strength when they finally did a C-section.