Is That C-Section Really Necessary?

Suzanne B. Robotti
Suzanne B. Robotti Executive Director

Cesarean birth avoids labor (C- Section) but cheats the mother and newborn of many benefits. Let’s find ways to make labor less painful rather than opting for  surgery.

Doctors are finding success in lowering the post-cesarean infection rate by pumping antibiotics into women even before they have the surgery . Fewer infections are good, but vaginal birth doesn’t carry risk of surgical infection. Wouldn’t that be the more appropriate goal?

Two bad things are happening with this new protocol: 1) Vaginal birth, with all its benefits, is increasingly avoided; and 2) Antibiotic resistance is promoted.

Nearly 1 out of every 3 births in the U.S. (32.2%) is done via C-section. Yet, only about 10-15% of Cesareans are medically necessary, according the WHO (World Health Organization).  

We have an epidemic of unnecessary surgeries and why is that? Why aren’t doctors helping women to avoid major surgery? Why are insurance companies so quick to pay for an unnecessary C-section? Why are women going under the scalpel for no reason?

OK, there is a reason. Birth hurts. It’s a long and grueling process. I’ve never given birth so I’m not qualified to tell you how much it hurts, but I feel confident it’s a lot. However, it’s pain with a purpose.

The process of vaginal birth helps the baby because the muscles in the birth canal work to clear fluid from the baby’s lungs, which lessen breathing problems. Also, the newborn is exposed to all the biomes and good bacteria available in the mother’s birth canal, which are believed to boost the immune system and help intestinal tracts. And, rather than being woozy from medication, the mom is more quickly ready to hold and breast-feed her baby, encouraging early bonding.

Further, vaginal births result in shorter hospital stays, lower infection rates and quicker recovery, according to ACOG (American College of Obstetricians and Gynecologists). 

ACOG recommends against scheduled repeat cesareans and maternal-requested cesareans, pointing out that women face “risk of bladder and bowel injuries as well as serious complications in future pregnancies. Placental problems, uterine rupture, and emergency hysterectomy are all risks that increase with each subsequent cesarean.” The only benefit to planned cesareans over vaginal births is a lower risk of excessive bleeding during birth that requires blood transfusions.   

Research released last year pointed to a link between cesareans and asthma, obesity and diabetes compared with babies delivered vaginally. 

Let’s not overlook the issue of antibiotic resistance, which is real and threatening. Antibiotics are one of the great medical discoveries in history. Wounds and infections that used to kill are now considered inconsequential. If antibiotics are rendered useless due to overuse, we’ll have no defense against infection. Using antibiotics to make avoidable surgery safer is illogical. Let’s work to avoid surgery. 

It’s clear that individuals, doctors and the medical community need and want to use fewer antibiotics, so why are we finding ways of making non-emergency cesareans safer rather than finding non-surgical ways to make childbirth less painful and better support those women who choose labor as part of their birth plan?

If you’re pregnant and want to avoid a C-section, try these suggestions from Lamaze International:

  1. Choose a maternity care provider and birth setting with low cesarean rates.
  2. Be skeptical of justifications for a cesarean that are not based on research.
  3. Let labor start on its own.
  4. Arrange for a skilled labor support person to be by your side.
  5. Take a childbirth education course.
  6. Remember that your body knows how to give birth.


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