There are many factors to consider when you’re deciding where to give birth. If you plan to have a hospital birth, make sure you find out the facility’s C-section rates. These are notoriously difficult for everyday consumers to access, which is why Motherfigure partnered with The Leapfrog Group to publish C-section rates and make them easily accessible for every birthing family. The Leapfrog Group’s cesarean section target rate or 23.9 percent. If your birth location is higher than that, you might want to ask deeper questions about why.
C-sections have been on the rise in the United States for decades, a rate of increase that some experts have called “alarming.” What many women don’t know when they’re considering their provider is that their birthing location and group policies can have a big impact on their birth outcomes. So knowing the hospital’s C-section rate — which might signal how much they perform C-sections that aren’t medically necessary — is insight that can help you choose the best hospital for delivering your baby.
In a Cesarean birth, doctors deliver a baby by creating a surgical incision in the mother’s abdomen and uterus. C-sections are very common. The Leapfrog Group reports that one in three women in the United States gives birth via C-section. It’s a powerful, life saving option for many — and at Motherfigure, we believe that all births are natural, and there’s no such thing as a “right way” to give birth.
But many experts think that the current C-section rate in the US is too high for all of them to have been medically necessary. And although C-sections are common, they are still a form of major surgery. This means that C-sections carry a risk of various complications, infection, and take time to heal. For many women, recovering from a C-section takes longer than recovering from a vaginal birth.
According to a 2018 study by Leapfrog, 60 percent of reporting hospitals had a C-section rate deemed “excessive” — meaning, in Leapfrog’s words, that “far too many women are undergoing a major abdominal surgery without medical necessity.”
Why women have C-sections
There are many reasons why women have Cesarean section births — it’s a powerful, life-saving option for many: Like taking the window instead of the door. Some C-sections are elective — because they don’t want to deliver vaginally, have a prior C-section and want a gentle Cesarean, or to schedule their child’s birth for a specific date.
Many C-sections are medically necessary due to conditions like placenta previa, preeclampsia, and more.
In these cases, the procedure is considered medically necessary to protect the health of the baby or the mother. Some medical reasons for having a C-section include:
- The baby’s vital signs are dropping. If the baby’s heartbeat becomes erratic or shows other signs of distress, a C-section may be required.
- Abnormal positioning. In these cases, a doctor will recommend a C-section because the baby is breech or transverse (positioned to the side or shoulder first), and the abnormal positioning is causing problems.
- Prolapsed umbilical cord. This means the umbilical cord exits the cervix ahead of the baby, which can cause problems.
- Carrying multiples. If you are pregnant with twins or multiples, a C-section may be medically necessary to avoid complications with delivery and ensure each baby can receive proper care. Multiples are often born premature and your healthcare provider may wish to get them to the neonatal intensive care unit as soon as possible.
- Mechanical obstruction. This describes a situation where there is something blocking the vaginal canal, such as a large fibroid or tumor, or cases where a fractured pelvis obstructs delivery.
- Other health concerns. For example, a C-section may be necessary if your baby requires neonatal surgery or has certain birth defects. C-sections may also be recommended if the mother has health concerns, such as a heart condition or an active outbreak of genital herpes.
Women also have C-sections if they’re attempting to deliver vaginally but the labor process is taking too long according to the care provider or facility’s policies, a condition known as “stalled labor.”
Is the C-section medically necessary?
Unnecessary C-sections pose risks to both baby and mom, including surgical injuries and infection, so attempting to understand whether your scheduled C-section is medically necessary is key. If the C-section rate at the location where you intend to give birth is higher than recommended, or if your doctor recommends a scheduled C-section, here are some questions you can ask:
- Do you employ midwives?
- If not, do you allow them in the delivery room?
- How do you feel about doulas?
- Will you do everything possible to avoid a C-section if it’s in my birth plan?
- Why would a C-section be better for my baby than a vaginal birth?
- Are there other alternatives?
- Can you walk me through a C-section procedure?
Risks of having a C-section
As with any major surgery, having a C-section carries risks of complications. This includes risks to you and to your baby, as Mayo Clinic reports.
Risks to the baby
Compared to vaginal delivery, a baby born via C-section is at greater risk of the following:
- Surgical injury, such as accidental cuts or nicks from a scalpel during the incision.
- Transient tachypnea. A respiratory condition where the baby has abnormally fast breathing for the first few days after birth.
Risks to the mother
Women who deliver by C-section face significantly higher complications compared to vaginal birth. These risks include:
- Infection, either at the incision site or in the lining of the uterus.
- Postpartum hemorrhage (bleeding), during and/or after delivery.
- Blood clots and deep vein thrombosis, which can also lead to life-threatening pulmonary embolism if the blood clot breaks and travels.
- Injury to the bladder or bowels via accidental nicks, which may require followup surgeries to repair.
Additionally, women who deliver via C-section are at risk of increased complications in future pregnancies. Having a C-section can lead to a condition called placenta previa, where the placenta becomes abnormally attached to the uterus. There is also a risk of the uterus tearing open at the scar tissue site.
Finally, having a C-section results in a much longer recovery time than a vaginal birth. Women recovering from a C-section may experience pain and discomfort, and activities such as lifting large objects, squatting, and driving may be very difficult for several weeks. Women are also advised not to have sex for six weeks after having a C-section.
By understanding the above information as well as the C-section rates available in the Motherfigure directory, you can plan for the best birthing experience for you and your child.
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