4 posts tagged “cesarean”

Low Birth Rates Increase to Highest Rates in 40 Years

There's a lot of other information in the article, so read carefully. Some put the blame on the economy, and while that surely shares part of the blame, I was happy to see that other causes of low birth weights were mentioned: multiple births, lack of prenatal care, and most especially, premature births caused by early, elective inductions. The article did not discuss the reasons these early inductions were done, but I find it interesting that as more and more women are being induced early -- or just having elective Cesareans before 39 weeks -- due to the worry of a "big baby" (>4,000 grams), the number of babies being born weighing less than 5.5 pounds is rising.

Maybe the March of Dimes is right when it recommends that babies should be left to gestate until they're as near term as possible.

If you're worried about a big baby, at least give yourself a chance to birth it; you might just be surprised what your body and baby can do when allowed to work together, without unnecessary interference.

You know, I've been posting all this stuff about statistics and studies and research, and I just realized: none of this is for me. All of this information is really for other people, people who don't yet know that I want a home birth or who don't take me seriously.

So, I'll only be posting studies and statistics that mean something to me. I'm no longer collecting data so that I can "prove" my decision to other people. The point is: I'm comfortable with the risks of VBAC; I'm comfortable with the risks of home birth; I'm comfortable with the risks of having a VBAC home birth. I am not comfortable with the risks of birthing in a hospital.

I will VBAC at home, and no study or statistics will change my mind.

VBAC Facts recently posted a written dialogue between a mom in Southern California and an OB acting as spokesman for a hospital that recently "banned" VBACs. Mom's letter is here and the OB/hospital response is here. Make sure to read the blogger's comments after the hospital letter.

If this is representative of the kinds of lies and twisted truths perpetuated by obstetricians and hospitals unsupportive of VBACs, it's no wonder the C-section rate is on the rise and VBACs are dwindling.

Contrast this study with the one below.

In short, mothers with multiple VBACs have increasingly lower levels of complications while mothers with multiple elective Cesareans with no labor have increasingly higher levels of complications.

Obstetrics & Gynecology (2006;107:1226-1232)

OBJECTIVE: To estimate the magnitude of increased maternal morbidity associated with increasing number of cesarean deliveries.

METHODS: Prospective observational cohort of 30,132 women who had cesarean delivery without labor in 19 academic centers over 4 years (1999–2002).

RESULTS: There were 6,201 first (primary), 15,808 second, 6,324 third, 1,452 fourth, 258 fifth, and 89 sixth or more cesarean deliveries. The risks of placenta accreta, cystotomy, bowel injury, ureteral injury, and ileus, the need for postoperative ventilation, intensive care unit admission, hysterectomy, and blood transfusion requiring 4 or more units, and the duration of operative time and hospital stay significantly increased with increasing number of cesarean deliveries. Placenta accreta was present in 15 (0.24%), 49 (0.31%), 36 (0.57%), 31 (2.13%), 6 (2.33%), and 6 (6.74%) women undergoing their first, second, third, fourth, fifth, and sixth or more cesarean deliveries, respectively. Hysterectomy was required in 40 (0.65%) first, 67 (0.42%) second, 57 (0.90%) third, 35 (2.41%) fourth, 9 (3.49%) fifth, and 8 (8.99%) sixth or more cesarean deliveries. In the 723 women with previa, the risk for placenta accreta was 3%, 11%, 40%, 61%, and 67% for first, second, third, fourth, and fifth or more repeat cesarean deliveries, respectively.

CONCLUSION: Because serious maternal morbidity increases progressively with increasing number of cesarean deliveries, the number of intended pregnancies should be considered during counseling regarding elective repeat cesarean operation versus a trial of labor and when debating the merits of elective primary cesarean delivery.