C-Section? Your Fault!

Well, you may have noticed that I have been mulling over the ACOG statement on homebirth lately, so excuse my anger and disgust 2 years after it appeared.  I just found it.  Here is a section that I find incredibly, hmmmmm, shall I say, "RUDE".  Why do we let them talk about us like this?

"Advocates cite the high US cesarean rate as one justification for promoting home births. The cesarean delivery rate has concerned ACOG for the past several decades and ACOG remains committed to reducing it, but there is no scientific way to recommend an 'ideal' national cesarean rate as a target goal. In 2000, ACOG issued its Task Force Report Evaluation of Cesarean Delivery to assist physicians and institutions in assessing and reducing, if necessary, their cesarean delivery rates. Multiple factors are responsible for the current cesarean rate, but emerging contributors include maternal choice and the rising tide of high-risk pregnancies due to maternal age, overweight, obesity and diabetes."

Lets look a little closer at this.  First, no "ideal" cesarean rate?  WHAT?  OK, so Dr Bradley, when he was practicing had a c-section rate around 4%.  He took high risk patients, let women go overdue like crazy, and never lost a mother.  NEVER.  And here is the kicker folks, Dr Bradley did almost all natural births, that was his thing, but guess what, ALL the Ob's back then had c-section rates about that low.  

Not only that, but the World Health Organization has stated that (and backed with research) a c-section rate over 15% does more harm than good and should be between 5% and 10%.  (Check above link).

Now lets look at these "multiple factors" contributing to the rising rate (read "Not our fault!!" claims ACOG in doctor speak).  

1) Women want more c-sections.   It is not like we are just giving them out- no! no!- consumer demand is driving this!! 

Here is another quote on this subject, this one actually backed up by research. 

"Despite some professional and mass media discourse about "maternal request" or "patient demand" cesarean when there is no medical indication, just one woman (0.08%) among 1314 survey participants who might have initiated a planned primary cesarean without medical reason did so." (To read the entire link, click here.)  

One woman folks, one.  

2) (This is my favorite one)  Women are FAT and OLD!

Yes ladies, you are having more c-sections because you are overweight and older.  YOUR FAULT.  I feel like I am in grade school playing tag with ACOG and they keep yelling NOT IT.  Fun.  Real fun guys.  

Yes, there is some research showing that older women are much more likely to have a cesarean birth.  I don't know why this is, but I think that it could in part be attributed to older women maybe having a) better insurance and b) being considered "high risk" and then being run through the system with that in mind, essentially being prepped their whole pregnancy for a surgical birth.  

That being said, women under 25 are seeing the greatest increases in their c-section rates.  Click here for more. 

And yes, overweight women are more likely to have a c-section.  Why is this?  Maybe they are less healthy going into a pregnancy.  Maybe they are treated as high risk the entire time and pushed in that direction.  Maybe they are more likely to have body issues and lack confidence in their ability to birth vaginally.  I am honestly not sure.  

I do not however think that these are the real reasons driving the majority of c-sections.  

ACOG is right about one thing though.  Women are the ones with the power to change this rate.  ACOG and their cronies will not do it for us.  They have no reason to.  Not when there is so much more money to be made with c-sections and not when they are running scared from lawyers.  We must educate ourselves and choose safe places to give birth.  

For me that place is as far away as I can get from anybody affiliated with ACOG


"Maybe they are treated as high risk the entire time and pushed in that direction."

I think you hit the nail on the head. Just being over 35 means you are suddenly "high risk." They are waiting for something to happen, and take drastic measures "just in case" when there's no proof those "risks" are actually going to be realized, instead of just a possibility, however low.

Some of these studies, when they're broken down and really analyzed, don't really say crap in the end, and are deeply flawed. Redefining maternal "choice" is essential!
I don't think women should be blamed, but I do not believe they are fault free. We, as women, need to educate and empower ourselves. We *let* this happen to us, in a sense. When 1 in 3 women deliver babies via c-section, there is undeniably a problem. WAKE UP! It's illogical to believe that is "normal". Smarten up and take care of yourself, because no one gives a shit about you like you give a shit about you.
ManderaStar said…
Until we do away with due date charts and start focusing more on women and birth as individual and unique we will continue to see the cesarean rates rise. Very few women actively choose to birth via c-section, often that choice is taken away from them by OB's who essentially operate on fear.