According to the World Health Organization (WHO), rates of cesarean deliveries have been rising in many countries, including the US, Canada, England, France, Germany, Italy, and Ireland. Now, countries like Brazil, India, and China are also seeing an increase in rates.
While the WHO recommends rates below 15%, C-sections account for about 30% of deliveries in the US. It is estimated that about one mother in three has a C-section.
Why is the rate rising? Reasons for C-sections range from life-threatening emergencies to simple convenience to threats of malpractice. Doctors agree that, when indicated because of complications involving either mother or baby, C-sections can save lives. And in the face of patients who demand the procedure and threaten malpractice suits if a vaginal birth goes wrong, the surgery may also save them time with their lawyers. Still, the major abdominal surgery has risks, including rare cases of death, infection, excessive bleeding, reactions to medications, and injury to the baby. Many doctors and patients worry that rising cesarean rates indicate too much of a good thing.
The American Congress of Obstetricians and Gynecologists (ACOG) advises that doctors and patients carefully weigh the benefits and risks associated with both cesarean and vaginal deliveries on a case-by-case basis. The earlier pregnant women begin conversations with their doctors about their delivery options, the better.
ACOG advises women to speak frankly with their doctors and ask plenty of questions, such as:
Even if you had a C-section in the past that does not necessarily mean that you will have to have another C-section. In some cases, a vaginal birth after cesarean delivery (VBAC) can be a safe choice. By talking with your doctor, you can learn more about delivery options and make a birth plan that is right for you and your baby.
American Congress of Obstetricians and Gynecologists
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
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Vaginal birth after cesarean delivery: deciding on a trial of labor after cesarean delivery. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq070.pdf?dmc=1&ts=20120625T1353426267. Updated August 2011. Accessed May 2, 2014.
1/29/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Lumbiganon P, Laopaiboon M, Gülmezoglu AM, et al. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08. Lancet. 2010 Jan 11.
Last reviewed May 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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