Here is yet another article where the media try to blame women for the increase in sections. We have had: women are too obese, women are too old and now we are tired and want convenience. This article does however put a bit of a balance on it. Especially when it comes to the attitude of VBAC, and the options that women really have when backed into a corner (er… no option).
Women aren’t ‘electing’ to put babies at risk
“Some women opt to deliver a little earlier for a variety of reasons, including being eager to see their baby, being tired of pregnancy or for convenience,” explained The Washington Post. Time castigated those mothers: “Today, a trend toward elective caesareans is presenting doctors with another problem — women who insist on delivering earlier than they should, with potential risks to the newborn.”
To be clear, the researchers did not survey the women in this study — they were looking strictly at the health outcomes of newborns. And previous surveys of women have found no evidence of a “trend toward elective caesareans”. But in classifying the deliveries as “elective” they imply patient choice. “These are all elective repeat caesareans without a medical indication and without labour,” Spong told reporters.
It’s true: scheduled, repeat caesareans are not “medically indicated”, at least not according to the research evidence. After a caesarean birth, a woman is left with a scar on her uterus, and there’s a small risk of that scar rupturing in subsequent deliveries, which has led to concerns about vaginal birth after caesarean (VBAC). But a VBAC baby has excellent odds: the risk of severe harm or death is one in 2000 — the same odds as for a baby born vaginally to a first-time mother.
However, in spite of the true risk, VBACs are often vehemently discouraged. In fact, many obstetricians now refuse to attend them, and hundreds of US hospitals have officially banned them. And malpractice liability fears are a strong motivation to schedule the surgery early, so as to avoid the possibility of labour — and vaginal birth. The fact is that VBAC is inaccessible to most women.
So, if a woman with a scar from a previous caesarean goes to her obstetrician and is recommended to schedule a repeat caesarean — and is told that a vaginal birth would be risky, and that anyway it won’t be done by this doctor, this practice or this hospital — can the surgery possibly be called “elective”?
There are risks to VBAC and risks to repeat c-section, and women should be weighing the risks and benefits with objective care providers who will support their decision. But this is not what’s happening. In a survey conducted in 2005, more than half of women seeking VBAC could not find a willing provider or hospital.
This is not about women “electing” to put their babies at risk. This is about women being backed into a corner and told what’s best, only to then be publicly shamed for “asking for it”.
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