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2003 sees highest cesarean birth rate ever

 
 
Reply Wed 24 Nov, 2004 09:01 am
http://www.salon.com/mwt/wire/2004/11/23/birth/index.html

Quote:
Nov. 23, 2004 | WASHINGTON -- More than a quarter of babies born in the United States in 2003 were delivered by Cesarean section, the highest rate on record, according to a government report released Tuesday.

Birth rates for teenagers continued their steady decline last year while increasing for women age 35 to 44, the report from the National Center for Health Statistics said. The agency is part of the Centers for Disease Control and Prevention.

Nearly 4.1 million births were recorded in the United States in 2003, a slight increase over 2002. Roughly 1.13 million, or 27.6 percent, were Cesarean deliveries. The rate is up by a third since 1996, said the report, which is a preliminary look at U.S. births last year.

A Cesarean section is major abdominal surgery with serious potential side effects. The report does not distinguish between those that were medically necessary and those that were elective.


The question of whether it should be performed when natural childbirth poses no threat to either mother or baby is controversial among obstetricians.

One unexplained trend in the annual report is the continued increase in the rate of premature and low birthweight babies even though the teen birth rate dropped, fewer women were smoking while pregnant, and more women were getting timely prenatal care.

The rate of babies born after less than 37 weeks of gestation rose slightly to 12.3 percent, the report said, and those weighing less than 5.5 pounds increased slightly to 7.9 percent last year.

Some of the rise in these early births can be tied to the increasing number of older mothers, who naturally and through fertility treatments are more likely to have twins and triplets. These babies are more likely to be born early and weigh less, said Joyce Martin, an epidemiologist and author of the report.

"But it's important to note that the increase in preterm and low birthweight is not restricted to older moms and for women just having singletons. So something else is going on here, too," Martin said.

Among other statistics in the report:

Births to unmarried mothers rose slightly.

Women of Hispanic origin had the highest birth rate, 22.9 per 1,000 people, compared to the overall rate of 14.1.

Two teenage girls younger than 15 gave birth to at least their fourth child. Shocked
There were 1,512 first-time mothers between the ages of 45 and 54.
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panzade
 
  1  
Reply Wed 24 Nov, 2004 09:03 am
I saw this item but didn't understand the implications duck.
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FreeDuck
 
  1  
Reply Wed 24 Nov, 2004 09:09 am
Which part, the high cesarean rate or the part I got bugeyed about?

The cesarean rate being at 25% is pretty high. In fact, I'll wager that it's one of the highest rates globally. There has been a lot of debate (especially in natural childbirth circles) about whether many of these are unnecessary or are brought about by excessively managed labors. I just think it's an interesting topic of discussion.

As to the other part, I can't even fathom how a girl of less than 15 can give birth to her 4th child. She would have to be continually pregnant since at least age 11. How does something like that happen?
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panzade
 
  1  
Reply Wed 24 Nov, 2004 09:13 am
FreeDuck wrote:
The cesarean rate being at 25% is pretty high. In fact, I'll wager that it's one of the highest rates globally. There has been a lot of debate (especially in natural childbirth circles) about whether many of these are unnecessary or are brought about by excessively managed labors. I just think it's an interesting topic of discussion.


So why is the rate going up? More older mothers need C's?
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FreeDuck
 
  1  
Reply Wed 24 Nov, 2004 09:13 am
The golden question.
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panzade
 
  1  
Reply Wed 24 Nov, 2004 09:16 am
At least I didn't ask a dumb question...
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FreeDuck
 
  1  
Reply Wed 24 Nov, 2004 09:35 am
You? Never. I guess I have an opinion on this topic but I am kind of reluctant to go into it because it is based solely on anecdotal evidence and my own suspicions, and might be easily dismissed with some hard facts. But I haven't been able to find much in the way of explaining the why of it.

When I was pregnant with duckie (my first) I used to watch A Baby Story on TLC. It was on 4 times in a row in the early afternoon. Every day that I watched at least one of those women had a c-section. One day all four episodes were c-sections. With very few exceptions, the sequence of events went pretty much like this.

Woman goes to the hospital in early stages of labor. Doctors check her, admit her, and stick her in a bed in a room. After a few hours, her labor has progressed only slightly. The doctor does something to speed it up -- usually breaks water. This speeds things up but causes the woman more pain so she gets an epidural. With the epidural comes a fetal monitor which requires the woman remain in one position (usually on her back) and it also comes with at least one IV. The woman can no longer move about freely. Doctor comes in again, womans labor is progressing but not fast enough for the doctor so he starts a pitocin drip to strengthen contractions. This goes on for a while but labor doesn't progress and the woman is getting tired. The woman, at this point, has had her water broken now for too long and is now at risk for infection. The doctor says it's time for a c-section. The end.

I have a few friends who have had c-sections whose stories are very similar. My feeling is that each intervention by the staff and doctors increases the risk that the woman will have to have a c-section. It seems to me that childbirth is overmanaged, that hospitals are an unatural environment for laboring women and that healthy women with uncomplicated pregnancies would be better served in another environment.
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panzade
 
  1  
Reply Wed 24 Nov, 2004 09:45 am
Hmmm...I am totally ignorant on these matters, never having been a father. I have some questions.

Why aren't the majority of OB?GYN Dr's women?

If natural birth is preferable...why so many CS's

If breast feeding is superior...why is it so rare?
0 Replies
 
FreeDuck
 
  1  
Reply Wed 24 Nov, 2004 09:53 am
I wish I had some answers.

My hunch is that few women opt to try completely natural birth because it is scary, and once you choose it, since it is almost impossible to do in a hospital, you pretty much exclude the option of pain relief should you change your mind. Most women choose hospitals to be safe. And then there's my theory that hospitals overmanage and cause non-elective cesareans.

As for breast feeding, I don't know that it's all that rare but there are a lot of reasons why a woman would choose not to. Some women aren't able to. Some women have to go back to work and are unable to pump at work. Some women just don't like to have a baby hanging off their breast.

I have no idea how many women are obgyns, but I'm not sure it matters. A doctor is a doctor and they are all trained in pretty much the same way.
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