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decade the rate of cesar–
can deliveries has tripled
in the United States, and
the rate is still rising.
Medica! researchers are
asking, Why?
A National 1nst i tutes
of Health task force sev–
era! years ago reported
that for 80 pereent of the
ccsareans performed, four
major reasons are cited.
Elaine checks Pam's progress (top photo) as
contractions intensify. Tbe fina l stages of labor
climax and David sees hjs second child born.
Difficult delivery or
dystocia accounts for the
largest part of the in–
crease in cesarean birth
rates. Of course, various
ing as obstetric procedures become
more complicated and hospital
stays more costly.
Childbirth ls Big Business
abnormalities in labor could hardly
have dou bled in the last 1
O
to 12
years, so a change in the obstetri–
cian's viewpoint of what is abnor–
mal labor is acknowledged.
years, cesarean bi rth rates were
high for those infants low in birth
weight. Birthing complications oc–
cur more frequently in this group.
An increase in thc number of first–
time mothers, along with the
increase in thc average age, is also
given as reason for increased cesar–
can rates.
Genital herpes on the r ise in the
popu lation is forcing cesarean
delivery to avoid ser ious neurologi–
cal damage or death that could
occur to the fetus infected by vagi–
nal birth.
Sorne obstctricians per form C–
sections to avoid possible malprac–
ticc suits arising from the delivery
of imperfect infants, although suits
are also filed against them for per–
forming cesareans.
Whether physicians' motivation
for this alarming increase in surgí–
cal delivery of children in the U.S.
is primarily humanitarian or eco–
nomical is dcbatable. ln somc states
the cost is almost double for thc
cesarean delivery.
Who performs cesarean dcliver–
ies? According to a report in
The
New England Journal of Medicine,
obstctricians more than nonobstetri–
cians such as general practitioners.
Where? Larger hospitals, which
havc had greater increases more
quickly in the rate of cesarean
births.
Parents·to-Be React
Back in the 1960s and 1970s more
and more expcctant parents began
Obstetrics is big business for physi–
cians and hospitals in the United
S tates.
Childbirth is the single most com–
mon reason Americans go to hospi–
tals. Of the 38.5 mi Ilion patients dis–
charged from short hospital stays in
1981, 3.9 million- morc than
JO
percent of the total- werc women
who checked into hospitals to deliver
children, according toa report by the
National Center for Health Statis–
tics.
After recording birth statistics, Ela ine
returns Ryan to his motber.
Next highest in the rate of
increase is repeat cesarean
births. Unlike other parts of the
world, in the United States the
great majority of women who
have had C-sections will have
one again if they choose to
become pregnant.
The rcport, by Edmund Graves
and Barbara Haupt of the agency's
Division of Health Care Statistics,
was based on data involvi ng
patients discharged from 550 hos–
pitals nationwide.
Adding to the obstetrical activity
in hospitals today has bccn the phe–
nomenal increase in thc surgical
delivery of newborns. In the past
September 1984
Twenty ycars ago, only a small
percentage of breech births were
by abdominal delivery. Now,
most breech births are cesarcan.
Surgical intcrvcntion for rea–
sons of fetal distrcss is thc fourth
major reason for the increasc in
the use of the cesarean birth. The
question is whether fetal distress
is better reeognized by electronic
fetal monitoring or wbether fetal
distress is being overdiagnosed.
Yet Ot her Reasons
Studies show that for at least 30