Women Choose Elective C-Sections Due to Fear
I’ve sometimes wondered what it is that makes a woman decide that she wants to deliver her baby by c-section before she ever even goes into labor. After having three very different deliveries myself (vacuum assisted, urgent c-section, and a VBAC), I really couldn’t figure out what the motivating factor was. Don’t get me wrong, I’m the first to admit that there are pluses and minuses to any type of childbirth. I just couldn’t figure out what would make major abdominal surgery more appealing to someone who’s never had a baby before.
For a long time, I think most people thought that women who elected for a scheduled c-section without any real medical indication were doing so for their own convenience, or just because they were too posh for all the hard sweaty work pushing a baby out usually entails. As it turns out, the real reason many women opt for a c-section is plain old fear.
This new information comes from recent study in Sweden, which surveyed women who had decided to deliver via elective c-section, a c-section for breech presentation, or via a normal vaginal delivery. The two part survey looked at negative expectations about delivery, and then went back to check with women in the vaginal delivery group to see if the had ended up with a successful vaginal delivery, or if they had needed an intervention like forceps or an emergency c-section.
The study has some limitations, including the fact that it only looked at women in Sweden, and fewer than half the women involved returned both surveys. However, it’s interesting that women who reported high levels of fear about delivery were less likely to have taken a child birth class.
The main thing I was afraid of when it came to child birth was pain, and with the availability of epidurals, having an incision in my belly while I was awake didn’t rank very high on my list of ways to avoid pain! What do you think? If given the chance, would you opt for an elective c-section over a vaginal delivery?
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February 10th, 2008 at 5:49 pm
Heck No! Everybody has to make their own decisions with their Drs, but I really think c-sections should only be performed if there is a real medical reason for it. I’ve read that vaginal deliveries are best both for mom and baby. I had my son vaginally with no drugs. I did a lot of research in advance and chose to try for a drug free birth. Of, course I had no idea what would happen since I never had a baby before, but thankfully I was able to do it. In large part b/c I delivered at a birth center with a philosophy of no drugs, let the mom move around, not being hooked up to a fetal heart monitor constantly (they used the dopler thing that they put up against your belly) etc. I almost did end up with a c-section though. Three weeks before I had my son we found out that he flipped from head down to a breech position. I had an external version done (where the Dr. pushes the baby back into position by pushing on your belly) and they were able to get him back to head down. If they hadn’t been able to flip him, I would have had a c-section. My Dr didn’t do vaginal delivery for breech babies.
I found Naomi Wolfe’s book, Misconceptions, to be a great introduction to all things pregnancy and childbirth (the realistic side, not the hearts and flowers and everything is wonderful side). She does a great job covering the topic of increased number of c-sections in the US.
There was a post on this topic on the WSJ work and family blog called “The Juggle” a few weeks ago. The comments were very diverse - everything from absolutely have an elective c-section, to no way it is terrible idea.
February 10th, 2008 at 6:50 pm
I agree with you about people needing to work this out together with their doctors. It still boggles my mind that people think an elective c-section sounds great! I was so disappointed when I ended up in the hospital with #2, knowing that she was breach and would almost certainly arrive too early to make a version an option for us.
Thanks for the book recommendation. I’ll have to look for it the next time I haul the brood to the library. I read a really great memoir of a midwife’s life (I’ll try to dig up the title) while I was pregnant with #3, and it inspired me to really think and learn more about natural child birth. Of course, I woke up in such intense pain when I went into labor with him that I thought my insides were being ripped out, and I ended up getting an epidural again because I ran out of coping mechanisms before I ever even got to the hospital.
February 11th, 2008 at 6:32 pm
Some people do not elect to do c-sections. They are pushed into it and it is their only option. I had my first two sons vaginally over a decade ago, my second son was a breeze and had me believing that if I ever had children again it would be natural.
My third son born nine years later was breech and this was not discovered until I was pushing and nothing happened. He was an emergency c-section. My next two children were c-sections as well. Not because I chose a c-section, the hospital in my county does not allow v-bac because of insurance reasons. I could have driven over an hour away and given birth in the city, without my regular ob and far from my children and visitors. My last c-section went well- it was an emergency c-section. My son was an “accident,” I was breast feeding and on the mini pill and yet he came along. We had no dates to go by. The start of my labor I had severe chest pains, and was rushed to the emergency room. It’s rare but cardiac problems are sometimes the start of labor- especially for older Mom’s such as myself. Whatever the motivation, c-sections were the best choice for me and my living children.
February 11th, 2008 at 8:21 pm
That’s a good point Michelle. I had a bit of a battle over my VBAC with the OB that supervised my midwife’s practice. He decided that since I’d had a preemie, he didn’t believe that I’d had a true low transverse c-section. Once I finally got him to read all my records, my choice won out.
Unfortunately, there are a variety of reasons why some hospitals don’t allow VBACS, whether it’s a malpractice or liability insurance issue, a staffing issue, or whatever. It doesn’t really sound like you had much of a choice when the other option would have forced you to drive so far, while in labor. I’m glad that your babies made it into the world safely!