My wife and I have two marvelous kids. The doctor early on was pushing us to have our children C-section, though we were very adamant about going through natural birth. It turns out that our little one had stress and the ideas were tossed out the window. After reading various news accounts of the steep rise in the use of the c-section procedure, I have to wonder if the doctor knew he would do this fro mday one and invented a good reason for it, knowing we wouldn't be in the frame of mind to question him. Not only that, but some hospitals around the country will not allow any procedure besides a c-section if a mother has previously undergone the same procedure according to other news accounts.

Questions for debate:

1.)Why is there a steep rise in the use of c-sections?

2.)Should patients have a "bill of rights" in forcing their doctors to only operate according to an individualized treatment plan?

3.)Is this a temporary trend or a permanent one?

1.)Why is there a steep rise in the use of c-sections?

Unlike natural childbirth, which gives a great deal of control to the mother and to midwives, Caesarean deliveries gives total control to medical and surgical staff. Very little can go wrong with it unexpectedly, so very few malpractice suits can arise from it - compared to vaginal deliveries, anyway, with their risks of tears, epesiotomies, bladder problems, sexual dysfunctions, etc.

2.)Should patients have a "bill of rights" in forcing their doctors to only operate according to an individualized treatment plan?
Not in childbirth. Parental preferences should be followed as a priority, but not once it becomes clear that real (rather than potential) risks to baby or mother come into play. Even an apparently straightforward birth can go awry, so C-section should always be available as a last resort.
In medicine generally, patient preferences should be taken into account rather than ignored, and should be factored into the decision making process of treatment professionals. However, this should not be at the expense of effective treatment itself. Here, I'm particularly thinking of the use of "alternative therapies" (i.e. more expensive placebos) instead of conventional medicine.

"As well as" is fine, especially if conventional medicine has been tried and has failed. But instead of is only one step up from doing nothing, and the "do no harm" that rules conventional medicine (but none of the New Agers) prevents this from being tenable.

3.)Is this a temporary trend or a permanent one?
It won't change unless the public becomes a great deal less litigious and sues the medical profession over pre-existing and innate risks of any given procedure, rather than straightforward malpractice.

1.)Why is there a steep rise in the use of c-sections?

One reason is likely a corresponding rise in older mothers. Once a woman reaches the age of 35 she is deemed to of "advanced maternal age" ()...hurt feelings aside, the medical community gets pretty skitish after that number is reached. Extra tests, more cesaereans, less control for the mother. My neighbor actually had her third child at hom with a doula become she didn't want the medical tampering. It was a perfect, trouble-free delivery. Of course, not everyone is that lucky.

Another aspect, as Jules mentioned, is "control" over the birth procedure and probably potential litigation issues as well. If anything goes wrong with the delivery that a cesarean might have avoided, the doctor and staff will likely be sued.

2.)Should patients have a "bill of rights" in forcing their doctors to only operate according to an individualized treatment plan?

I agree with Jules here, too. The parent isn't necessarily in the position to know what is best during the delivery process, and so many things can go wrong. That's what the doctor is being paid to do. Of course, good communication and a good relationship with a doctor who respects the patient's wishes is important, so a patient could hopefully have some influence that way. By changing doctors if possible, for example. I know my two deliveries were entirely different. The first one, with a midwife I had seen throughout the pregnancy, was wonderful. The second one, with an old-school doctor I had never met before that day, was awful. Such maternal stress can lead to problems that require c-section.

3.)Is this a temporary trend or a permanent one?

An increase in the use of midwives over doctors, doulas and home deliveries would impact that figure. I think this is much more common in Europe where the number of c sections, not coincidentally, is much lower than ours.

1.)Why is there a steep rise in the use of c-sections

C-sections have been very trendy lately. In Hollywood, women, like Britney Spears, have said long before their due dates that they will be delivering via C-Section even though there is no health reason for the mother or baby to have the C-Section.

I think that reality TV shows, like A Baby Story, that show women giving birth have made women too scared of the pain of giving birth naturally. Even though it is not natural and, some say, not as healthy for the baby or mother, many women still just want to avoid the whole vaginal birth process.

2.)Should patients have a "bill of rights" in forcing their doctors to only operate according to an individualized treatment plan?

I think that women should ONLY be allowed to have a C-Section if it is absolutely necessary for health and safety reasons.

3.)Is this a temporary trend or a permanent one?

I truly hope it is only temporary.

1.)Why is there a steep rise in the use of c-sections?

Because doctors these days need to add a bit extra to the bill in order to make even MORE money, at least that is my theory.

2.)Should patients have a "bill of rights" in forcing their doctors to only operate according to an individualized treatment plan?

Yes they should, and if I ever get to Congress, that will be one of my first acts.

3.)Is this a temporary trend or a permanent one?

Who knows, the medical "experts" change their opinions so often.

Hasn't anyone heard the expression "there are no minor surgeries"?

I think in theory Julian is correct. Doctors feel they are in control. They may feel that C sections are safer (but I'd hate to think anyone thinks that being born is just too dangerous to do by nature's method ).

In practice, I think Centurion hits closer to the mark: it costs more AND it allows the hospital to properly schedule the birth. Higher cost (read: higher margin) plus the revolving door of a 2-day guaranteed stay in the hospital.

Both of these feed into another aspect: fear of lawsuits.

According to this article, C section deliveries lead to increased risks :



The only increased risks from vaginal births are incontinence.

The article also details the costs:


Anyone want to hazard a guess why health care costs are exploding in this country?