I read an article about a woman who chose to have a cesarean because she was afraid she'd have to have an emergency cesarean after being in labor. She acknowledged that it was rare (I wish it truly were) but said she "didn't want to deal with it." (Chung, http://www.time.com/time/magazine/article/0,9171,1731904,00.html) An interesting side note to this story is that the woman is a psychiatrist. This may just show that birth remains a very emotional issue.

The article goes on to say that she was able to get her cesarean on demand and that it was "without any complications." (Really? No pain? No long recovery period? Does she know how many adhesions she'll have later?) The article called this "a tidy way" to deal with "messy ...childbirth." I guess to counterbalance this seeming bias on the part of the author, it goes on to say, "A panel of experts convened by the National Institute on Child Health and Development in 2006 stresses that [moms-who-have-their-babies-inside] need more scientific data that directly weighs the benefits and risks of both delivery methods." But, the author doesn't point out that elective cesareans can raise the risk of neonatal mortality or maternal mortality, only that it can cause babies to "suffer from respiratory problems..." and that moms may have pelvic damage and incontinence. (Did you catch that word "suffer" and do you remember that women who've never been pregnant can have the same problems?)

The article ends with saying that maybe our thoughts around birth will change and allow women to not feel so defensive about elective cesareans.

In our culture, we have mandatory child restraint laws in every state because we don't want little children to die when it can be prevented. That's the purported reason for such high cesarean rates, too. In 2004, 451 children age 4 and under were saved because of child restraints (NHTSA). Yet, elective cesareans raise the neonatal mortality rate from 0.62 per 1,000 vaginal births to 1.77 per 1,000 births. We have about 4 million births a year. The stated cesarean rate nationwide is 30%+; I'm not sure what the elective rate is. As you can see from the above article, this is usually kept quiet. Think about it. How many babies died just because they weren't born vaginally? And how many moms died because of their cesarean? Our maternal mortality rate is RISING, as is our cesarean rate. I think these are some of the risks moms should know before they make their decision for an elective cesarean.

My heart goes out to women who are afraid of labor. I so wish we could give them the information to help them have the birth they really want. I so wish we could show them that this huge cesarean rate doesn’t have to be so. That’s why we need more midwives and why we need to keep talking about this issue.