According to a U.S. health officials report, the rate of delivery by cesarean section in the United States has finally stabilized after more than a decade of steadily rising.
In 1996, 21 percent of births were by C-section. In 2009, the rate rose to 33 percent. Two years later, in 2011, the figures leveled off at about 31 percent, according to the U.S. Centers for Disease Control and Prevention (CDC).
Still, that means nearly one in three live deliveries are by C-section, which is “way higher than it should be,” according to Dr. Mitchell Maiman, the obstetrics and gynecology chairman at Staten Island University Hospital in New York.
C-sections became increasingly commonplace between 1996 and 2009 for a few reasons. First, it was convenient for doctors and mothers-to-be to schedule a delivery date. It also provided a chance for mothers to avoid the potential complications of a vaginal delivery. Dr. Maiman also points out that women were uninformed about the benefits of traditional vaginal delivery during those years.
One reason that C-section rates are holding today is the altered guidelines from the American College of Obstetricians and Gynecologists regarding elective surgical deliveries. The new guidelines discourage mothers from having C-sections before 39 weeks unless there’s a serious medical need. Dr. Maiman and his staff have followed these guidelines for more than 15 years, and the C-section rate at Staten Island University Hospital is 22 percent, well below the average figures reported by the CDC.
While the overall number of C-sections has leveled off, the rate is different depending on gestation length. At 38 weeks, cesarean delivery decreases by 5 percent, while at 39 weeks, it increases by 4 percent.
Michelle Osterman, lead author of the study and a health statistician at CDC’s National Center for Health Statistics, says she can’t explain the rate increase at 39 weeks. She’s also unable to predict whether the rate of delivery by cesarean will continue to hold.
Having more than one C-section significantly increases the risk of complications and death for the mother. That’s why many doctors today encourage women who have had one C-section to consider a traditional vaginal birth if they have another child.
Babies are at risk from cesarean births as well. Many C-sections are performed at or before 38 weeks, which is considered early term. Full-term babies born 39 to 41 weeks have more developmental advantages over babies born at 37 to 38 weeks, by cesarean or otherwise. Any prematurity presents risk to the baby, such as breathing, feeding, and body temperature problems. C-sections are also associated with higher asthma rates and a greater risk of obesity for the child.
If you’re concerned about the risks of having a C-section, maintain close, honest communication with your doctor to pinpoint a plan A and plan B when delivery day arrives.
