Limited Training, Obesity Epidemic Causes High C-Section Rates in First-Time Moms

With my first pregnancy, I tried to do everything right. I ate fresh fruits and vegetables, exercised as regularly as my nausea would allow and I planned for a natural birth.

But all of my careful planning and best efforts couldn’t stop me from developing Preeclampsia, a condition that produces dangerously high blood pressures.

Going into my weekly appointment in my thirty-fifth week of pregnancy I thought, OK, I’ll go in, they’ll tell me everything’s great and I’ll be home with my feet up in no time.

The next thing I knew I was being wheeled into labor and delivery with the words of the doctor rolling around in my head. Pre-term baby. Birth defects. Stroke. Surgery.

When my blood pressure wouldn’t succumb to all of modern technology’s advances and my baby refused to come out, there was only one option left. The option I had worked so hard to avoid—a Cesarean section.

Lying on the operating table, waiting for the doctors to pull my baby out from behind the large blue curtain like a trick in a magic act, I couldn’t imagine why anyone would choose to have a C-section.

But that is exactly what more and more women are doing.

According to a new study published by the American Journal of Obstetrics & Gynecology, one in three first-time moms are having C-sections.

“The interesting thing is that there has been an increase in the number of C-sections in the last ten years,” said Scott & White gynecologist, Russell E. Fothergill, M.D.

And there are four main reasons why this has become a trend over the past decade.

Obesity

“As you know, there’s an obesity epidemic in our country,” Dr. Fothergill said. “When you have an obese pregnant woman, she is an independent risk. If she is a Class 3 obese person, meaning she is morbidly obese, than she is 50 percent more likely to have a C-section.”

Limited Training

Doctors and medical staff aren’t trained or don’t feel comfortable doing operative vaginal deliveries—using forceps and vacuums.

“Because they lack the training or practice with these techniques, there’s greater fear of the effects of this type of delivery,” he said. “And some doctor’s don’t want the liability.”

Special Requests

Some mothers come into their first doctor’s visit and ask that their delivery be a scheduled C-section. It is called an elective primary C-section and it is recognized by the American College of Obstetrics.

“Women choose this for a variety of reasons including fear of having a baby vaginally or concern of physical damage to the pelvic floor,” Dr. Fothergill said.

These requests also seem to be more popular in the north east and on the west coast, but have become an increasing trend everywhere.

Inductions

“We are seeing the number of inductions increase,” he said. “They may be considered convenient, but they increase the risk of C-section, especially when the mother is induced with her first baby.”

In general, the thought is that there are more risks of adverse effects with a vaginal birth, leaving many physicians to practice defensively.

But Dr. Fothergill said the biggest risk is the surgical route.

“Their risk of infection and damage to the internal organs is much higher with a C-section than with a natural birth,” he said.

But the gynecologist says there are ways to help prevent a C-section and avoid the risks.

“Have a normal pre-pregnancy weight,” he said. “See a doctor before you get pregnant and see if you have any pre-existing conditions like hypertension or diabetes. During your pregnancy, maintain an appropriate weight and have an ongoing dialogue with your doctor about the pros and cons of a C-section.”

And don’t rush the birthing process. If your baby’s taking a little longer to make his or her way into the world, try to give your new little one time to get there. It is safer and more efficient, Dr. Fothergill said.

But if you’re like me and you’ve already become a member of the C-section sisterhood, than there’s always hope for the next birth in the form of a VBAC, or vaginal birth after C-section.

“If you’re the right candidate, a VBAC has a lower rate of complication than a repeat C-section,” the doctor said.

While many hospitals around the country have a lower rate of VBACs and a higher rate of C-sections and inductions, Scott & White does its best to provide medical technology and trained staff to help keep their rates down.

“The rate of C-section in the country is about 33 percent and our hospital’s rate is between 24 and 26 percent,” Dr. Fothergill said. “We’ve had a good success rate with VBACs and with operative deliveries.”

About the author

Jessa McClure
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Jessa McClure holds a degree in journalism and mass communication from the University of Mary Hardin-Baylor in Belton, TX, where she is currently an adviser for student publications. She has been a writer in the health care field since 2009.

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Limited Training, Obesity Epidemic Causes High C-Section Rates in First-Time Moms