Elective Cesarean: Babies On Demand
C-Sections are on the rise and moms are getting blamed, but is it really the woman's fault?
One look at People Magazine or Entertainment Tonight, and
you might think the old-fashioned labor and delivery way to birth a baby has
gone the route of the horse and buggy.
In its place: The mother-requested cesarean, or C-section, delivery -- the
fast, high-tech, hip celebrity way to have a child.
Or so, a popular theory goes.
"There's no doubt in my mind that the current interest in elective
cesarean births has been ignited by the fact that in our in pop culture many
celebrity deliveries have been elected cesareans," says Manuel Porto, MD,
chairman of the department of obstetrics and gynecology at the University of
Indeed, from media reports on the pregnancies of rock stars like Madonna,
Victoria Beckham, and Britney Spears, to actresses like Gwyneth Paltrow, Kate
Hudson, Patricia Heaton, and Elizabeth Hurley -- not to mention a gaggle of
super models in between -- the C-section appears to be the "it"
activity of the decade.
Despite health risks for both baby and mom -- including a life-threatening
uterine rupture for women and a greater risk of stillbirth for baby --
C-section deliveries are rising. According to the National Institutes of
Health, the current rate is 29.1% -- up some 40% between 1996 and 2004.
But who is really responsible for the rise? Not everyone is ready to blame
the lady on the table.
Some suspect the guy wielding the scalpel. After all, the word
"elective" simply means there is no medical justification -- it doesn't
specify who made the request.
True, in celebrity-conscious New York City, some doctors say women are at
least partly to blame.
"I have definitely seen an increase in C-section requests, even when
there is no real medical justification behind it," says Ashley Roman, MD, a
maternal fetal medicine specialist at NYU Medical Center in New York.
Her patients don't necessarily want to mimic celebrity life. They frequently
cite other reasons -- particularly a reduced risk of incontinence and an
easier, less painful birth, though she says medical literature is scant in
support of either.
But organizations like Childbirth Connection argue this doesn't reflect the
attitudes of women nationwide. Their surveys show less than 0.08% of pregnant
women request a C-section.
"From our research we can say for sure that it is not mothers who are
causing the elective C-section rate to rise," says Maureen Corry, executive
director of ChildbirthConnection.org.
What Mothers Say
Indeed, when you look beyond the glitter of the Hollywood delivery and into
the nurseries of working class America, a very different picture emerges.
"Some of the increase in elective cesareans is due to mother request,
but I personally believe that group is a very small, very affluent subset of
women and does not represent the desires or needs of most mothers," says
Peter Bernstein, MD, MPH, a maternal-fetal medicine specialist at Montefiore
Medical Center in the Bronx.