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Health & Pregnancy

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Elective Cesarean: Babies On Demand

C-Sections are on the rise and moms are getting blamed, but is it really the woman's fault?

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.

In fact, in two surveys aptly titled, "Listening to Mothers," Childbirth Connection says they found that the numbers prove this is so.

Referring to the group's latest survey, released in March 2006, Corry says, "Despite some professional and mass media discourse about 'maternal request' or 'patient demand' cesarean ... just one woman (0.08%) among 1,315 survey participants who might have initiated a planned primary cesarean ... did so."

According to the report, of 252 survey participants who had a primary, or first birth, cesarean, only one woman (0.4%) initiated it.

Applying these numbers to the most recent figure for annual births, Corry estimates a scant 2,600 out of 4.1 million pregnant women actually requested a C-section.

Moreover, while in March 2006, the National Institutes of Health held a state-of-the-science conference entitled "Cesarean Delivery on Maternal Request" to address the issue of rising C-section births, officials were not able to pin the rise on moms, according to Corry.

"They failed to report a single study citing the extent to which American women are initiating C-sections and revealed only 'limited evidence' suggesting that mother-requested cesarean deliveries are what are spiking the rise," says Corry.

She says many women are curious enough about a C-section to question their doctors, but, she adds, "being curious and requesting a C-section are two very different things."

So if mothers aren't responsible for the burgeoning C-section trend, who is?

An alternative answer, Bernstein says, can be found in the medical-legal climate pervading every labor and delivery floor.

The Labor Room: Who's Really Pushing?

In the not so distant past, the drive to reduce cesarean deliveries caused hospitals in many states to require the signature of two obstetricians before this surgery could be performed.

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