C-Sections: Necessity or Choice Issue?
More Women Opt for Surgery; Some Experts Say it's a Woman's Right
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He calls a government push to lower the C-section rate to 15% nationwide "irresponsible" and says it is unethical to fail to offer cesarean sections to women who are at high risk for having them anyway.
"A good example is a woman who is shorter than 5'2", is having her first baby, is a week past her due date, and her cervix is firm," he says. "If the baby is around 8 pounds, she probably has at least a 50% chance of ending up with a C-section. Ethically, she should be offered a C-section at the outset. If she ends up having one after a long labor, which is very likely, it is much more dangerous."
He says women have not been told about the potential long-term consequences of vaginal birth, including urinary incontinence and loss of vaginal muscle tone, which could interfere with sexual satisfaction. And those who try to have a vaginal delivery after a C-section birth have a slightly higher risk of uterine rupture, research shows.
The obvious downside to cesarean deliveries is a longer recovery time for the mother -- roughly two weeks without complications, compared with a day or so for uncomplicated vaginal deliveries.
"There is no scientific data that supports one method of delivery unequivocally over another," he says. "Women should be told about the advantages and disadvantages of both, and should be trusted to make the right decision for them."