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Study Shows Steep Rise in Elective C-Sections

Trend Most Prevalent Among Older, First-Time Moms

Sea Change in Attitudes continued...

"It could be that the waning popularity of VBACs has led to a rethinking of cesarean delivery for (first-time) births," he says.

New York obg-yn Howard Minkoff, MD, says doctors are struggling with how to best counsel their patients about elective C-sections. In an effort to help them do this, a government-sponsored conference is planned for sometime next year, he says, to "try to come up with some sort of consensus about the appropriateness of this trend."

Those who favor choice say C-sections are far less risky than they were even a decade ago and that the evidence suggests women who have them have a lower risk of urinary incontinence and other pelvic issues as they age. Minkoff counters that there is growing evidence that surgical delivery increases the risk of stillbirth and other problems in later pregnancies.

In a New England Journal of Medicine editorial published last year, Minkoff wrote that the evidence still favors vaginal deliveries over elective C-sections for uncomplicated labor. But he added that women who are informed about both procedures should be allowed to make up their own minds about their method of delivery.

"Elective C-section certainly shouldn't be routinely recommended," he tells WebMD. "But it also wouldn't be unethical to accede to the wishes of a woman who wants one if she has educated herself on the issue."

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