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A C-section Baby Boom

Why Cesarean Delivery
Is on the Rise

By Alexandria Powell

According to Dr. Moritz, one of the reasons the Cesarean rate is rising is that the rate of higher-risk births is also climbing. He notes a rise in multiple births due to the increasingly common use of fertility treatments, an increase in the numbers of older first-time moms and rising obesity rates (being overweight increases the chance a woman will need a Cesarean) as three factors that have had an impact.

However, in a small but growing number of cases, women are actually choosing Cesarean delivery over vaginal birth. According to Dr. Elliot Philipson, head of Maternal-Fetal Medicine at the Cleveland Clinic, some of this is related to convenience. It is easier to plan for time away from the office or arrange childcare for older children when you know the exact date and time of your delivery. Women are also concerned by reports suggesting vaginal deliveries can lead to loss of bladder and rectal function later in life, Dr. Philipson adds.

"Women have also become much less tolerant of taking any risk to the baby to decrease the chance of having a C-section," says Dr. Moritz. "For example, when given the choice of using forceps to pull the baby out, which is a relatively low-risk thing, or having a C-section – which offers almost no risk to the baby but does pose some risks for the mother – they will choose the C-section."

But new mothers aren't the only ones concerned about risks. The United States is in the middle of a very real crisis when it comes to medical liability issues. "The medical legal issue is huge," says Mavis Schorn, director of the nurse-midwifery program at Vanderbilt University in Nashville, Tenn. "It's not everything, but I think that if there is any doubt, any question [about how a woman's labor is going or will go], providers are much more prone to just say, 'Let's do the [C-] section.'"

"There are OB/GYNs who spend $250,000 a year just for permission through their insurance coverageto practice," says Brad Imler, president of the American Pregnancy Association, a national health organization committed to promoting reproductive and pregnancy wellness. "If it was easier for an obstetrician to practice and do what he or she believes, then I do think fewer would elect for the Cesarean."

Want to see more?

• Obesity and C-sections: Is There a Link Between the Two?
• A Guide to C-section Births: What Dads Need to Know
• Bottoms Up: Dealing With Breech Babies
• Talk about it!