What the rest of the country can learn from Utah's low C-section birthrate

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  • Jacob Zonts Pleasant Grove, UT
    July 19, 2018 9:21 a.m.

    WHO published a statement on caesarean section rates in Apri 2015 (5 years after Anonyme - Orem, UT suggests WHO withdrew their recommendation) which states:

    "Since 1985, the international healthcare community has considered the ideal rate for caesarean sections to be between 10-15%. Since then, caesarean sections have become increasingly common in both developed and developing countries. When medically necessary, a caesarean section can effectively prevent maternal and newborn mortality. Two new HRP studies show that when caesarean section rates rise towards 10% across a population, the number of maternal and newborn deaths decreases. When the rate goes above 10%, there is no evidence that mortality rates improve."

    The last sentence of the statement is most enlightening. It states that there is no marked implovement of mortality rates after 10%. This would suggest that anything above a 10% rate of caesarean sections are not necessary and the mother and baby would have been fine if they wouldn't have had the procedure. The US is definitely over prescribing C-sections.

    This article is well written and gives actions that can be taken to reduce risk at childbirth.

  • Anonyme Orem, UT
    July 5, 2017 10:18 p.m.

    Jennifer Graham makes inaccurate claims in this article. She says “The World Health Organization sets that rate at between 10 and 15 percent.” In fact, in 2010 the WHO officially withdrew that recommendation, saying “there is no empirical evidence for an optimum percentage" and “what matters most is that all women who need Caesarean sections receive them.”

    Graham relies on Theresa Morris for much of her information. But Morris is a sociology professor, not a medical scientist. Morris says induction increases the risk of c-section. Scientific evidence to the contrary is so great that ACOG now says there is “either no difference or a decreased risk of cesarean delivery among women who are induced.”

    For her claim about microbiota, she cites a study with “Hypothesis” in the title. That should be a clue that there is no scientific consensus about any immune-boosting properties of vaginal birth. There are other similar unfounded statements in the article.

    Our goal shouldn’t be to reduce cesareans to an arbitrary number; it should be to reduce maternal and newborn mortality. C-sections are safer for babies than vaginal birth. It's time to stop vilifying cesareans.

  • Laura Bilington Maple Valley, WA
    July 1, 2017 8:24 a.m.

    "Some women and their doctors want C-sections for the convenience of being able to schedule the birth. The American College of Obstetricians and Gynecologists estimates that about 3 percent of births in the U.S. are C-sections requested by the mother with no medical cause."

    No ethical doctor would agree to do a C section on a patient with no medical cause, no matter how earnestly she pleads for one. And no woman who has had a vaginal birth and a C section is going to request another C section. A C section is major surgery. It also more lucrative (and certainly more convenient) for the doctor. Yes, unneccessary C sections happen every day (but far less often on holiday weekends..). But the "cause" is the doctor's preference, even if s/he claims that the patient requested it.

    Some hospitals require C sections if the woman's water has broken and labor hasn't started within 24 hours. The excuse given is that the chance of infection is high if this is the case. But this is only true if the woman has had a vaginal exam after the break--if the exam was rectal, there is no risk of infection.

  • AZgrandma Pomerene, AZ
    June 30, 2017 9:43 p.m.

    My first child was a vaginal birth and over 8#. Second child was breech and bigger (9#) so C-section. For third child tried a V-BAC (vaginal birth after caesarian) but my body refused to co-operate after 20 hrs hard labor even with pitocin administered so another C-Sec. Due to possible complications of attempting another natural birth, children 4-6 were also C-Sec. With those 3, I never went into labor. Now in their 30s, my natural birth daughter is 5'10" and overweight and of my 5 c-section children, my four sons are 6'3" and appropriate weight as is my youngest 5'6" daughter. And none of them have had any respiratory problems.