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Are doctors performing too many cesareans?

A birth of any child is an amazing event. But even the most routine pregnancies carry a risk. In pregnancies where the risks become too high for a vaginal birth to proceed, a cesarean procedure will be ordered. This makes medical sense, and you presume your doctor will keep a careful watch on you and your baby's condition. If your doctor informs you that you need a cesarean, you will assume it is because of some type of medical necessity.

But in the U.S., cesarean rates have been increasing in recent years. The troubling element to this increase is that there does not appear to be any increase in either mothers' or babies' health. If the increase were being driven by medical necessity, you would expect to see improvements in other health outcomes.

The reasons for the high rate in the U.S. varies, but the use of cesarean delivery in a third of all births appears too high according to one doctor. In some cases, it appears to be done often because that is "standard practice." A cesarean, in addition to the inherent risks of any surgery, presents other risks. It can affect whether the mother will be able to have a natural childbirth with subsequent pregnancies.

Clearly, cesarean procedures should be used when the standard of care indicates. That standard, however, should be based upon medical evidence of what produces the best outcome for the mother and the baby, and if evidence indicates practices need to change, such changes should be required of all doctors.

Source: contemporaryobjyn.modenmedicine.com, "The cesarean epidemic: Are we too quick to cut?" Aaron B Caughey, MD, PhD, April 01, 2016

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