Why choose a C-section?

Hudson Valley OBs weigh in on this hot issue

Things to do today:

9 am: hair appointment

11am: pregnancy yoga class

Noon: Have baby!


Cesarean births used to be an option for pregnant women only if something went wrong during pregnancy or delivery. Not anymore. C-section births are at an all-time high in this country, accounting for more than 30 percent of all births. This is roughly 3 in 10 women, some choosing this surgical procedure when it’s not medically necessary.


Why the rise in elective C-sections? Some women want the convenience of a scheduled birth due to their busy work schedules; this allows them to work up until the baby’s birth. With a scheduled C-section, mothers know when and how long to take off from work and get help from their relatives and friends, and they are ensured that their preferred physician will be present at time of the delivery.


Some women have a fear of pain. They fear they will be unable to deliver vaginally, and do not want to experience a prolonged labor and delivery. Some women fear they may suffer incontinence or other bladder problems after delivering a baby vaginally, although there is no substantiating evidence of this occurring after a natural delivery.


“There are multiple reasons,” says James Shanahan, MD, of Community OB/GYN Associates in Warwick. “Convenience is part of it, but it’s not the main reason. We live in an era where there is zero tolerance for any mishap. There is a fear of having a complication during vaginal birth, which is rare. Many women are fearful of the vaginal birth process, or even slightest hint of a difficult birth.


“There are a large number of women who say ‘I just don’t want to have labor’,” he adds. “And there are a large number of women who begin the labor process and decide it’s not for them.”


Doctors are also seeing a larger number of older and heavier women giving birth now than in the past 20 years, prompting physicians to schedule an elective C-section.


Lewis Broslovsky, MD, director of the obstetrics/gynecology department at Crystal Run Healthcare in Middletown, offers other reasons for the increase. “We have better recognition of fetal distress, larger babies and moms gaining more weight, less tolerance for a prolonged labor that doesn’t progress in a normal fashion, as well as more multiple births due to infertility and assisted reproduction.”


Dr. Shanahan says that the fear of a complication isn’t necessarily felt just by moms. Doctors deal with these fears as well.


“All obstetricians practicing in 2008 are caught in a conundrum,” says Shanahan. “They were trained at a time when they were taught that the safest way and the most natural way is a vaginal birth, and the literature bears that out. Most obstetricians feel that this is true. However, they are also aware that there is zero tolerance for an adverse outcome, so they tend to intervene at any sign of complication.”