Cesarean section over a vaginal delivery
Gas And Cesarean Operations At Record Highs
By Dr. Gifford JonesNot only is the price of gas rocketing to high levels. A recent report by the Society of Obstetricians and Gynecologists of Canada (SOGC) says that 26.3 percent of women now have babies delivered by Cesarean section. There are many different opinions of why this has happened in both Canada and the U.S. But William Shakespeare had the ultimate explanation.
Not just North America has seen this increase. In Hong Kong the Cesarean rate is 27 percent and in Brazil 32 percent. And the rate in some private clinics in Brazil is an astounding 75 percent! These are hefty figures when the World Health Organization claims that a rate of over 15 percent is questionable.
Years ago it would have been utter madness to perform a Cesarean operation unless there were life-threatening complications. Many women would have died from uncontrollable bleeding and post-operative infection.
I speculated years ago that the Cesarean rate would increase. Women in North America were starting to request Cesarean deliveries. Other women in Thailand were asking for Cesareans on a lucky day such as the birthday of their revered Queen or on Valentine’s Day. And in China, some women wanted a child to be born at the Chinese New Year. This is a dangerous game to play as the lucky day may be a lethal day for the baby.
So what are the reasons for and against either natural or Cesarean delivery? You need the Wisdom of Solomon to reach a final conclusion. But there are several vital points to consider. Most doctors still claim that the natural delivery is the best way to deliver a baby unless there’s an obstetrical complication. Natural birth, however, can leave a trail of woe. It’s illogical to expect an eight pound baby to pass through a narrow canal without causing some vaginal stress.
Tissues supporting the bladder are sometimes stretched beyond their limits. The resulting falling down of the bladder causes a loss of urine on coughing or sneezing. And if rectal muscles have been seriously injured, fecal loss can occur. These are very discomforting problems and explain why several years ago a survey of female obstetricians in London, England, showed that one-third would personally prefer a Cesarean section over a vaginal delivery.
The Cesarean can prevent these problems. Moreover, due to today’s improved surgical techniques, better anesthesia and antibiotics, fewer surgical complications result. But this operation requires longer hospital stays, greater expense and there’s always the chance of infection, and even unexpected death.
A study at the University of Toronto revealed that of 100,000 women having an elective Cesarean, six women will die compared to two women who have a vaginal delivery. But of 100,000 women who require surgery to repair an injured bladder or bowel following a vaginal delivery, some will also die. This fact is often forgotten.
The SOGC is currently exploring options to decrease the number of Cesareans such as educating doctors and women on the benefits of vaginal delivery. But I believe they face an impossible task.
Today more women are working and want to time the date of delivery by choosing a Cesarean. There are also an increasing number of obese women resulting in diabetes, hypertension and kidney disease. Others are deciding on having pregnancies later in life. All result in more complicated pregnancies requiring surgery.
But the major problem is the doctor’s fear of litigation. If a baby is born with an abnormality, too many patients immediately conclude it’s the doctor’s fault. Unfortunately, too many lawyers agree with them bringing questionable law suits against doctors and hospitals when what’s happened is often “an act of God”. No doctor chooses to endure this legal stress when the Cesarean operation might avoid calamity.
So unless William Shakespeare gets his wish when he wrote in King Henry VI, “The first thing we do, let’s kill all the lawyers”, the fear of years in court will continue to affect a doctor’s decision about natural or Cesarean delivery.
My prediction is that rather than a decrease there will be an increase in both the price of gas and the number of Cesareans births in the years ahead.
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W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of The Harvard Medical School. He’s been a ship’s surgeon, hotel physician and family doctor and later trained in surgery at McGill in Montreal, University of Rochester N.Y. and Harvard. His medical column is published by 60 Canadian newspapers and several in the U.S. He is the author of seven books. Dr. Walker has a medical practice in Toronto. His Web site is: http://www.mydoctor.ca/gifford-jones. He can be reached at:
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