C-section information incorrect

Published 12:00 am Friday, May 29, 2009

I believe the article titled “Beating the odds” in the special health section of Sunday’s paper was very misleading. Expectant moms and women who plan to give birth in the future all across the Miss-Lou, probably once again let out a sigh of disappointment, as this article depicted vaginal birth after cesarean as an impossibility.

Marie O’Neal’s comment, “It is almost unheard of (to deliver vaginally after cesarean),” and Theresa Cole’s comments, “It can be very dangerous and is generally avoided,” along with her statement that “once a woman delivers by c-section the internal uterine incision is likely to rupture in subsequent births” were just not factual statements.

There is at least one obstetrician in Natchez who continues to do vaginal births after c-section under the right circumstances. He is working in line with what the American College of Obstetrics and Gynocology recommends for the births. (Their latest position being that women can be offered a vaginal birth after c-section, if there is an anesthesiologist on call at all times to assist if the need arises for a c-section.)

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The ACOG’s 2004 Practice Bulletin (No. 54) lists uterine rupture risk as less than 1 percent, and much lower when induction agents were not used. In the cases of uterine rupture fetal and maternal mortality are not certain either. Again, while uterine rupture has been proven to be scarce, other studies verify that death from uterine rupture is also not common. Many women, unfortunately are coerced into repeat cesareans because they are not given an accurate depiction of the risks involved with repeat cesareans.

It is disappointing that information on the risks involved in a vaginal birth after a c-section are not given equally with the risks involved in repeat cesareans, and woman are not given the opportunity to weigh out what is best for them. For instance, The Nisenblat study on multiple cesareans found a hysterectomy rate of 1.1 percent and overall “major complication” rate of 4.3 percent for second cesareans and 8.7 percent for third or more cesareans.

Unfortunately, even with proof of safety, in 2006, 90.3 percent of women with a previous cesarean delivered by repeat section. This has to be only because women are not given the choice to decide for themselves based on truthful information regarding the risks and benefits of both procedures.

There are many more statistics that also point to the high risks involved with c-sections and repeat c-sections, of which I do not have the space to include.

A couple that stand out to me are as follows: The risk of death to a newborn delivered by c-section to a low-risk woman is 1.77 deaths to 1,000 live births.

The risk of death to a newborn delivered vaginally to a low-risk woman is only 0.62 per 1,000 live births. (Marian MacDorman, PhD, et al., “Infant and Neonatal Mortality for Primary Cesarean and Vaginal Births to Women with “No Indicated Risk,” United States, 1998-2001 Birth Cohorts,” Birth: Issues in Perinatal Care 33, no. 3 -September 2006) Between one and two babies per 100, will be accidentally cut during a c-section, according to The Coalition for Improving Maternity Services, (CIMS).

The title of the article, “Beating the odds” is sad. Now, pushing one third of all births in the United States are cesarean sections. It’s a shame to pat ourselves on the back for being on target locally with that terribly high rate. Not when the United States is tied for second-to-last place with Hungary, Malta, Poland and Slovakia for neonatal mortality in the industrialized world. (Save the Children, 2006)

I am not an angry person who is seeking debate on this matter. I am merely another woman in the Miss-Lou who is hoping our local maternity care is finally leaving behind the technological birth machine with its one size fits all mentality.

Are we moving into options for birthing women, some who desire to bid farewell to the high-risk interventions they feel forced in to, or are we still running our hospitals and offices based on fear of litigation, greed, and sheer convenience, much at the expense of our area moms and babies?

Calley Reed

Vidalia resident