C-sections on the Rise Despite Risks

Cesarean sections seem to be getting a fair amount of press lately.  Many believe that an uncomplicated vaginal delivery is the safest way to give birth, but the relative safety of vaginal versus Cesarean deliveries has never been directly address in a study where women are randomly assigned to deliver their first baby by C-section or vaginally.  Despite the risks inherent in any surgical procedure and longer recovery time, some women are scheduling C-sections even when they are not medically necessary.  The rate for C-sections has increased over 50% in just the past decade and now nearly a third of all births are by Cesarean delivery.  As the rate of C-sections continues to climb, so does the rate of pregnancy associated deaths.  Whether there is a direct relationship between the two is not clear. 

Blood clots known as deep vein thromboses (DVTs) are one of the risks posed by C-sections.  The clots frequently form in the lower legs and then break free heading to the lungs where they are known as pulmonary emboli and can cause sudden death.  A woman’s risk of DVT increases during pregnancy and for about six weeks afterwerd as a result of slower blood flow from weight gain and reduced activity.   Blood composisiton also changes making it thicker and easier to clot.  To combat this risk, the American College of Obstretetions and Gynecologists has recently published new guidelines recommending the routine use of inflating compression boots, like those already used for other major operations such as hip replacements. 

Of course, avoiding C-section altogether is the best way to reduce this risk.  Nurses seeking ways to reduce the rate of C-sections have now developed a tool called the peanut ball.  The ball is used on women who receive epidural injections to alleviate pain during pregnancy and cannot use other proven birthing methods.  The peanut shaped ball fits between a patients legs helping open the pelvis to create a path for the baby.  In clinical trials the ball not only significantly reduced labor times, but decreased the rate of C-section by 13 percentage points.  The balls cost about $40, a relative bargain when compared to a Cesarean procedure.  Not bad.

Posted in Cesarean Section, Health Care Costs, Hospitals |