Belly Up

* bellies * birth * babies * breastfeeding *

Tuesday, March 22, 2011

Seeing Is Believing

So while you keep hearing that c-section rates are ever increasing, there is nothing like a good chart to demonstrate what that increase "looks" like.  In one of my favorite blogs ( I found this graph  for the c-section rates here in Texas.
In the last 10 years you can see that every year the rates have increased and the overall rate since 1990 is much higher.  Bummer right? Or maybe not...let's look closer.  Have Texan women changed in the last ten years and are they now less capable of birth?  Perhaps infant or maternal  mortality rates have improved dramatically in the last ten years thus all the surgical births were necessary to save lives?  Obviously Texas women have not become disabled in any way, nor has immigration brought this state a large influx of ladies who are less capable of birth than those that resided here in the early 90's.  Fetal and maternal death rates have also not improved, in fact tragically, statistics show a small increase in maternal and fetal death in the last decade, so not only is all this rush to the OR apparently not saving lives, it may be putting them in jeopardy.

The ability to facilitate vaginal birth seems to be becoming a lost "art" for more and more careproviders.  The blame cannot simply be laid at the feet of OBs.  Certainly insurance costs drive up the number of women each OB needs to care for to be able to maintain his practice and therefore he has less time to spend providing continuous care and more incentive (assuming he wants sleep and have some semblance of a life) to schedule (week)day inductions...and inductions often lead to c-sections.  With each surgical birth, the c-section becomes more and more entrenched as the standard of maternity care.  Thus an OB is rarely ever going to be sued for a c-section, unnecessary or not.  Given the risk of being sued and losing one's livelihood vs performing a surgery that is considered standard, it is only logical that an OB may be inclined towards doing surgery, not to mention that is leads to more compensation and a better schedule along with the reduced exposure to liability.

Couples also need to look at themselves for the role they may play in the still increasing c-section rate.  I am not talking about the small percentage of moms that request elective c-sections or even moms that may not have access to education or options.  These moms do exist but are a small part of the picture.  Instead I am talking about couples that for whatever reason don't educate themselves about their options.  When moms continue to give their business to careproviders that do not provide good care they perpetrate the problem.  A pregnant mom is many things, but when it comes to her maternity care she is a consumer and she votes with  her feet, her wallet and her belly.   Taking more responsibility for pregnancy and birth is certainly personally empowering for moms, but it is also powerful in that if enough moms demand better care and purposely seek it out, more careproviders will start to offer that care for which these moms seek.  In fact parents simply using their clout as consumers could change how that c-section graph looks a few years from now - wth bars getting smaller not bigger.

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