Dear Friends:
    I am so sad at seeing articles such as this one. There is no mention of
the baby anywhere; what is important is the mother's fear (despite medical
recommendation) and lifestyle. It is incredible to me that physicians debate about
the virtues of cesarean section as if it was so easy.

More Women Choosing C-Sections
By LAURAN NEERGAARD, AP
WASHINGTON (June 28) - Doctors reassured Randi Rosenberg there was no reason
to fear natural childbirth - she was in fine shape. But she so wanted to skip
labor with her first baby that she switched doctors to get an elective
Caesarean section.
It's still very rare - and intensely controversial - but more expectant
mothers seem to be choosing C-sections even when there's no clear medical need.So
says a new study that, by counting insurance claims data, estimates some 80,000
women had preplanned, elective C-sections in 2002, up from an estimate of
just under 63,000 the year before.
Proponents of elective C-sections say the worst risks are extremely rare,
especially in a healthy, rested woman - and that vaginal birth has its own
problems, including a possible but unproven higher risk of incontinence from vaginal
tears or use of forceps. They say fully informed women should be able to
choose.
"Most doctors, when they are being honest ... recognize there are cases to be
made for both sides - and also recognize that the question hasn't been
studied in a way that permits anyone to know for certain what the best course is,"
says Dr. Jeffrey Ecker, a Massachusetts General Hospital high-risk obstetrician.
Years ago, Rosenberg had surgery to remove a fibroid. Now she feared that
pushing during natural childbirth could rupture her uterus. Moritz and another
doctor said the old scar wasn't a threat, but she wasn't convinced. And the
convenience of knowing when to temporarily close her business added to the allure
of a planned C-section.
"There are lifestyle considerations on top of the health considerations," she
says. "In the end, you have to make the decision that fits your life."
Rosenberg seems typical of the fledgling trend: Women getting elective
C-sections are usually over 35, more affluent, and planning only one child, says Dr.
Samantha Collier of HealthGrades, a Denver-based company that studies health
care quality.
HealthGrades culled insurance claims from 16 states, covering half the
nation's deliveries, in estimating first-time, preplanned C-sections without a clear
medical indication. They accounted for 2.2 percent of deliveries in 2002, a
25 percent increase in three years, the study says.

Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
Support the WHO Code and the Mother-Friendly Childbirth Initiative

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