My daughter, who turns two years old next month, is becoming something of a medical rarity. This isn’t because she is showing signs of a late-developing handicap or extraordinary ability for her age – it’s because she came into the world as a vaginal birth after Cesarean section (VBAC).
Although more than three-quarters of women who choose a trial of labor over a repeat Cesarean section (including my wife) successfully deliver vaginally, studies showing slightly elevated risks of rupture or infection of the uterus with VBAC, pressure from insurance companies concerned about lawsuits, and restrictive medical guidelines discourage most women from even trying.
After reaching a high in 1996 of 28.3 percent of U.S. women who previously delivered by Cesarean, the VBAC rate today is fewer than 1 in 10. Surgical deliveries are rapidly becoming the norm rather than the exception in the U.S. and the U.K., reaching record highs of 32 and 24 percent of all births in their respective nations in 2008.
The rising number of surgical deliveries is troubling, given that more than three-quarters of first-time mothers who are employed during pregnancy will return to the workforce within their infant’s first year of life. In a 2006 study in the Annals of Family Medicine, Dr. Pat McGovern and her colleagues at the University of Minnesota reported the relationship between delivery type and measures of postpartum health 5 weeks after childbirth.
Participants were 817 employed women who gave birth to single healthy infants at one of three Minneapolis-St. Paul community hospitals in 2001. Study personnel telephoned each woman to conduct an interview that lasted approximately 45 minutes. The interviews assessed overall physical and mental health as well as typical postpartum symptoms, including fatigue, decreased interest in sex, back and neck pain, constipation, hemorrhoids, and appetite problems.
The authors found that women who delivered by cesarean section reported significantly worse physical health 5 weeks after birth than women who delivered vaginally, although mental health scores were similar between the two groups. This is important to know, since while surgical deliveries aren’t always avoidable, there are some simple things that a woman can do to reduce her risk (such as asking her obstetrician, family physician, or midwife what the practice’s average c-section rate is and their most common reasons for doing one). If you want more information, I refer you to a website that pulls no punches with the facts about how to avoid an unnecessary cesarean.
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Tags: Cesarean Section, Pregnancy, Type of birth
