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tazzygirl -> RE: American and pregnant? Go to Italy, or Albania. (4/15/2010 8:18:54 AM)
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well, kittin, having worked in the field for a decade, i think i know a bit of what i speak about.
First, according to WHO, yes, the US has a c-section rate of roughly 30% (2008). Most Asian countries are above 40%. Latin America 35%.
quote:
Nearly half of moms-to-be surveyed in China were delivering by cesarean sections, the world's highest rate recorded by the World Health Organization, which warned Tuesday that a boom in unnecessary surgeries is jeopardizing women's health.
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In China, a quarter of all C-sections recorded were not medically necessary, the report said.
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Women undergoing C-sections that are not medically necessary are more likely to die or be admitted into intensive care units, require blood transfusions or encounter complications that lead to hysterectomies, the study found. The procedure was shown to benefit babies during breech births.
Reasons for elective C-sections vary globally, but increasing rates in many developing countries coincide with a rise in patients' wealth and improved medical facilities.
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In Asia, some women opt for the abdominal surgery to choose their delivery day after consulting fortune tellers for "lucky" birthdays or times. Others fear painful natural births or worry their vaginas may be stretched or damaged by a normal delivery. Some women also prefer the operation because they believe it is less risky.
"I think it's safer for the mother and child to have C-sections, and the relatives feel more secure because it's very simple and very common now," said Trang Thanh Van, 25, just days away from giving birth to her first child in Vietnam. "People worry that using tools to pull the baby out may affect their brains."
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The survey, published online Tuesday in the medical journal Lancet, mirrors similar results reported by WHO in 2005 from Latin America, where 35% of pregnant women surveyed were delivering by C-section.
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In Latin America, C-section rates in all eight countries surveyed earlier by WHO were 30% or higher, with Equador posting 40% and Paraguay 42%. Some expectant mothers there scheduled elective surgeries to avoid giving birth during holidays or even so they could attend parties, said Dr. Archana Shah, from the WHO in Geneva, who worked on that report and cautioned that data in both studies represent a sample that may not reflect overall national rates
In the U.S., where C-sections are at an all-time high of 31%, the surgery is often performed on older expectant mothers, during multiple births or simply because patients request it or doctors fear malpractice lawsuits. A government panel warned against elective C-sections in 2006.
Meanwhile, an earlier WHO survey of African countries found that C-sections occurred in about 9% of deliveries surveyed and that many medical facilities were ill equipped to perform emergency surgeries, leading to increased deaths.
The Asian survey examined deliveries in 122 randomly selected public and private hospitals in 2007 and 2008 across Cambodia, China, India, Japan, Nepal, the Philippines, Sri Lanka, Thailand and Vietnam. The hospitals were located in capital cities and two other regions or provinces within each country, all logging more than 1,000 births a year.
China's 46% C-section rate was followed by Vietnam and Thailand with 36% and 34%, respectively. Cambodia and India had the lowest rates of 15% and 18%, respectively.
The study did not discuss specific reasons for the high number of C-sections, but it noted that more than 60% of the hospitals studied were motivated by financial incentives to perform surgeries.
At Vietnam's National Hospital of Gynecology and Obstetrics in Hanoi, about 40% of the 20,000 babies delivered there annually are via C-section, said Dr. Le Anh Tuan, the hospital's vice director, who did not participate in the study.
http://www.usatoday.com/news/world/2010-01-12-China-C-Section_N.htm
Now, the Lancet, while a notable paper, i tend to view them with a bit of criticism especially after the Vaccine article. You remember that one... the one that had parents declaring vaccinations cause autism. sad actually.
Now, its true VBACs have gone by the wayside. Many hospitals no longer allow the trial by labor. Some Drs prefer not to even attempt them based upon the potential lawsuits. A trial by labor for failure to dialate. Woman attempts another labor, it doesnt go well. late decelarations, and its off to the OR. if anything happens to the baby, the Dr will be sued.
The current trend seems to be moms demanding c-sections.... it seems to the the "posh" thing to do.
quote:
When she learned she was pregnant with her second child, Missy Beiting issued an ultimatum to her obstetrician. “Schedule me for c-section or I’ll find a doctor who will,” she remembers saying. Beiting gave birth to her first child, a 10-pound, 14-ounce son, by c-section after a failed induction and a stressful nine hours waiting for a labor that never began. She avoided the stress the second time around and welcomed her 10-pound, 11-ounce son after a scheduled c-section at 37 weeks.
Like a growing number of women across the country and around the world, Beiting, 39, of Southgate, Kentucky, determined to gain more control over her childbirth experience by requesting a cesarean section. Stanford University’s Dr. Maurice Druzin and colleagues observe that “the issue of cesarean section on maternal request has been described as being part of a ‘perfect storm’ of medical, legal, and personal choice issues, and the lack of an opposing view.”
http://healthlibrary.epnet.com/GetContent.aspx?token=b93d114e-5009-4f6a-9917-6c594254fcc7&chunkiid=84008
Seems the Drs.. at least in the US... are damed if they do and damned if they dont. Now im not saying all OBs are above using a c-section to make that boating trip. However, depending on the hospital, the review boards, the lawyers, the patients themselves, many Drs are stuck between a rock, a hard place, a brick wall, and a pitt bull.
Stars like Madonna made c-sections popular. Cut, birth, and back to work with a fantastic bode because of that tummy tuck. This is what moms expect and insist upon having.
Blaming the system because the powers that control the system have become more demanding by the minute doesnt work.
Again, another example of lawyers and bean counters running health care.
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