Do I Have To Have A Cesarean?

July 4, 2010

Mothers read a great deal about multiple births increasing their risk for complications. What they aren't told is that the risks don't have to translate to something automatic. It's very possible to have a twin pregnancy and not require a cesarean delivery. Moms pregnant with multiples are often capable of having vaginal deliveries and in fact, this is often the safest choice.

High Risk for a C-Section

But physicians take the stance that expectant moms need to know how to spot the signs of complications in order to receive prompt treatment. Therefore, women who are pregnant with multiples are bombarded with statistics and advice about the risks. More than this, these moms-to-be earn a label: "high risk."

Of course, hospitals (and physicians) tend to prefer the idea of an elective cesarean delivery over the sudden need for an emergency surgery. Still, logic should prevail and a vaginal birth should always be the goal, even in the case of a multiple pregnancy. No matter how you look at it, a c-section is major surgery. Having an unnecessary cesarean involves a risk too great to ignore.

No Benefit for Cesareans

One study published by the Cochrane Library showed that elective cesarean deliveries don't offer any advantages over vaginal deliveries for twin births. A second study found that when the second twin is delivered by cesarean because he is not in an optimal, head-down position, the risk of infection is high and the surgery offers no known benefit for mother or infant.

In 2007, 31.8% of all U.S. deliveries were performed by cesarean surgery. The rate for surgical births has seen a steady rise over several years. Part of the reason for the surging rate for surgical births is due to physician fears of malpractice suits. Many doctors think that cesarean births are safer because they occur under controlled circumstances. Other physicians believe that surgical births can serve to prevent damage to the uterus and the urinary tract.

Hospitals too, fear lawsuits, with many of them refusing to allow vaginal births after cesarean (VBAC). This only drives up the rate for surgical births that much higher. Then again, couples undergoing fertility treatments are more liable to conceive multiples. With so many couples postponing having a child, and then finding themselves past the point of natural conception, the multiple pregnancy has become de rigueur with a concurrent rise in the rate of cesarean deliveries. Meantime, the Washington, D.C.-based Public Citizen Health Research Group states that half of the annual one million cesarean deliveries performed may not be necessary.

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