Unnecessary Caesareans: How Healthcare Professionals are Advocating for Change

As far as surgical procedures go, caesarean sections are among the most commonly performed procedures in the US. In 2009, 32.9 percent of deliveries were the result of a caesarean, however this number has been on the decline.

As a result of the risks associated with giving birth by caesarean, health practitioners are working towards reducing this practice as much as possible. Some doctors and nurses are looking to change the guidelines for low-risk patients, where a caesarean is often unnecessary.

“We know women who are admitted in early labour are more likely to have a caesarean and routine interventions, even if not clinically necessary,” said nurse practitioner Holly Smith. Smith introduced the updated guidelines in an online seminar on the California Maternal Quality Care Collaborative (CMQCC), which is focused on reducing surgical deliveries.

Among the approaches used to reduce the necessity of caesarean, delaying labour could be one of the most effective. “There is a little bit of denial that [caesarean delivery] is major surgery and that it poses a lot of problems,” Carol Sakala of the National Partnership for Women & Families, told Financial Times.

Since the late 1990s, the number of births by caesarean has steadily increased in the US. Some physicians have even been accused of overusing the procedure in otherwise healthy patients, because it’s more convenient to deliver a baby by caesarean than to wait for the mother to have a vaginal birth.

Of course, the caesarean is a life-saving operation in cases of higher-risk pregnancies, such as when a baby is in a breech position, or goes into distress during labour. Pregnant women who have diabetes or obesity may also face an increased risk of complications, prompting doctors to deliver by caesarean.

As the caesarean is a type of major surgery, patients face a number of post-surgical complications including a risk of infection and longer recovery times. Along with being approximately 50 percent more expensive compared to vaginal births, babies delivered by C-section may suffer impaired respiratory function.

“It’s much more convenient to say, ‘Well, you know, it’s getting to be my dinner time and my family time. Labour is not progressing very fast. I’ll just do the caesarean now,’” explained Sakala. Vaginal birth “requires a lot more patience and resources and inconvenience on the system.”