Rising cesarean rate isn't good for women

May 09, 2011

The article "Planned C-sections satisfying to moms" (May 8) claims that the rising cesarean rate reflects women's voices being respected by doctors. The research does not back up this claim.

The GBMC/Bayview study looked at maternal satisfaction after planned cesareans and planned vaginal births (whether ending in a vaginal or cesarean delivery). The lowest levels of satisfaction were from moms who had an unplanned cesarean. Unplanned cesareans accounted for 30 percent of the planned vaginal births (48 out of 160) — well above medically necessary levels (typically around 10 percent or 15 percent). The real message seems to be that we need to do more to reduce unplanned cesareans.

Counseling about the risks, benefits and alternatives of any intervention could help to reduce unplanned cesareans since many result from preventable situations. As Dr. George A. Macones states late in Meredith Cohn's article, providing full counseling about cesareans has reduced requests down to just one in his entire (nearly 20-year-long) career. Listening to mothers does not mean rubber-stamping unneeded major surgery. It means understanding the request, providing information to support good decision-making, and then listening. That would show real respect for mothers.

Maya Brennan, Baltimore

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