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Monday, January 17, 2011

Cesareans and family size

The rate of Cesarean section in the US is at an all time high, with almost 1 in 3 women haveing C-sections.  I believe that part of the reason for so many cesareans is that we are anxious.  We cannot wait to meet our babies or for labor to begin, so we induce labors.  And, let's face it, labor takes a long time...so we use medication to speed up labor, and other medicines to take away the pain of a labor that we are trying to rush through.  I think that we sometimes create problems due to a lack of patience.  There are also many ligitmate reasons for a cesarean, but whatever the reason, many women are having this common surgery.

One thing that doesn't seem to come up until after the fact is that the first cesarean can dictate your family size.  Many doctors are resistant to Vaginal Birth After Cesarean (VBAC), even thought ACOG has stated that VBAC is safe even after two previous c-sections.  And some womean are scared to choose VBAC.  I remember talking to a friend when she was pregnant for the second time, her first birth was via cesarean.  She was scared to try for a VBAC.  We hear a lot of talk about uterine "rupture" and that just sounds really scary.  One of the things that surprised me, after doing to research, looking just at the stats, the risk of a complication from cesarean was higher than the risk of a complication from a VBAC.  The risk of a uterine rupture or tear is real, but it is very small.

The point that I am getting to, is that more and more women are having multiple cesareans.  How many ceseareans are too many?  I cannot find a concrete answer.  I met a woman once, who had had 5, the last two were against her doctor's wishes.  A quick Google search, led me to a discussion board, where a woman had 9!  I know of doctor's who have limited women to 3.  There is not always a choice when it comes to needing a cesarean or not, but there is a choice with subsequent pregnancies to choose VBAC.  Choosing to have multiple c-sections can limit family size.  Even if you think you don't want more than 1 or 2 children now, doesn't mean that you won't change your mind in the future.

I feel that this is an important aspect that is too often over looked until it is too late.  A great resource on this issue is the International Cesearan Awareness Network.  http://www.ican-online.org/

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