“I’m begging the doctor, ‘Don’t do it.’”
Do C-sections reduce childbirth complications – or increase them?
Apr 11, 2019
Reuters – Pregnant women are more likely to have complications during labor and cesarean deliveries than during vaginal births, and a new study offers fresh evidence that older mothers are most at risk.
Rates of cesarean deliveries, or C-sections, have risen in the developed world to more than 20 percent of births, even though the World Health Organization recommends this surgery only for the roughly 10 to 15 percent of cases when the health of the mother or baby is in danger.
While C-sections can be life-saving, the procedures carry risks like infection, excessive bleeding, damage to reproductive organs and blood clots.
For the current study, researchers wanted to get a clearer picture of how often complications might result from the surgery versus from underlying medical problems that might have caused mothers to get these operations.
To do this, they examined data on 1,444 women who experienced severe complications after delivery that were unrelated to pre-existing health problems. They also looked at a comparison group of 3,464 women who didn’t have complications.
Women who had C-sections were 80 percent more likely to have complications than those who delivered vaginally, researchers report in the journal CMAJ. And women over age 35 who had C-sections were almost three times more likely to have severe complications.
“Overall, delivery is safe,” senior study author Dr. Catherine Deneux-Tharaux of INSERM in Paris said by email. “However, in a minority of cases, severe complications can occur in the mother during or soon after the delivery. This happens in about 1.5 percent of deliveries and the main cause is major hemorrhage.”
As women age, the uterine muscle loses its ability to contract efficiently, and this can contribute to heavy bleeding after C-sections among older women, Deneux-Tharaux said.
“The physiological stop in bleeding after birth involves a contraction of the uterus; that might be reduced in older women,” Deneux-Tharaux said.
About 85 percent of the complications involved bleeding after delivery.
Roughly 36 percent of the women who had severe complications delivered by C-section, compared with 18 percent of the mothers who didn’t have complications. Read more.
Women who were forced to have C-sections against their will
“I feel so sad about it,” she remembers. In her dreams, “I’m begging the doctor, ‘Don’t do it.’”
In 2011, doctors performed a cesarean section on Rinat Dray, a 32-year-old, religious mother of two without her consent.
Dray adamantly refused a cesarean throughout her labor, she told us in an interview, but “The [hospital] manager said, ‘Take her… to C-section. We got permission. …Take her to the room for the C-section.’”
Doctors wheeled her into the operating room, told her to be quiet, and performed a cesarean. The baby was healthy, but during the surgery the physician lacerated Dray’s bladder, requiring extensive surgical repair. Dray’s malpractice lawsuit is ongoing.
To study forced and coerced cesareans, we searched for cases like Dray’s in LexisNexis and the National Advocates for Pregnant Women’s (NAPW) online case file.
We found ten between 1990 and 2014 and were able to interview Dray and Jennifer Goodall, as well as two of the attorneys, Michael Bast (Dray’s attorney) and Colleen Connell (Tabita Bricci’s attorney), involved in forced C-section cases.
We also interviewed three attorneys with Birth Rights Bar Association (BRBA), Deborah Fisch, Susan Jenkins, and Indra Lusero; NAPW senior staff attorney Farah Diaz-Tello; and President of Improving Birth Dawn Thompson.
The low number of published cases is partly a result of an exceptionally small fraction of court cases being published and thus accessible on LexisNexis, but it also reflects the high bar to entry into the legal system for these types of cases.
Even so, we were surprised at how few cases we found: advocates and attorneys we’d interviewed had told us that instances of coerced and forced cesareans were common.
For example, when we asked Dawn Thompson how often she receives calls from women in such situations, she answered, “Oh, every day.”
Similarly, Michael Bast told us, “We’ve heard many times where women have said, ‘I was forced to have a C-section.’” Read more.
MORE OF TODAY’S TOP HEALTH NEWS: