Did you know that Kentucky has one of the highest rates of cesarean deliveries (C-sections) in the country? That’s not good news, according to a new report from the Centers for Disease Control and Prevention that reaffirms the agency’s belief that vaginal births are safer than C-sections.
In the United States, one in three first-time moms will require a C-section, said Dr. Lily Hahn, an OB-GYN with St. Elizabeth Physicians. It’s a rate that has increased dramatically over the past 20 years.
Hahn said C-section rates have increased for many reasons: more cases of obese mothers-to-be have meant more cases of slower-than-normal labor progression; in addition, more women getting pregnant later in life and a higher number of multiple gestation births have spiked the incidence of C-section deliveries. Also, the induction rate has increased over the past two decades, which has raised the C-section rate, as well.
So, what’s the problem with C-section deliveries?
According to the CDC report, blood transfusions and admission to the intensive care unit are more common after first-time C-section deliveries than after vaginal deliveries or repeat C-section deliveries.
Also, Hahn said, babies generally do better after vaginal deliveries than after C-section deliveries.
“They don’t have as many problems immediately after birth, such as issues with breathing patterns or issues with keeping their sugar stable,” she said.
The CDC report also shows that after a first C-section delivery, about 90 percent of women have a repeat C-section delivery.
Whether or not a woman can have a vaginal birth after a C-section delivery depends on the reason why she had the first C-section delivery, Hahn said.
“If someone had a C-section because the baby was breech, she’s probably a good candidate for vaginal delivery with her next baby,” she said. “But if she had a C-section because, for instance, she pushed for three hours and couldn’t get the baby out, then she would have a much lower rate of success with a vaginal delivery in a subsequent pregnancy.”
Vaginal deliveries after C-section deliveries generally are safe, Hahn said, but there is a 1 percent chance of the previous C-section scars tearing open.
“If that happens, it’s an emergency and requires an emergency C-section delivery,” she said. “Patients need to be able to understand that if it happens it could be really detrimental to them and to their baby.”
The only thing women can do to prevent a C-section delivery is to await spontaneous delivery, Hahn said.
“Sometimes women need to be induced,” she said, “but in a healthy patient with a healthy pregnancy, awaiting spontaneous labor puts you in a much better position for a vaginal delivery than an induction, especially among first-time moms.”
