Elective C-Sections on the Rise

Today, nearly one-third of all babies born in the United States are delivered surgically via Cesarean section—a considerable increase over C-section rates in past years. In 1970, C-sections were performed in only one of 20 births.

According to Adriana Hunter, mother and author of The Queen Charlotte's Hospital Guide to Pregnancy and Birth, medical reasons indicating a C-section include:

• Abnormal presentation: the baby is in the breech position (lying bottom or feet first) or lying across the uterus (transverse lie).
• Disproportion: if the baby appears very large or the mother's pelvis is very small or unusually shaped.
• Placenta previa: a low-lying placenta that blocks the baby's exit.
• Preeclampsia: dangerously high blood pressure brought on by pregnancy.
• Small baby: if the baby is very small, even when the pregnancy reaches term, the consultant may recommend that he is delivered by C-section to spare him the stress and potential damage of labor and delivery.
• A twin or higher order multiple pregnancy can indicate surgical delivery under some circumstances.

The International Cesarean Awareness Network (ICAN) indicates that the C-section is now the most frequently performed major surgery in the United States. Doctors attribute this to the increasing number of women requesting the operation even in the absence of clinical necessity. This is major abdominal surgery with all the associated risks and discomforts. So why are elective, or "patient choice," Cesareans so popular?

A Matter of Convenience?

You may have heard the catchphrase "too posh to push," but convenience cesareans only appear to account for a small fraction of elective surgical births. They've gained intense media coverage due to celebrities including Madonna, Elizabeth Hurley, and Claudia Schiffer, who scheduled their deliveries via C-section. Some in the media conjecture that these surgeries were done because scheduling their babies' births was convenient for the mothers or because the stars in question were hoping to avoid abdominal stretching in the last month of pregnancy. Whether or not the speculation about these specific mothers is accurate, there is a percentage of women who elect to have a C-section because they want to control the delivery date.

"Simply put, I enjoyed the idea of being able to plan when my baby was going to be born," says Jennifer Barnard, mother of 15-month-old Cameron, who characterizes this factor in choosing an elective C-section as slightly selfish. "Also, my husband was due to go away on business before I was due, and I just could not imagine having to go through the whole childbirth thing without him."