Birth date not always up to baby

Giving birth has never been easy. Long hours of labor. Irresistible urges to push. Unexpected complications. Pain. All in the hope of bringing a beautiful baby boy or girl into the world.

Many women are opting to have scheduled Caesarean sections, bypassing traditional labor, says Dr. David Downing, associate chairman in the department of obstetrics and gynecology at Washington Hospital Center in Northwest.

“It’s not necessarily easier,” Dr. Downing says. “The benefits are definitely control. Sometimes, there is less potential trauma to the newborn.”

In 2004, the maternal mortality rate in the United States increased to 13 deaths per 100,000 live births, according to figures from the National Center for Health Statistics in Hyattsville. In 2003, the rate was 12 per 100,000 live births. Medical experts disagree on whether obesity and C-section births have contributed to the rise in this statistic.

Caesarean births account for approximately one in three births in the United States, according to the American Pregnancy Association in Irving, Texas. While some of the surgeries are done in emergency situations, more and more women are scheduling them ahead of time.

“It was one in four just as recent as last year,” says Brad Imler, president of the association. “The elective Caesarean plays a part in this.”

While many women opt for scheduled Caesarean births, Mr. Imler says he is still in favor of vaginal births. C-sections have a risk of infection, hemorrhaging, potential injury to other organs, adhesions and scar tissue.

“The body usually does a pretty good job taking care of things itself,” Mr. Imler says. “We certainly believe in interventions when necessity dictates that, but we don’t like moving into interventions when they’re not necessary.”

Once a woman has a Caesarean birth, she may not be able to have a vaginal birth in subsequent pregnancies, Mr. Imler says. Although it is possible, there is more risk involved. Mr. Imler has a doctorate in psychology and counseling.

“Our recommendation is to get educated on all the different options and look at your birthing choices,” Mr. Imler says. “Some people are completely fine with not having a vaginal birth. They want them all as C-sections.”

There is more public awareness about C-sections than there was a few years ago, Dr. Downing says.

“Women’s magazines have presented it as an option,” Dr. Downing says. “Some women fear, ‘I won’t be able to tolerate a vaginal birth.’ ”

One reason patients give for wanting a C-section is they know someone who has had pelvic floor problems after a vaginal birth, Dr. Downing says. Urinary incontinence, stool incontinence and a drop in bladder position are other possible complications.

Sometimes patients hear of a bad delivery experience. When they compare it to delivery at a specific time on a day of their choice, they opt for the C-section, he says.

In a more extreme example, a patient told Dr. Downing she wanted a C-section because she didn’t want to endure a vaginal examination, he says.

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