Public Health is…Humanizing Births

In the U.S. we spend $98 billion on hospitalizations from pregnancies and childbirths each year. This is the largest amount spent by any country in the world! Yet we are ranked 50th for maternal mortality.

Countries across the globe, 49 in fact, are doing a much better job at keeping women and their newborns alive.  And they are doing it at a much lower cost. Maternal mortality has doubled in the last 25 years and approximately 2 million infants die within the first 24 hours of birth every year. There are many factors that contribute to maternal and infant mortality, but I will focus on just one – the increase in cesarean sections (C-sections).

Since the 1970s, rates of C-sections have risen.  In the US, one in every three births are C-sections – making it the most common surgery in America! This may bCSection Cartoone influenced by the fact that the doctors responsible for pregnancy care and childbirth – obstetrics and gynecology doctors (OB/GYNS) – are surgeons.  They are trained to deal with complications among women in labor. Therefore they are more familiar with what to do when complications arise than when there are none.  As a result, they often intervene without it being medically necessary. Moreover, doctors may not be willing to wait until the baby is ready for birth and begin a series of interventions to speed the process that ultimately results in a C-section. Though C-sections are often glamorized when we hear of celebrities that set the date for their delivery, C-sections are dangerous and come with unintended consequences.

Risks for the mother:

  • Infection
  • Hemorrhage or excessive blood loss
  • Extended recovery time
  • Risk of future surgeries
  • Reactions to medication
  • Maternal mortality

A c-section is a complete surgery and leads to the risks associated with any other type of surgery. For example, one in every six women that delivers through C-section will require a blood transfusion.

Risks for the baby:

  • Premature Birth
  • Breathing Problems
  • Low APGAR score
  • Fetal Injury

The baby may not be ready to be born when a C-section is performed leading  to  a premature birth. Babies delivered through C-section have a 50% greater risk for a low APGAR score (a quick exam that is performed on the baby at 1 and 5 minutes after birth to determines how well the baby tolerated the birthing process and is acclimating to the outside world).

Though these risks are well documented, other complications that we may not completely understand may also be taking place. When a woman delivers naturally, there is a hormonal release that allows the mother to bond with the child, but when deliveries are performed through C-section this is not the case. In one study, Monkeys that have their birthing process interrupted to surgically deliver their offspring refuse to take care of it. We need to reshape our delivery practices, to reduce the over medicalization of births and move towards more humanized births.

Humanizing births consists of respecting women’s values while “Reducing over-medicalized childbirths, empowering women and using evidence-based maternity practice.” (Behruzi et al. 2010)Though C-sections are necessary at times, it is important to limit medical interventions when they are unnecessary and give women more options during the birthing process, leading to more humanized births that may ultimately help reduce maternal and infant mortality.

For more information on this topic, you can visit the following sites:

http://www.americanpregnancy.org/labornbirth/cesareanrisks.html

http://www.cesareanrates.com/

2 thoughts on “Public Health is…Humanizing Births

  1. Great post highlighting this important issue. As public health advocates, which policies and institutional practices should we support to reverse this trend?

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