To Trend or Not to Trend?

Two decades ago Cesarean sections (C-sections) were only performed because of previous cesarean delivery, breech presentation, dystocia, fetal distress, and other emergencies (Tafel et al. 957), now commonly known as emergency C-sections. This widely considered timely operation might have caused the rate of women undergoing C-sections to increase (Beydoun, 334). Since 1965, national U.S. C-section rate rose from 4% to the current 32.8% (Martin et al. 10). Along with its convenient appeal, there are other explanations of why elective C-sections are on the rise, including the inaccurate belief that C-sections are safer and better. Despite the vast increase in numbers of C-section, it seems that the awareness of vaginal birth being the most beneficial option for both mother and child under regular circumstances has become trivialized. C-sections should be performed only in emergencies.

A great deal of research has been done to compare the differences between vaginal birth and C-sections. There has been strong radical evidence that vaginal births are better than elective C-sections (Childbirth 5), but still the questions arise: why are the rates of C-sections rising? What is influencing women’s decisions to undergo a surgery instead of a natural vaginal birth?

It wasn’t until the eighteenth and early nineteenth century that human anatomy was explored in detail, further enhancing the publics understanding of female genital and abdominal areas (National Institutes of Health 4). C-sections prior to the sixteenth and seventeenth century were only done on a dying or a dead mother in an attempt to save the child (Low 1131). In the seventeenth century, men were slowly taking control over childbirth instead of midwives, and by the early nineteenth century, medical students, mostly male, began to practice Cesarean operations on human cadavers, furthering improving the skill (National Institutes of Health 3). Additionally, hospitals were also beginning to expand.

In 1900, 95% of births in the United States took place at home, by 1955, less than 1% of births took place at home (Business of Being Born 2008). Although physicians have chances to use the procedure, there are limited comprehension and prevention on the patient’s pain during the surgery. In the nineteenth century, “reports from the U.S. showed that maternal death from the operation declined significantly when it was performed in early labor, rather than when it was used as a last resort when difficulty with vaginal birth was encountered.” (Beydoun et al. 334) Consequently, this caused many women to believe that it’s safer to have a C-section. Unlike vaginal births, there mother has to go through labor and conceive after an effort of pushing, a C-section procedure is usually done one or two weeks prior to due date. Over 50% of C-sections are done for early preterm, less than 34 weeks of gestation, infants (Menacker 4). Once anesthesia started to flourish in 1847, C-sections and any surgery performed were much safer and favorable (Low 1134). Deliveries by cesarean began to improve subsequently in the late nineteenth century after refining issues on location of incisions, reducing risks of infection, and modifying techniques used (National Institutes of Health 7).

Currently there are different types of cesarean sections. There are unplanned and planned cesareans. Most of the cesareans done are planned cesareans, also known as elective cesareans. Unplanned cesareans can be split into two categories: labored cesareans and emergency cesareans. Labored cesareans are performed after labor has begun because of unexpected maternal or fetal conditions in an attempt at vaginal birth. Emergency cesareans are performed before labor states (Childbirth Connection 1). Along with different types of cesarean, the rates of cesarean also increased, from the 20.7 % in 2006 to the current 32.9% (Martin et al. 10). Fortunately with the recent technology