Safely Reducing C-Section Rates Among Low-Risk, First-Time Pregnancies
As many as one in three babies are born via caesarean section (C-section). While C-section deliveries can be life-saving and are certainly medically necessary in many situations, research has also found that there has been an increase in C-sections among low-risk, first-time pregnant mothers. In the obstetrical world, we have been tracking this trend, in hopes to determine if we can safely reduce this statistic.
Shawna Ruple, M.D., obstetrician/gynecologist, who delivers babies at MyMichigan Medical Centers in Midland and West Branch, is part of Michigan’s Obstetrics Initiative (OBI), a group made up of maternity and OB physicians, providers, midwives, beside nurses and more that are committed to safely reducing the C-section rates at over 70 Michigan maternity hospitals.
We asked Dr. Ruple to answer some of the most common questions regarding C-section deliveries.
Q. What is a C-section, and how does it differ from a vaginal delivery?
A. A C-section is a surgical procedure where a baby is delivered via incisions in the abdomen and uterus. Compared to a vaginal delivery, a C-section does involve a slightly higher risk of complication, as well as a longer recovery period. It’s important to keep in mind that a C-section is a major surgical procedure. However, there are situations in which a C-section is the safest option for mom and baby.
Q. What are some of the reasons why a C-section may be necessary?
A. There are certain medical conditions or situations that may require a C-section to be scheduled in advance, and there are situations when a person is in active labor and an unplanned or emergency C-section is required to safely deliver the baby. Some reasons why you may have a planned C-section could include multiples (or triples, etc.), placenta location or a presentation of the baby that is contraindicated for vaginal delivery (breech, etc). Sometimes, during labor, a baby’s heart rate can drop to the point where they can no longer tolerate labor, or the umbilical cord could prolapse, or the mother shows signs of distress. All of these reasons would indicate that a C-section is medically necessary and the safest option for both mom and baby.
Q. If C-sections can be necessary and even life-saving, why is there an effort to reduce the number of C-sections being performed?
A. It’s important to clarify that the OBI and other similar groups across the country are working to safely reduce the C-section rates for low-risk pregnancies. As more research becomes available, we are gaining a greater understanding of how long a baby can tolerate labor contractions, pushing and more. C-sections do carry an increased risk of birth and post-birth complications, complications for future pregnancies and births. Therefore, we are not looking to eliminate C-sections. We are trying to ensure they are being performed only when they truly are the best option.
Q. What are some efforts being put in place?
A. There are several evidence-based practices that support vaginal deliveries – preparing patients for prolonged hospitalization when induction is medically necessary, continuous labor support and education and an emphasis on shared decision-making with patients. I encourage patients to talk to their OB/GYN or midwife throughout pregnancy and before delivery. Support for laboring moms, both physically and mentally, is always available.
