Delivery by cesarean section is a surgical operation performed to make delivering a baby faster and more precise. The operation involves cutting into the mother’s abdomen to reach the uterus, and delivering the baby through this incision rather than the vagina. It is a controversial procedure, because there exists a belief that many cesarean sections are being performed needlessly, for the convenience of the doctor rather than for the benefit of the patient&mash;a cesarean allows greater control over the timing and duration of the birth, permitting more exact scheduling. As with any surgical procedures, there are inherent risks, an some, such as postpartum depression, unique to pregnancy. This is why many patient advocates want to see cesarean sections limited to cases in which vaginal delivery is itself expected to be unusually dangerous.
In some cases, however, even if there is a heightened risk with vaginal delivery, doctors or patients are reluctant to turn to cesarean section as an option. For example, in a breech birth, the fetus fails to turn around prior to the beginning of labor, creating a situation in which the head of the fetus can be trapped, which can be deadly for the fetus and harmful to the mother. Although this is one of the complications for which cesarean section is medically advised by most doctors, as many as 40 percent of mothers of breech fetuses prefer vaginal delivery.
Nonetheless, while the number of cesarean sections leveled off at the beginning of the decade, there has been a sharp increase in recent years. Many obstetricians are moving towards looking for specific criteria before suggesting a cesarean section, or performing one as an emergency procedure. These criteria include difficult labor, abnormal fetal heart rate, breech birth or other issues with the position of the fetus, or an unusually large fetus. Multiple births, particularly triplets or more, also often call for cesarean delivery.
In some cases, such as preeclampsia or overdue pregnancy, doctors may use medications or hormones to induce labor. Though this also carries risks, it does not increase the chances of cesarean delivery. In fact, recent studies have found that it reduces it; women who have labor induced are 12 percent less likely to have to undergo cesarean delivery than those who allowed nature to take its course.