Do You Need a Cesarean?

I am quite sure you know someone who had a cesarean. Probably many people. They may believe their cesareans were necessary, life-saving, or a “lucky save.” They may have been. But the fact that you know so many people who have had one (and you do, even if you don’t know it) means that they cannot all have been in the best interest of mother and baby. Increasing evidence is coming out all the time that shows unequivocally that many primary cesareans and repeat cesareans are unnecessary and dangerous. And cesareans really are a dime a dozen. Your hospital does them all day long. This is actually great news for you if you do need one!But do you need one?

With a breech baby, the evidence is more shaky, depending a lot on the position of your baby and what kind of care is available to you. What you need to understand, if you haven’t already caught on from other media, is this: If your doctor acts scared, annoyed, put out, shocked, dismissive or defensive when you ask about pursuing vaginal breech birth, it does not mean that VBB isn’t what is safest for you or your baby.

So very few OBs offer vaginal breech birth. Here’s more about vaginal breech birth. But also, not many mothers are asking for it. If there is no demand, there is no immediate and compelling reason for them to change their comfortable ways. Martin Gimovsky, a much-published and decorated OB in Newark, NJ, says, “We need to have consumers demand breech delivery.”

Research and long-standing practice shows that a cesarean is often not necessary.

Henci Goer, an award-winning medical writer and one of the foremost thinkers and experts in evidence-based maternity care, wrote an article 10 years ago that points out how ACOG is willfully misleading the public about safe maternity care. At first it seems like serious conspiracy theory (because it is), but she displays a lot of evidence for her claims. Please do read it if you are interested in lies, damned lies, and statistics. The most poignant part (besides the disgusting burying of scientific evidence) to me was what she said about ACOG’s role in promoting it’s members–like a business. Read:

“The light bulb lit when I heard Marsden Wagner speak at the 2001 ICAN conference. He said that ACOG was really a trade union. As such, its primary goal was protecting the interests and income of its members. If that happened to coincide with what was best for mothers and babies, well and good. If it didn’t, it was women and children overboard.

I think that what happened in the 1990s was that ACOG’s leaders woke up to the conflict of interest between promoting evidence-based care and ACOG’s prime directive: benefiting OB/GYNs. They then deliberately changed course to wield ACOG’s clout and credibility on behalf of OB/GYNs and to hell with evidence-based care.

Wagner went on to say that we shouldn’t be allowing ACOG to regulate maternity care any more than we allow the auto worker’s union to regulate car safety. I would take his thought further.

As regards safety, a better parallel than the AFL-CIO would be if tobacco companies had their scientists conduct research on cigarettes, they published studies concluding that smoking has benefits, they buried studies showing that smoking had hazards and then they wrote the rules that governed their liability in lawsuits. The situation is actually worse. Unlike what would be the case with tobacco companies, no one suspects ACOG or its academically credentialed obstetricians of an ulterior motive. Anything ACOG or its minions say is uncritically swallowed whole. It’s a sweet arrangement, although not, of course, for the women and children.” (Henci Goer, 2002)

So just keep that all in mind when dealing with hospitals and doctors.

By the way, I HIGHLY recommend her book The Thinking Woman’s Guide to a Better Birth for any pregnant woman.