What Pregnant Moms Really Should Be Asking About C-Sections


Pregnant women are obsessed with C-section rates at hospitals, or so weโ€™re led to believe by the number of studies released annually on the dreaded โ€œsectionโ€ as OB/Gynโ€™s call them. Yelp is so convinced women need a hospitalโ€™s C-section rates that now theyโ€™re including them on their profile page. The fact that youโ€™re reviewing the place where you plan to give birth to your child on Yelp is a whole other topic of horror altogether, but I digress. The reality is that if you are a pregnant woman concerned about having a C-section, a hospitalโ€™s C-section rate should be relatively low on your list of questions to get answered. Youโ€™re better off understanding why C-sections happen if you want to attempt to avoid one.

Begin by asking the C-section rate of your doctor and your OB/GYN practice. Since these are the professionals who will be handling your labor and delivery, they will ultimately be the ones making the call for you to be โ€œsectioned.โ€ In fact, your doctorโ€™s attitude toward birth will most likely be the determining factor in how your labor and delivery progress. Most doctors will opt for a C-section at the 24-hour mark (if not sooner) in labor even if the baby is not under duress simply because it doesnโ€™t financially benefit them to allow a woman to labor naturally for an extended period of time. Statistically, most C-sections are performed during the work day by doctor preference. As a low-risk candidate myself, I was advised by the midwives in my practice that I would be allowed to labor for as long as necessary as long as my baby and I were not under duress. However, the doctors in my practice advised that if I hadnโ€™t delivered within a day Iโ€™d be facing a C-section, warranted or not.

Itโ€™s also important to understand which complications in pregnancy and labor lead to C-sections. Diabetes, birth defects, and preeclampsia are only a few of the conditions listed by the American Pregnancy Association as reasons a C-section may occur. While some reports indicate that doctors abuse advanced maternal age as a method to push women into C-sections, it is also statistically accurate that women over 35 are more prone to the risk factors that lead to C-section deliveries.

When looking at the C-section rate of any hospital or practice, itโ€™s important to remember that some women choose to have C-sections. Elective C-sections are not broken out of the statistics given in most research. For instance, Consumer Reports recently rated Hialeah Hospital in Florida as having the highest C-section rate in the nation at 68 percent. A more detailed analysis in the Miami Herald notes:

Dr. Rafael Perez, an obstetrician for Baptist Health South Florida, said that Miami area physicians perform a lot of C-sections on first-time mothers with low-risk pregnancies because their patients demand it โ€” and he said those patients tend to come from Latin American countries such as Argentina, Brazil and Chile.

โ€œIn those countries,โ€ Perez said, โ€œthe C-section rate is very high, and the patients are used to delivering by C-section. Thereโ€™s some cultural thought that if I deliver vaginally, my sexual function might not be the same as before.โ€

The percentage of elective C-sections taking place at Hialeah or the other Florida hospitals listed were not included in the Consumer Reports breakdown. Yet, the trend towards elective C-section, while on the downward slide, still has a major impact on these published statistics.

A holistic understanding of why a C-section takes place, including risk factors encountered during pregnancy and labor, is more valuable than simplistic statistics. If anything, women should be more concerned with their doctorโ€™s view on what justifies a C-section, especially in an otherwise low-risk scenario.