By looking at insurance claims, it is estimated that almost 100,000 women elect to have Caesarean sections, when there is no medical need.
This statistic is a concern, as Caesarean sections are major abdominal surgeries. The mother is more at risk, and so is her infant.
Therefore, when it was noticed that most of these surgeries were due to older women (above 35 years old) concern levels were raised even further.
We do know that overall, older mothers are more likely than younger women to experience complications during pregnancy and delivery.
Such complications include excessive bleeding during labor, prolonged labor lasting more than 20 hours, and dysfunctional labor that does not advance to the next stage.
Premature birth and infant deaths also increase as the mother ages.
Older women are also more likely to have diabetes and hypertension during pregnancy.
Yet, none of the above was the case in these seemingly elective C-Sections.
The facts as we know them, however, indicate that women giving birth for the first time are much more likely to deliver by Caesarean. First-time mothers were six times more likely to have a Caesarean delivery than were women who had given birth before, and even when their pregnancies were low risk (full-term, infants without birth defects, with a normal, head-down presentation, and in the absence of any bleeding complications).
The number of Ceasarean Sections is likely to increase in the future, as the number of women giving birth for the first time at age 30 and older has shown a marked increase in the last two decades. The National Center for Health Statistics reported that, between 1980 and 2004, the number of women in the United States giving birth at age 30 or older has doubled and at age 35 and older has tripled. The number of mothers giving birth at age 40 or older has nearly quadrupled.
The study authors attribute the trend of more women giving birth at an older age, in part, to the increased use of fertility-enhancing therapies. Those women taking fertility-enhancing therapies are at a high risk of pregnancy and birth complications; possibly due to the nature of their inherent fertility problems initially.
To be able to fully understand why C-Sections are increasing, birth certificates now in use will note whether other methods of delivery were attempted prior to C-Sections. This might provide health beneficial information to why C-Sections have increased among older mothers.
Until we learn why older mothers with low-risk pregnancies have a disproportionately high rate of Caesarean delivery, the utmost caution is needed in evaluating older mothers as candidates for this type of surgery.
In the meantime, women should explore a few options by themselves:
• If fear of pain is overwhelming, discuss this with your doctor. There are many effective methods for managing labor and birth pain that did not exist a few years back.
• If your fear is that vaginal deliveries may make you incontinent, know that the facts do not bear this out. However, with C-Sections that is a much greater risk of hemorrhage and infection, and C-sections, like any surgery, are not painless.
• Think seriously about whether you are going to have future children. One C-Section may make your next delivery a C-Section also. The risks for C-Sections increase with repeated use.
• For further information about delivery methods, several excellent web sites are available. One in particular is a resource which clarifies other options, other than C-Sections: See the following link: http://www.childbirthconnection.org/home.asp?Visitor=Woman
Sources
National Institute of Child Health and Human Development, March, 2007
http://www.nichd.nih.gov/news/releases/caesarean_release_030807.cfm
Childbirth Connections
http://www.childbirtmanhconnection.org/home.asp?Visitor=Woman
MSN News Report
http://www.msnbc.msn.com/id/5317976/
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