Rise in cesarean birth rate

Hi my name is Kristin and I am a nursing student at the Orvis School of Nursing in Reno, Nevada. I am writing a paper on the rising rate of cesarean births and whether or not it is justifiable. In The Journal of Nurse Practitioners, it is evident that the rate of C-Sections has increased from 1 in 20 in 1970 to 1 in 4 in 2003 (Terhaar, 2005, p. 141-147). Consequently, C-section is the most frequent surgical procedure in the United States. The dramatic increase has led me to investigate the cause. According to Social Science & Medicine, physicians prefer to perform a C-Section over a vaginal delivery more often than medically necessary. Based on the journal’s findings, the trend towards more C-Sections is based on factors such as rising malpractice rates, fear of malpractice suits, desire for higher income since C-Sections are more lucrative, and the convenience to the physician's schedule since vaginal deliveries take much longer to complete (Lo, 2003, p. 91-96). In contrast, The Journal of Nurse Practitioners points to the mother-to-be as the cause for the increase in C-Sections. This journal states that late in pregnancy mothers want their pregnancy to be over and that they are anxious about their ability to handle labor. Also they are fearful of the pain to come and they are concerned for the safety of their unborn child. Consequently, some women prefer a C-Section even when it is medically unnecessary (Terhaar, 2005, p. 141-147). Based on your experience, do you feel that the increase in the cesarean birth rate is due to the doctor’s partial preference for cesarean birth or is it due to the choice of the mother-to-be? Also in your practice, when a doctor chooses to do a cesarean delivery, is it your observation that it is medically necessary or not medically necessary?

References
Lo, J. (2003). Patients’ attitudes vs. physicians’ determination: implications for cesarean sections. Social Science & Medicine. 57 (1, July): 91-96.

Terhaar, M. (2005). The Decision For Cesarean Birth. The Journal for Nurse Practitioners. 1 (3, October): 141-147.

In my observation, it seems at times, that c-sections could be avoided if the doctor did not rupture membranes when the baby was too high in the pelvis. Once the membranes are ruptured then the baby drops down but not always in the right position. If there is little room to begin with, then it is hard for the baby to turn to move down the birth canal. I have seen situations where labor progressed so slowly due to malpresentation and resulted in a c-section that had plenty of room to deliver naturally. The head has to be perfectly aligned to move through and if it is not so then that results in a c-section.