After an emergency cesarean with her first baby, Ruby Wales was holding out for a vaginal birth with her second one ... finding a physician to deliver her second child wasn't easy. Her first obstetrician turned her down flat ...
... the cesarean is now ... the most common operation in the U.S. ... performed in 31% of births, up from 4.5% in 1965.
... the intensive and expensive U.S. brand of medicine has failed to deliver better results and may, in fact, be doing more harm than good.
... As the No. 1 cause of hospital admissions, childbirth is a huge part of the nation's $2.4-trillion annual healthcare expenditure, accounting in hospital charges alone for more than $79 billion.
Because the average uncomplicated cesarean runs about $4,500, nearly twice as much as a comparable vaginal birth, cesareans account for a disproportionate amount (45%) of delivery costs ...
... The problem ... is that the cesarean ... exposes a woman to the risk of infection, blood clots and other serious problems. Cesareans also have been shown to increase premature births and the need for intensive care for newborns. Even without such complications, cesareans result in longer hospital stays.
Inducing childbirth ... also is on the rise and is another source of growing concern. Experts say miscalculations often result in the delivery of infants who are too young to breathe on their own. Induction, studies show, also raises the risk of complications that lead to cesareans.
Despite all this intervention -- and, many believe, because of it -- childbirth in the U.S. doesn't measure up. The U.S. lags behind other developed nations on key performance indicators including infant mortality, birth weight and neonatal intensive care admissions.
... The maternal death rate began to rise in 2002, and the typical American newborn is delivered at 39 weeks, down from 40 ...
... "Cesarean birth ends up being a profit center in hospitals, so there's not a lot of incentive to reduce them,"
... Among California hospitals, cesareans range from 16% to 62% of births.
Such variation means a lot of women are getting unnecessary cesareans ...
... "If the old incision was a vertical, then a trial of labor is not a good idea," ... "But what happens now in the United States is the low, transverse, an incision in the bottom part of the uterus, from side to side. Those heal better. All the studies say, in those types of incisions, the risk is less than 1%, probably a half percent, that it will open during labor."
... Saddleback supported Wales' desire for a vaginal birth. Nine days after her due date and after 30 hours of labor, she gave birth -- the way she wanted -- to an 8-pound, 11-ounce boy.