How did c-sections begin, and why are they so common? This is a question on the minds of many, including healthcare professionals, lawmakers, and individuals like you. A recent article published in Slate online examines the origins of c-sections in the United States, as well as various factors that may have contributed to steady increases in the procedure’s use.
At Brown & Brothers, we like to provide information that is useful and interesting. Read on to learn more about the history of c-sections, what factors may have led to its rise, and what you need to know about making healthcare choices that are best for you and your family.
A History of Cesarean Sections
Cesarean sections, or C-sections as they are commonly known, originated in the U.S. in the early 19th century, and continued to become more common as medical advances made the procedure safer. The first recorded account of a c-section in U.S. history was in 1830. Dr. John L. Richmond went to the rural home of an Ohio family to assist in delivering their child. The woman had been in labor for hours and had fits of convulsions and fainting between contractions. Dr. Richmond administered laudanum and sulphuric ether to help with the convulsions, but was unable to determine why labor was not progressing.
Dr. Richmond decided that a c-section was the best course of action to hopefully save the mother and child. As friends and family watched, Dr. Richmond made an incision, but couldn’t pull the baby out. In intense pain, the mother begged for him to stop searching through her uterus to locate the baby. Based on the ethics of the time, a horrifying decision was made. Dr. Richmond delivered the baby in pieces through the c-section incision, opting to save the mother’s life.
The horrifying ordeal did save the mother’s life, and she returned to work in less than one month following the procedure. A thorough examination after she healed revealed that she had an “abnormally shallow vagina with no discernible cervical opening”.
During the 19th century, physicians were trained to allow childbirth to happen as naturally as possible. Medical intervention was to be facilitated as needed. Physicians were also trained on the premise that saving the mother’s life was paramount to that of the child. C-sections were only to be used in dire circumstances and as a last resort.
The 20th century brought about a shift in mindset. A greater focus was placed on saving the life of the child, as well as the mother. Physicians became increasingly concerned with infant mortality rates, and the federal government became more involved. Physicians developed diagnostic tools like the Bishop and Apgar scores. Advances in medicine had changed the way that women were treated during childbirth, including medications administered.
C-Sections Become Increasingly Common
In the early days of the 20th century, c-sections were still very rare. By the 1960’s, however, there was a stark increase in the number of c-sections performed in the U.S. Between 1965 and 1987, c-section rates had increased by 455 percent. Today, an estimated one in every three babies are born via c-section – a number which is twice the recommended 10-15 percent established by the World Health Organization.
During the mid 20th century there was also an increase in public attention to issues like childbirth and c-sections, largely thanks to the media who covered notable medical events among people like Jackie Kennedy. Some people believe that increased attention and cultural factors may be part of the reason why the number of c-sections began to increase during these years.
Another possible reason why c-sections have increased is advances in technology. As electronic fetal monitoring (EFM) became a standard in hospitals, the decision to perform a c-section or not was determined by doctors’ interpretation of the monitor results. Over time, doctors relied on the information provided by EFM in making their decisions about labor and delivery.
Advances in technology have come a long way toward identifying possible health risks to mother and child, however, which can help doctors determine when a c-section is medically necessary. Today, doctors can use innovative diagnostic tools to monitor pregnancy, test for possible diseases, and administer treatments during pregnancy.
Doctors also have many more tools at their disposal in terms of helping the childbirth process proceed in the safest way possible. Doctors and mothers have much greater information and control over the process.
C-Sections in Today’s Medical Environment
Today, c-sections are so common they have been called “unremarkable”. Many women are given the option of an elective c-section, meaning that they can choose to have a c-section rather than allowing labor and delivery to occur naturally. There are supporters and opponents to this idea, but many believe the decision should be left up to the woman.
There are also many doctors who prefer c-section deliveries, as well as some hospitals with higher rates of c-sections than others. There are many reasons for these variables, and it can be difficult to make sense of all the information. With such a great focus on increases in c-sections and questions of whether the procedure is overused, many women have questions about how to prepare for labor and delivery, and what choices they should make. One maternal-fetal medicine specialist offers the following advice:
- Remember that when you choose a doctor, you are also choosing a hospital. Doctors may be affiliated with one or more hospitals, so you should ask upfront what you can expect.
- Research and evaluate available information about your doctor and his or her hospital of choice for deliveries. Look at reviews, c-section rates, and other information about their services.
- When choosing a doctor or hospital, Recognize that some hospitals are better equipped than others in terms of labor and delivery, availability of specialists, and specialized departments like a neonatal intensive care unit (NICU).
- If you are determined to have a vaginal or natural birth, make sure your doctor knows your wishes and plans immediately. Together, you should create a birth plan that is on par with evidence-based practice, but is tailored to your individual situation and healthcare needs.
C-Sections and Your Legal Rights
While society may see c-sections as commonplace and elective, they are still a major surgical procedure with risks and consequences. As a patient, you have certain legal rights, and you deserve to know what they are, and how they may affect you as you make important healthcare decisions.
To learn more about your rights, or if you have questions about medical malpractice or birth injuries, contact Brown & Brothers today. Fill out our online form to schedule a free consultation with one of our skilled birth injury attorneys.