C-sections are not safer than vaginal deliveries. and have many risks. A battle is raging over the safest way to deliver a baby. Some want everyone to have a C-section and others want a $75 million dollar study with a lottery determining who gets a C-section and who delivers vaginally. I don’t know who would be the winner either way. Does the patient have a choice and can she dictate how she wants to deliver. Who has the medical degree?

Having been an obstetrician for over 37 years I remember C-section rates of 3% for first deliveries and combined rates of under 6%. But in those days we had mentors who showed us how to deliver breeches, how to be patient, how to use forceps safely and how to give anesthetics.

Those days are gone. Today’s obstetricians are under 45 and have sharpened their surgical skills Most mentors over 45 have quit delivering babies and have become full time gynecologic surgeons. Thanks to the fears of frivolous litigations.

Thing have changed. C-section rates in 2006 were 31%, a rise from 2004 of 26%. Maternal death have comparably risen to 14 per 100,000 from long time rates under 10 per 100,000.

More doctors recommend C-section and their patients obediently accept their recommendations. “Mary your baby looks big! We could do a C-section.” There still are no guarantees that you will have an uncomplicated delivery and that your child will go to Harvard.

C-sections are not safer than vaginal deliveries. and have many risks. Some risks are: higher cardiac arrests, infections, hysterectomies, higher infertility post operatively, more frequent readmissions to hospital within 30 days, and placental complications rise with each C-section.

Whys the big push to recommend Sections? Thoughts go through the obstetrician’s mind: I am not paid for all this waiting. If I do a C-section I am done, get paid twice as much, can finish my office hours, and above all will not likely be sued.

Other factors come into play. Is my hospital small? Do I have residents to watch my patients while I am at the office or if the patient develops a problem? Can I rely on my hospital staff on midnights, weekends and holidays to be well staffed? And above all will I be sued if my patient happens to deliver vaginally and doesn’t have an IQ of 200.

Vaginal deliveries have always been safer, but today I don’t know

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