Women and medical professionals across North America have been opting for a caesarian section for childbirth in increasing numbers, according to recent guidelines jointly published today by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine. As a result, obstetricians are urged to wait during the labor process before putting the mother through what could be an unnecessary c-section.
The new guidelines state that doctors need to give healthy women more time to deliver their babies vaginally. It seems doctors may be assuming labor has stalled sooner than it has actually stalled and turning to local anesthesia and scalpels sooner than necessary. Certainly, there are times where women require caesarian sections in order to successfully deliver a child, but the report argues that doctors have been following the labor standards set in the 1960s, which may not actually be as relevant as they once were. In fact, some stages of labor may take longer than originally thought, largely because women are generally older when they have their first child and they tend to weigh more. One stage of labor, for instance, has been estimated to last up to 2.5 hours longer than originally thought, according to the report.
Currently, roughly 1 out of 3 women have a c-section, or 33 percent. A 2012 National Institutes of Health study suggests that the other reason why the one stage of labor now takes considerably longer than previously thought simply because more anesthetics are used, such as epidurals, and it is believed that while epidurals numb the pain that comes with labor, they also slow the process of labor down.
In the efforts to push for a waiting period prior to having a c-section,, it’s now suggested that if women are delivering their first baby, they should be allowed to push for three hours, while women who are delivering their second or more babies should be allowed to push for at least two before a surgical intervention is contemplated. Active labor begins far later than once previously thought. The cervix has to be dilated six centimeters for labor to be considered as active, and the cervix will continue to dilate rapidly during this stage. Contractions will also become stronger and more frequent until the time comes to deliver the child.
C-sections can also be avoided, according to the report, if the physician delivering the child has been trained in the proper use of forceps for delivery. Forceps training, however, is not frequently undertaken by many physicians, according the newspaper The Ledger. There are currently no firm statistics about how many women opt for a c-section, though Today reports that many women may opt for the surgery in order to alleviate fear they have about the surgical procedure. In addition, a c-section does bring with it a certain convenience, as women are able to know conclusively exactly how much recovery time they will likely need. That said, waiting for labor to proceed rather than opting for a c-section for an otherwise healthy woman continues to be the recommendation from the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine.
By Christina St-Jean