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Thursday, March 4, 2010

Safety, ease lead to C-section surge

Hospital rules bar natural deliveries after Cesareans


Rising C-section rates that show no signs of letting up have stirred a vigorous national debate about whether many are being performed too often, too early and without medical necessity.

With nearly one in three babies born by Cesarean, the highest rate ever, doctors and natural birth proponents are concerned that factors such as a woman's preference to schedule birth on a particular day and a doctor's fear of malpractice are, in part, driving the increase.

There's worry, too, that fetal heart monitors, which often raise false alarms about the condition of a baby, or drugs used to induce labor might be leading to unnecessary C-sections and subsequent problems, such as a rupture of the uterus, which can lead to a hysterectomy.

"The C-section rate is probably higher than it should be," said Dr. Roberto Romero, chief of the Perinatal Research Branch of the National Institutes of Health, headquartered at Wayne State University in Detroit. "We have to figure out which ones are medically necessary."

An initiative at 60 Michigan hospitals hopes to make a dent in at least first-time C-sections by encouraging natural delivery techniques. The hospitals also are encouraging women to postpone scheduled C-sections until the 39th week of a pregnancy, when a baby's lungs are healthier, and use labor-inducing drugs less often…

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