The alarming trend in ceasarean sections: "From the Womb, Untimely Ripped" By Steven Cahill The rate of Caesarean births performed in the U.S. over the last ten years has nearly tripled, according to official estimates, and the increase has sparked controversy nationwide. A recent study conducted by The Clinton St. Quarterly indicates that Portland-area hospitals may have an even higher Caesarean section rate than national estimates. Caesarean section (C-section), the removal of the fetus through surgical incision in the abdominal and uterine walls, was once a rare lifesaving procedure. Twenty years ago, C-sections accounted for an estimated two to four percent of all births. But by 1971, the approximate rate of C-sectipns in the U.S. was5.7%. By 1978, according to the National Center for Health Statistics, the estimated rate of C-sections nationally had jumped to 15.2%. The average total C-section rate reported by Portland area hospitals thus far in 1979 is 19.7%, according to the Quarterly's survey. For some, the increasing C-section rate is cause for serious concern. “There’s an alarming increase in the number of C-sections being performed locally,” says Hazel Woodward. a Portland midwife who has delivered over 250 babies. “A lot of them are unnecessary.” “ Instead of taking the time and care to facilitate a long or difficult vaginal birth, often doctors will just go ahead and operate,” she adds. Most physicians interviewed who perform C-sections, however, generally agree with Dr. L.S. Caspersen, a Portland obstetrician. “ It’s no therapeutic triumph to pull out a kid with a banged-up head just so someone can say it was a natural birth." His stated opinion is that “ few if any" C-sections performed by Portland area doctors are unnecessary. According to the recent Quarterly survey, Portland-area hospitals report the following total C-section rates: One of the highest rates of C-section births in Portland is found in the Medicaid population. According to the Professional Standards Review Organization, the C-section rate for mothers between the ages of 15 and 44 who delivered under the Medicaid program in 1978 was 29.7%. “Frankly we're surprised by the high rates and cannot comment at this time." admits Susan Dietsche, proHospital Times Period Total Births Percentage Caesarean Dwyer Jan-Sept., 1979 1970 320 29% 383 7.8% Eastmoreland Jan.-Aug., 1979 1970 168 13.1% 393 3% Emanuel Jan.-Sept., 1979 Jan.-Sept., 1970 1873 19% 2719 9% Forest Grove Jan.-Sept., 1979 1970 330 15.7% 153 7.8% Good Samaritan Jan.-June, 1979 1970 1184 20.8% 2269 10% Kaiser Jan.-June, 1979 1970 1866 18% 2623 6.9% Portland Adventist Jan.-Sept., 1979 1970 1556 19.9% 1040 6.3% St. Vincent Jan.-Sep t., 1979 1971 978 13.1% 1174 / 4.5% Tuality Jan.-Sept., 1979 1970 477 16.5% 642 8.4% UOHSC University Hospital Sept.-June,. 1979 1971 2200 17.3% 1668 16% Willamette Falls Jan.-Sept., 1979 670 19.1% Woodland Park Jan.-Sep t., 1979 1970 562 34.8% 893 5% gram director for the Regional Office of Adult and Family Services. “ It's viewed as a serious statistic and we’ll be looking into it." While there is dispute among various members of the local birthing community as to how many C-sections are actually necessary, there is general agreement that the surgeries are accompanied by greater risks. According to an 11-year Brown University study published in 1978, women who deliver by means of C-section face a risk of death 26 times greater than those who deliver vaginally. "We're concerned that in our enthusiasm to do well by the baby, we may be losing perspective and fail to do well by the mother." comments Dr. John R. Evrard, co-author of the study, which appeared in the journal Obstetrics and Gynecology. Common C-section risks for the mother include complications relating to infection, hemorrhaging, anesthesia, and gastro-intestinal problems. Psychological distress can also present serious difficulties, experts say. Risks for the baby include respiratory distress, wet lung (fluid left in the lungs), premature removal, and the possibility that anesthetics and other medication may enter the baby’s system. In addition, some argue that bonding — the process of establishing a close, loving relationship between parent and child by early physical closeness — may be interrupted. Indications commonly listed as reasons for C-sections are cephalo- pelvic disproportion (baby too large to Looking for a special Christmas present for a special person? Try ANTIQUES + FUNK 3734 S.E. Haw thorne, Portland M onday through Saturday 11 am to 6 pm GREAT OLD PICTURES AND PRINTS • COLLECTIBLES ART DECO • ART NOUVEAU JEWELERY • FURNITURE • RUGS • MANY UNIQUE ITEMS 20% - 25% discount on most merchandise with this ad “Invest in your Christmas presents 5
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