Stars 4 Kidz

As a chiropractor I am well-aware of the many important benefits of vaginal births versus Cesarean births for the overall health of babies. When an infant is allowed to make its way completely through the birth canal, this natural process encourages many of the primitive reflexes that will later help the baby to develop healthy motor function. Of course, vaginal births are not always possible, but they can and should be encouraged far more frequently than they are in this country. The national Cesarean rate has been steadily rising for the past eleven years to its current 31.8 percent. Though there is no consensus on what the rate should be, government health agencies and the World Health Organization have suggested 15 percent as a goal in low-risk women.

Why is the rate in the U.S. so high? Statistic show that it is fed by repeat patients. Many doctors and hospitals in this country refuse to let women who’ve had a prior Cesarean even try to give birth vaginally. The reasons for this have a practical financial basis (as do most expensive healthcare procedures) rather than their being performed for the safety and well-being of the patient, both mother and baby. Doctors and hospitals not only fear malpractice lawsuits and insurance premium increases, but they also get far more money for performing Cesarean surgery than assisting with a natural birth — several billion dollars a year, in fact, for a procedure that is unnecessary in most cases.

Vaginal births save money and are better for many mothers and infants. The National Institutes of Health is holding a conference this week in Bethesda, Maryland, where they will discuss this country’s dismal rates of vaginal birth after Cesarean (VBAC) that have descended dramatically since 1996. “I think it’s the purpose of this conference to see if we can turn the clock back,” said Dr. Kimberly D. Gregory, vice chairwoman of women’s health care quality and performance improvement at Cedars-Sinai Medical Center in Los Angeles.

Years ago fears that the scar on the uterus would rupture during labor, which can be life-threatening for both the woman and the child, was given as the reason for not allowing a VBAC. But even as far back at 1980, an expert panel declared it safe for many women, and yet the trend continues

While Congress is debating affordable healthcare, they should consider sweeping, fundamental changes in medical practices like Cesarean surgery, such as removing the profit motive for performing it, and allowing midwives to handle more deliveries. Federally funded medical care during pregnancy and labor would preclude the threat of insurance companies to increase premiums or withdraw coverage is doctors and hospitals allow VBAC, and midwives help to reduce costs in many ways, not the least of which is helping to reduce costly complications through their extended presence during labor and the birth process.

Nurse-midwives at at hospitals run by Indian Health Services on reservations, where Cesarean rates are a low 13.5 percent (less than half the national rate), deliver most of the babies born vaginally, with obstetricians available in case problems occur. Midwives staff the labor ward around the clock, a model of care thought to minimize Cesareans because midwives specialize in coaching women through labor and will often wait longer than obstetricians before recommending a Cesarean. They are also less likely to try to induce labor before a woman’s due date, something that increases the odds of a Cesarean.  In the rest of the country, nurse-midwives attend about only 10 percent of vaginal births.

There is much to be done to fix our ailing healthcare system and, yes, this is just one area. But, giving babies a healthy start in life through natural childbirth will, no doubt, help to reduce future health problems for them as they grow old and, therefore, to reduce future healthcare costs as well.

Source: nytimes.com

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