Time Magazine: “Choosy Mothers Choose Caesareans”
Time Magazine (April 28, 2008 Special Environment Issue, page 65) includes a really poor article “Womb Service. Why more women are making caesareans their delivery of choice.” You can read it online (under the title "“Choosy Mothers Choose Caesareans”).
The author, a senior reporter with Time, apparently bought the medical myths -- that women are choosing cesareans, that they are “safe”, and that vaginal births cause pelvic floor damage -- hook line and sinker, and/or did little or no research on her own.
Time should hear from us! You can e-mail a letter to the editor by clicking on the author’s name on the on-line version, or writing to: letters@time.
The worst fallacy is that the author states that some of the rise in C-sections “can certainly be attributed to women with routine pregnancies, like Chung [the only mother featured] who make a pragmatic decision to keep their deliveries just as uneventful.” [not sure what the author means here as uneventful as??] In fact, the ONLY evidence collected about women choosing cesareans is the Listening to Mothers Survey which found that fewer than one percent of women who could ask for a primary cesarean section for no medical reason actually do so. Prior research claiming to indicate rising rates of “Patient Choice Cesareans” was based on hospital discharge data which shows only that there has been an increase in cesarean sections performed prior to labor for no recorded medical reason. The hospital data used did not include any information about women’s preferences or choices.
The author also states “Since doctors are sued more frequently after vaginal births than caesareans, surgery is often the prudent choice when there is even the slightest indication of a difficult vaginal birth.” In other words, the doctor’s fears of lawsuits trumps a woman’s right to true informed consent and to bodily integrity! Fear of a lawsuit justifies surgery!!
And the author states “Vaginal delivery can, for example, lead to future incontinence and pelvic damage…” This conjecture, widely touted by the obstetrical community as a justification for medically unnecessary cesarean sections, has been roundly discounted. Harmful birth practices by obstetricians, including drugs to intensify labor, epidurals that lead to medically assisted birth, episiotomies, supine (on the back) position for pushing, and breath-holding pushing on command definitely contribute to pelvic damage and may contribute to future incontinence, but these are not caused by vaginal birth itself.
A useful resource for facts, links and references on so-called maternal choice cesarean section can be found on the CfM site.
Susan Hodges, "gatekeeper"