Caesarean sections should only be done out of medical necessity, WHO says

[Eugene]

Source: The Guardian

Caesarean sections should only be done out of medical necessity, WHO says

Sarah Boseley Health editor
Friday 10 April 2015 13.28 BST

Caesarean sections should only be carried out when medically necessary, according to the World Health Organisation, which says the surgical procedure can put the health of women and their babies at risk.

The WHO reiterates the view of its health experts, who have said since 1985 that the “ideal rate” for caesarean sections is between 10% and 15% of births. Caesareans save lives for example when women are in obstructed labour or their babies are in distress. But two new studies show that in countries where they account for more than 10% of births, “there is no evidence that mortality rates improve”, the WHO said.

About 25% of UK births are through caesarean section, up from 12% in 1990. The rise is worldwide and thought to be a combination of doctors believing surgery is safer in potentially difficult births and women choosing not to undergo labour. More than half of women giving birth have caesarean sections in Brazil and the figure rises to over 80% in private hospitals.

There are risks in any surgical procedure. According to the National Institute of Healthcare and Clinical Excellence (Nice), a caesarean increases the risk that a baby will end up in intensive care and that women will stay longer in hospital, have a hysterectomy or a cardiac arrest. Its 2011 guidelines, however, state that women who want a caesarean should get one, even if it is not for medical reasons.

[font size=1]-snip-[/font]

Read more: http://www.theguardian.com/society/2015/apr/10/caesarean-sections-medical-necessity-who

[Erich Bloodaxe BSN]

1. " and that women will stay longer in hospital,"

Erm, a lot of women I know complain that hospitals kick new mothers out too fast after a birth nowadays, I assume because insurance won't cover longer stays.

[DeadLetterOffice]

2. Hospitals are not good places for healthy people.

Don't agree at all with insurance companies dictating when new moms should go home, mind you.

Just personally couldn't get out fast enough after my second son was born (complication & medication free, big factors there).

[Erich Bloodaxe BSN]

3. I certainly agree with your headline.

I just know that sometimes the complications don't pop up right away. My mother has the hospital bill for her birth framed on the wall in their house. I think it was $12 for the birth and roughly a week's stay in hospital. (Admittedly, she's in her mid70s now, so that's a pretty old bill....)

[DeadLetterOffice]

9. You're quite right.

I wasn't in nearly the same hurry to leave when my first child was born. But after the second one I just wanted to be back in my space with my family and my baby.

Every person, every birth, is different, and it's nuts that the insurance companies get a say in when a new mom is discharged.

[SheilaT]

7. Not all women recover so quickly after giving birth,

even an uncomplicated birth.

A C-section is major abdominal surgery, and unless a woman has very good support at home, going home even after three days is pushing it. I had 2 C-sections, and recovered incredibly fast after both of them. I could actually stand fully upright the day after each time, which is apparently somewhat unusual. I was in 5 days the first time, 4 the second, and the 4 days felt just a bit quick. I was quite bored, I must admit, but there was still a certain amount of physical recovery needed.

It sometimes feel that if the insurance companies had their way, women would be driven to the hospital in the final stage of labor, walk inside, squat down, give birth, have the baby cleaned up and then leave.

For a woman who wants to breast feed, but may be having trouble getting started, a couple of days in the hospital simply isn't long enough to work out early problems. If there was a very good system of home visits, and not just for a nursing mom, then super-short stays would be ideal.

[DeadLetterOffice]

8. Insurance companies are not patient focused at all.

They really have no business deciding when any patient should leave hospital. It's ludicrous.

And I love this:

If there was a very good system of home visits, and not just for a nursing mom, then super-short stays would be ideal.

SO TRUE!!

I was lucky with son #2 and I know it -- no C-section, no tearing during delivery, no fetal distress, not a first time mom.
Son #1 was a much harsher delivery all around, and I would've loved another day or two in the hospital before they made me go home.

[Smithryee]

4. My wife had a C-section

and she stayed in the hospital for 3 days. I think that's the minimum needed time to recover from a C-section.

[elleng]

5. Both of my daughters had 'normal' births

but both 'marginally' complicated so they stayed 1-2 days longer than 'normal.' No problems with insurance.

[kdmorris]

6. I begged to get out of the hospital after my c-section

The hospital was like "but you can stay for 4 days" and I was like "But this isn't my home and I want to go home". So I left (with permission from my doctor and the pediatrician) after about 54 hours. Nothing was better than being back in my own house with my husband and babies. My husband did everything and I healed well.

[PADemD]

10. Five days in hospital after a C-section

The first day, the nursing staff complained I wasn't moving enough. Maybe, it was because I felt like I had been run over by a truck.

Then someone told me to get out of the bed because they wanted to change the sheets. No one helped me as I struggled to get out of bed.

Day two or three, I can't remember which, I walked down the hall to look in the nursery window and felt like I was going to faint.

After getting home, then I got a wound infection; and try walking the floor at night with a colicky baby with one arm and holding your guts together with the other.

Having a C-section sucks!