(no subject)
I've been meaning to post this for a while, but I'm just getting to it. It's an article in the New Yorker by a doctor who was wondering why the C-section rate is so high. It's a long read, but it's really interesting if you're into medical history. Or if you're looking at giving birth in the next few months. *wail*
http://www.newyorker.com/archive/2006/10/09/061009fa_fact?currentPage=all
For the lazy, here's the Cliff Notes:
OBs have a big bag of tricks to get a baby out when a birth isn't going well. Forceps, a lot of intra-uterine maneuvering, drugs... In the good old days, OBs used to use these a lot, and a C-section was kind of a last resort.
Around the 30s, though, more women started giving birth at hospitals, but when hospitals turned out to be no safer than giving birth at home, the APGAR* score was introduced. Scoring every baby at birth meant OBs had a quantitative measure of how they were doing, so they could improve hospital performance. OBs started to be pressured to get their scores up and keep them up.
The good news: After introducing APGAR scores, infant mortality at hospitals plummeted, since all the doctors were using the same metrics and essentially competing to see who could deliver the most healthy babies. The unfortunate side effect, though: the C-section rate bounced waaaaay up.
Turns out, C-section is a very reliable way to get a baby out in good shape, with a good score. Bonus: It's also easier to teach a new OB to do a C-section, where a lot of the "old" tricks take a lot more practice and hands-on experience. (No one wants a n00b doctor delivering their kid with salad tongs.)
The author notes that an increase in C-sections might be the tradeoff as giving birth has gotten a lot safer since the 30s. He also notes that the moms don't get an APGAR score. Mom gets a longer recovery time, bleeding, scarring, more pain, and all the other side effects that go with major surgery. Oh joy.
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* APGAR of 1: Dead baby. 8 and up: Go baby, go! http://en.wikipedia.org/wiki/Apgar_score
http://www.newyorker.com/archive/2006/10/09/061009fa_fact?currentPage=all
For the lazy, here's the Cliff Notes:
OBs have a big bag of tricks to get a baby out when a birth isn't going well. Forceps, a lot of intra-uterine maneuvering, drugs... In the good old days, OBs used to use these a lot, and a C-section was kind of a last resort.
Around the 30s, though, more women started giving birth at hospitals, but when hospitals turned out to be no safer than giving birth at home, the APGAR* score was introduced. Scoring every baby at birth meant OBs had a quantitative measure of how they were doing, so they could improve hospital performance. OBs started to be pressured to get their scores up and keep them up.
The good news: After introducing APGAR scores, infant mortality at hospitals plummeted, since all the doctors were using the same metrics and essentially competing to see who could deliver the most healthy babies. The unfortunate side effect, though: the C-section rate bounced waaaaay up.
Turns out, C-section is a very reliable way to get a baby out in good shape, with a good score. Bonus: It's also easier to teach a new OB to do a C-section, where a lot of the "old" tricks take a lot more practice and hands-on experience. (No one wants a n00b doctor delivering their kid with salad tongs.)
The author notes that an increase in C-sections might be the tradeoff as giving birth has gotten a lot safer since the 30s. He also notes that the moms don't get an APGAR score. Mom gets a longer recovery time, bleeding, scarring, more pain, and all the other side effects that go with major surgery. Oh joy.
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* APGAR of 1: Dead baby. 8 and up: Go baby, go! http://en.wikipedia.org/wiki/Apgar_score