C-section rates continue to rise, there are many theories why, but no conclusive evidence to definitively prove them. One persistent theory is women wanting them, which has gained the tag ˜too posh to push”. Different studies in different parts of the world claim proof or disproof of this theory one way or the other. A new one done in Scotland suggests there may be something to it if we take the ‘posh’ part literally.
This study published in the May 18 online edition of the journal BMC Public Health suggests that in Scotland at least there has been a shift in the likelyhood for an elective c-section, from the lower to higher social classes. “Thirty years ago, mothers having cesarean sections were more likely to come from deprived areas and/or from a lower social background. This was true for both elective and emergency sections. Ten years later, the rates had changed so that, although women from a lower social background were more likely to have emergency sections, there was no difference between them and women from a higher social background in elective surgery rates. By 1999-2000, the rates had equalized for emergency section, but babies born by elective surgery were more likely to belong to mothers from the higher of the social classes measured.” study co-author Ruth Dundas, a researcher with the Medical Research Council/Chief Scientist Office, Social and Public Health Sciences Unit said.
There is a danger in making generalized assumptions about all populations from a study like this. I would also argue that unless it’s findings were in some way used to help find means of reducing medically unnecessary c-sections, such studies are of dubious value.
One additional element in the theory of “too posh to push” is the idea that some women are just too afraid of the potential pain of vaginal birth – a legitimate condition in fact, called Tokophobia. In the UK again, women who have such fear will be offered psychiatric counseling. They will also be told of all the potential risks of a c-section, to both themselves and their infant, in an attempt to change their minds.
While the fact that a vaginal birth with minimal interventions is safer for both mom and baby is emphasized, for a National Health Service of the type Britain has there is a big financial incentive as well. A cesarean delivery in a state hospital in the UK costs more that three times that of a vaginal delivery. This being said, that it is indisputable that for healthy women vaginal birth is safer and lacks the many challenges of recovering from a c-section
photo courtesy of jessicafm