One in three babies is cut out of the womb
Figures released today by the National Obstetric Information System show that one in every three babies (33%) born here is delivered by Caesarean section, either elective (which means it is done even when it is not necessary, or just in case) or emergency (which means that the baby, the mother or both would be in serious trouble otherwise). This appears to me to be a disproportionately high number. Are there any doctors out there who can comment? Meanwhile, I found this UK press release which details the situation in Britain, where a one-in-four incidence of Caesarean section in 2005 was considered cause for concern and for analysis by the health authorities. Caesareans are hugely more expensive than normal deliveries, which means greatly increased profit for the private hospitals and clinics, but spiralling costs for the state health care service, as pointed out in these facts and figures from Britain. As in Britain, the escalating number of Caesarean sections may be linked to the fact that increasing numbers of Maltese women are now having their first babies in their 30s. The link between Caesareans and what the medics call an ‘elderly primagravida’ is made in the UK press release, too – but there, the elderly first-time pregnancies are in women in their 40s and not just their 30s. I had noticed that lots of women I know who gave birth in their 30s were given a C-section almost as a matter of course, and I did remember thinking that it can’t possibly be that all of these were incapable of giving birth normally. Women gave birth in their 30s in the 1970s and 1980s, too, after all, and Caesarean sections were really exceptional. Women weren’t stronger then; they’re probably much stronger now. So what exactly is happening?
34 Comments Comment
Leave a Comment
OMG Daphne you made my day! A new topic at last! :D
Although I am not that interested in Caesarean sections, you did remind me of a crazy article Paul Vincenti recently wrote on The Times:
http://www.timesofmalta.com/articles/view/20080530/opinion/economy-and-abortion/
Here he sort of gave up on the religious argument and said that abortion is actually dangerous to the economy because it contributes to the declining rate of population growth. It sounds very Handmaid’s Tale to me – one step further and he’ll be making it compulsory for women to have at least 3 babies each.
He is nuts.
Please rip him to shreds!
Hi Daphne,
I agree with you, in my opinion people ARE waiting too long to try and conceive, and then panic when they find that they find it hard to conceive at 36 or so! No wonder there is such a rush on in vitro fertilisation!
Another point many people miss is that when having children late they risk literally not having the energy to deal with them. An employee of mine had her children (luckily without problems) at 38 and 40. This means that during puberty and their teens, which I believe are the hardest years, the parents will be in their mid fifties, close to sixty in fact. Will they have the energy to deal with two teenage girls at that age?
For the record I am 33 and have two kids with a 3rd (and last) due in September :) I have been married 3 years and my wife is 29. Anyway, in their teens I will be in my late 40s and so hopefully will be able to tackle 3 teenagers head on! It may seem silly but I think it’s an important thing to take into consideration!
Whilst in the UK there was once a newspaper frenzy about women being “too posh to push” (ie, having elective C-sections as a matter of choice (not out of necessity), a la Victoria Beckham), I very much doubt that that is the case here.
Having had my first child by emergency Caesarean (following a gruelling 26+ hours on the “maternity ward factory producton line” – because that’s what it was like) I had no choice but to have an elective Caesarean with my second child; the determining factor being that it was too soon after my first child, and I would have risked having my scar ruptured.
From my experience with the first Caesarean, I would say that it was solely because of incompetence of the various doctors (who were all male, incidentally), who refused to listen to what I had to say. (Female intuition, despite the fact that it was my first, apart from the fact that there were problems with the Oxytocin drip, which was not feeding properly for several hours, despite my protestations – Putting aside the fact that their “bedside manners” were atrocious, to say the very least, sometimes finding it amusing to pass crass jokes; at other times failing to acknowledge the presence of the very person whom they were examining.)
As for the second one, I can only have praise for the polite and gentle doctor concerned, who ensured that all went well, moreso since she was aware of my previous experience.
The situation being what it used to be (and might still be) at the state hospitals, could it be that if women didn’t “hurry up and get on with it”, then they may sometimes have been given a C-section simply to vacate the maternity-ward beds?
One of the main reasons for elective Caesareans is a short time gap between pregnancies. With women having children at a later age now, the gap between children could be too close, thus making a second (and sometimes third) Caesarean necessary.
Another factor could be multiple births – Again sometimes a result of fertility treatment for whatever reason, though here again, the reason often being the mother’s age.
These are just my observations, since I am not a doctor, and neither have I ever worked in the medical field, though I do take a keen interest in reading about issues which may concern me.
Your definition of Elective Caesarian Section is grossly flawed. ECS is performed (or should be) when there is a high possibility that letting nature take its course may put either mother or baby or both at risk. It is also performed to reduce the risks of an emergency CS which are much greater than those of an elective. This is putting it all very simply to get as many people as possible involved in the discussion.
Having said this the increasing rates of ECS worldwide has been a burning controversial topic for donkeys’ years. This is a multifaceted problem. Maternal age, increased safety of major surgery, litigation, patients’ preferences etc. etc. play a part. Finally I must admit that the 33% figure came as a great shock to me and warrants looking into.
It seems that 17% were the actual planned caesarean sections (within the norm even when compared to other countries). The worrying part is the 16% of emergency operations as these carry some risk.
The question is why so many emergency procedures? Are the obstetricians practicing defensive medicine (this could be the case following a number of legal actions)? On the other hand, we might be having some medical/genetic problems not present in other countries e.g short stature, large babies, obesity come in mind. It would be interesting to have the reasons why these procedures were carried out – something that is missing in the report.
An important distinction is who chooses to have the operation – mother, obs or hospital policy.
An elective C-section is generally quicker and more profitable than a vaginal delivery – especially the first birth. In some countries it is a bit of a status symbol, too.
A reason given by some women opting for a C-section is vaginal tone (i.e. how slack – or not – the muscles remain after the vaginal birth)… go figure
@ Caphenni
You say that Paul Vincenti “sort of gave up on the religious argument and said that abortion is actually dangerous to the economy because it contributes to the declining rate of population growth”
If one looks at abortion from a “right” or “wrong” perspective at some point one must drag in ethics and morals – which is where the terms have complete meaning.
If one tackles abortion from any other point, one has to hypothesize and/or interpret data (one cannot exclude bias or error) and/or draw inferences (again, not an error free endeavour) from a limited (or worse, biased) knowledge base.
I think that Paul Vincenti’s arguments, a prima facie, appear to contradict forecasts in global population growth … but then again any theory with the figures to prove it (even if it flies in the face of common sense) stands – unless falsified. (Popper has a good “go” at scientific method in his seminal Logic of Scientific Discovery)
It’s a matter of convenience Daphne as life grows fast paced people look for cut to save time…… even in delivering their babies ….plop and off it goes.
Its funny how even the most fundamental natural functions , childbirth becomes an express procedure.
Rate of women who deliver their babies via Caesarean section stands at a record high in Malta.
While the procedure is sometimes medically necessary for preserving the lives of mother and child, many health experts believe a desire for convenience has driven the Caesarean section rate to its current heights even though there is health risks.
Patient preference is one reason why the rate of Caesarian sections is growing. Rather than waiting in suspense for labour to begin, women can schedule to the hour when they will deliver their child.
If the woman has been told it’s just as safe as vaginal childbirth, there’s that temptation to make an appointment for the best birthday date. This will save time for obstetricians and also for mothers, a C-section takes half an hour and normal childbirth especially if its primagravida can take 12hours.
Vaginal birth is safer but takes time, it a choice mothers take which happen to be the best choice for obstetricians cause its time consuming, more profitable and no push push just plop! …………
Caphenni Wednesday, 11 June 1814hrs
“It sounds very Handmaid’s Tale to me – one step further and he’ll be making it compulsory for women to have at least 3 babies each.”
If the homo sapiens species depended on the likes of you to go forth and increase and multipy , it would have been as extinct as the dodo by now.
[Moderator – Sybil, I know. We should shoot gay people like dodos and have them strung up from lamp posts. The last I heard, gay people were holding secret ‘pink masses’ (liked ‘black masses’, except gay) where they eat babies and pregnant women. There’s even one openly gay Maltese chef who published a book recently, containing recipes that contain secret codes for instructions to make deep-fried or roasted babies. They’re trying to take over the world, I tell you!]
Prat inspector cum prat nominator …
(Click on the 2nd photo – No, it’s not ALFRED Sant)
http://www.josephmuscat.com/pages/lc/genInfo.asp?id=29
Click on the 2nd photo of the “Vittoriosa event” on the above site to see the one
I read it somewhere on an American magazine that gynecologists are not taking ‘risks’ so they opt for Caesarean, they lower their risk of being sued, not to mention the amount of ‘business’ they create( from which some take a commission).
@ Caphenni : you are out of subject.
There was a report on Sky some time ago that there was a much greater chance of a woman in labour ending up having a Caesarean on a Friday. This was so that more doctors could have the weekend off.
@david:
you have to find the right person to marry first.. that’s the problem I guess and the reason why some marry late. Not everyone is as lucky as you to have found the right person at an early age. But then there are those who have married at a young age, have children, and end up separated or divorced, so I’m not sure it’s better to have married young. In fact I think it’s not a good idea at all.
@off topic,but…:
what did you see? I clicked on the photo and it just goes to the next one…
Caphenni seems unable to resist scratching his/her itch for even one topic.
@John Schembri: C-sections in the US are one in three births, the same as in Malta.
@Off topic, but: I clicked on the photo, but….please give us the name.
@Sybil –
(with apologies to everyone else for going off-topic – unfortunately we can’t send private messages to each other here.)
Luckily for everyone, God* was very clever when he created the world. He didn’t make EVERYONE gay, and he didn’t make gayness a choice. Instead he apportioned being gay to only about 7-10% of the population.
He was also careful to make sure that gay people are not all born infertile, so if push comes to shove, quite literally, we WOULD be able to procreate.
God was even clever enough to not remove the paternal and maternal instinct in gay people so as to make sure that they would want to help in raising children that are so kindly abandoned by their straight parents (you know, the ones who we think are the best option for raising children, even when they abandon them).
Oh, and I am proud of not being defined by my function. I would hate to be put on earth purely to procreate. And if I were a straight fertile woman, I would be heavily pissed off at Paul Vincenti for insinuating that I am nothing but a functional womb, there to help make the world go round and procreate, even when I am not ready to.
European birth rates are not decreasing cos of abortion but because of several complicated social and cultural factors. Its also not the end of the world seeing as a country like Malta is so overpopulated. It will require some shifts in the way we do things however, like the raising of the age of retirement etc.
*replace with your choice of creator.
@Caphenni – the religious right-wing sees women in terms of our reproductive function, begging the question as to what our purpose could possibly be in the half-century of our life between 45 and 95. Oh yes, to help change the nappies of subsequent generations….
Caphenni: well said. They Sybils of this discussion, here and elsewhere, need a little mind-broadening.
DCG – Dr Sant the gynae, in a salmon-coloured t-shirt
Caphenni – You said “He didn’t make EVERYONE gay, and he didn’t make gayness a choice.” Well said. I agree with you entirely on that one, and would like to apologise once again for my comment of yesterday. As I said previously, it was meant as a dig at one particular (female) person, though not at yourself (who I don’t know from Adam). I really shouldn’t have said it, I know, especially since I didn’t even mean it.
I agree with Daphne when she asks what on earth is happening? I have three children all born naturally and over the years have realised that friends have opted for Csections for various lame reasons – it is safer (which it is not!) baby too big!! less pain etc often their gynae actually reccomends a csection – i am baffled by the argument stating that our doctors ‘dont take risks’ what does this mean??? My take is that gynaes just love to slit us open – it means they are in control when in a natural birth it is your midwife that delivers your baby. When it is necessary then a c-section should be undertaken but this should be the exception and not the rule!
[Moderator – Sybil, I know. We should shoot gay people like dodos and have them strung up from lamp posts. The last I heard, gay people were holding secret ‘pink masses’ (liked ‘black masses’, except gay) where they eat babies and pregnant women. There’s even one openly gay Maltese chef who published a book recently, containing recipes that contain secret codes for instructions to make deep-fried or roasted babies. They’re trying to take over the world, I tell you!]
I know. But next time make them pay for the advert and don’t do it for free for them.
;)
ps.I was referring to those culinary delights mentioned earlier of course.
@Caphenni et al
I think that were you to look closer at what the Gift of Life movement is saying, you would notice a different, subtler message than the one you seem so keen on interpreting. Treating a person purely in functional terms, such as procreating, would not fit in with their philosophy at all.
Theirs is not just an-anti abortion stance, but a pro-life, which is a far more positive approach to life, rather than an instrumental view of the female body. It does, however, imply being against abortion, as well as other issues which do not embrace life.
Quoting from their website, their aim is
“Supporting the full protection of human life from conception through all stages of development to a natural death.”
They also offer counselling services as well as help with pregnancies by qualified personnel.
@Zizzu
Glad to see Popper being quoted here!
David Schembri: If Gift of Life’s message can only be read with a magnifying glass then the fault is not in the interpretation of the message but in its formulation and transmission. If the medium is the message, a middle-aged man translates into “an instrumental view of the female body”. This may not be the intended message of Gift of Life but it is the one that is received by many.
@David
Isn’t that God’s job? Or doctors? Or the law’s? How do they hope to go about it?
Does it mean that they are going to have similar campaigns to make assisted suicides and euthanasia even more illegal too?
It’s a slippery slope. A very dangerous one where they are out to control people’s bodies and choices in the name of some God or something. I don’t like it.
@Off topic, well in that case it’s not really off topic at all, is it?
@Corinne Vella
I do not think my view of the matter requires a magnifying glass more than any other viewpoint expressed here: quoting Marshall Mc Luhan doesn’t seem to be the most straightforward way of going about interpreting things either.
I think, however, that important topics such as life and death issues require more thought and insight than others, in which case there is no problem whatsoever with using a magnifying lens to distinguish between concepts and schools of thought. The devil’s in the details they say.
@Caphenni
Read what I just said. Please.
That said, GoL might want to try different PR methods. They seem to be ever-so-slightly ineffective…
I’ll gladly help them with their PR:
Create a campaign that is actually needed, even if just by one person.
U halluna mill-Gift of Life. Why dont u take a look at what is happening at MLP HQ tonight! Or you haven´t heard yet?
David Schembri – take it from somebody who works in the field: their ineffectiveness is almost wholly to do with the fact that they are a bunch of middle-aged men banging on about what are essentially women’s issues. Now if they had spokespersons who were young women….
Uncle Fester – Maybe you could shed some light on this issue, given your medical experience. X’tahseb? (And I’m not being sarcastic here.)
@Amanda Mallia. Medical experience? What medical experience? I stayed clear of this blog because I know absolutely nothing about the issue of giving birth much less giving birth by caesarean section.
The only thing I have to say on this issue is addressed to Daphne – the religious right’s political home in Malta is the Nationalist Party. That’s to say the party that you support. Daphne, hate to tell you this, your place is in New Labour not the PN. You are a progressive person on so many issues. The only thing keeping you in the PN is the fact that you feel that you were born into the Party. That coupled with the trauma of what you saw the country go through in the 1980s under Old Labour.