07 Sep
Obstetric Care Consensus:
In 2011, one in three women who gave birth in the United States did so by cesarean delivery. Even though the rates of primary and total cesarean delivery have plateaued recently. There was a rapid increase in cesarean rates from 1996 to 2011
Although cesarean delivery can be life-saving for the fetus, the mother, or both in certain cases. The rapid increase in the rate of cesarean births without evidence of concomitant decreases in maternal or neonatal morbidity or mortality raises significant concern that cesarean delivery is overused. Therefore, it is important for health care providers to understand the short-term and long-term tradeoffs between cesarean and vaginal delivery. As well as the safe and appropriate opportunities to prevent overuse of cesarean delivery, particularly primary cesarean delivery.
Balancing Risks and Benefits of Obstetric Care Consensus:
Childbirth by its very nature carries potential risks for the woman and her baby, regardless of the route of delivery. The National Institutes of Health has commissioned evidence-based reports over recent years to examine the risks and benefits of cesarean and vaginal delivery.
For certain clinical conditions––such as placenta previa or uterine rupture––cesarean delivery is firmly established as the safest route of delivery. However, for most pregnancies, which are low-risk, cesarean delivery appears to pose the greater risk of maternal morbid-it and mortality than vaginal delivery.
It is difficult to isolate the morbidity caused specific call by route of delivery. For example, in one of the few
randomized trials of approach to delivery, women with a breech presentation was randomized to undergo planned cesarean delivery or planned vaginal delivery, although there was crossover in both treatment arms
In this study, at 3-month follow-up, women were more likely to have urinary, but not fecal, incontinence if they had been randomized to the planned vaginal delivery group. However, this difference was no longer significant at 2-year follow-up. Because of the size of this random-the sized trial. It was not powered to look at other measures of maternal morbidity.