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Pregnancy & Birth

Maternal Request for Cesarean Delivery: Myth or Reality?

The rate of cesarean deliveries in the United States has skyrocketed in recent decades; in 2010, 32 percent of women who gave birth had cesarean section deliveries,1 up from 5.5 % in 1970. 2 According to Childbirth Connection, the best outcomes for women and babies appear to occur with cesarean section rates of 5% to 10%, and rates above 15% seem to do more harm than good.

Why is the cesarean rate so high? Many factors contribute to this rise, including the failure of hospitals to support normal physiologic labor, providers’ fear of malpractice suits, the increasing tendency of hospitals to induce labor and use electronic fetal monitoring, the myth that cesarean sections are safer than vaginal birth, and a lack of awareness of the harms that are more likely with cesarean sections. (For an excellent analysis of why the cesarean rate has skyrocketed, see Childbirth Connection’s Why Is the National U.S. Cesarean Section Rate So High? ) Another factor often cited as contributing to the rise is maternal request for cesareans.

According to some popular media, many moms are “too posh to push” and choose, for a variety of reasons, to have cesarean sections when there is no medical reason to do so. But is it true that increasing numbers of women are themselves choosing to have cesarean sections?

The results from a recent national survey, Listening to Mothers III, found that the answer to that question is a resounding no. The survey polled 2,400 U.S. women who gave birth in hospitals in 2011 and 2012. It found that just 2% of women asked their provider to schedule a cesarean section when there was no medical reason to do so.

Cesarean sections and vaginal birth both have benefits and harms to women and babies. To learn more about them, see Childbirth Connection’s What Every Pregnant Woman Needs to Know About Cesarean Section (last revised in 2012).

To find out more, see the following:

  • Don't Blame Mothers for C-Section Vogue 
    A commentary by Our Bodies Ourselves Executive Director Judy Norsigian and professor of maternal and child health at Boston University School of Public Health Gene Declerq.

  • Patient-Choice Vaginal Delivery? 
    This essay from the American Annals of Family Medicine examines why the language of choice is used to justify elective cesareans, but not to allow women the option of vaginal birth after cesarean or vaginal breech birth.

Notes

1. Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2010. Natl Vital Stat Rep 2011;60(2):1-25. Accessed 1.10.14 at http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdf.

2. P J Placek and S M Taffel. The frequency of complications in cesarean and noncesarean deliveries, 1970 and 1978. Public Health Rep. 1983 Jul-Aug; 98(4): 396–400. Accessed 1.10.14 at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1424454/

Written by: Our Bodies Ourselves
Last revised: May 2006

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