Should We Care How Beyoncé Gave Birth?

Update: after posting this, Beyoncé released a statement saying that she had a “natural” birth.

Right now, the blogosphere, facebook, and apparently the entire internet, are all on fire about how Beyoncé gave birth to her baby. Does it matter? Should we care? My answer is, yes… and no.

Celebrity is a two-edged sword. The same people that want tons of attention when it comes time to sell an album, star in a movie, or play a game, can’t just suddenly plead the interests of privacy, and desire inattention, when it comes to their personal lives. That sort of sucks, but there you are. I wouldn’t want to be stalked by paparazzi, either, and have every bad photo of me and my cellulite plastered over every tabloid, but for the most part, that is unfortunately the price to pay for celebrity. We can argue over whether it should or shouldn’t be, but the reality is, for the moment, that is what is.

I remember a reply by John Lennon, in an interview in which he and the rest of the Beatles were asked if they would like to be able to walk down the street without anyone recognizing them or without anyone causing an uproar; his response demonstrates that he understood the reality that he couldn’t have it both ways; he said: “We used to do that all the time, without any money in our pockets. Why would we want to go back to that?”

Beyoncé, and certainly every other celebrity, justly or unjustly are put under the microscope, and fortunately or unfortunately thousands of people will follow the example of one famous person. In that aspect, those of us who care about issues of birth and pregnancy, and especially those of us who support and promote vaginal birth, unmedicated birth, and/or home birth — “natural child birth” folks — are frequently (and rightly, I believe) dismayed at the high rate of C-sections, and what we perceive as almost the promotion of it in celebrity births.

So, thinking about how that many people (particularly today’s generation of teenage and young girls) may look up to Beyoncé, and possibly may be influenced by reports of her C-section, to plan on having their babies by C-section, it is possible that every celebrity C-section today may result in an increased percentage of C-sections in the future, and therefore, it does matter, and we should care about how others, particularly celebrities, give birth, because of that influence; and while Beyoncé’s C-section may have been the best choice for her (either for medical benefit/necessity or personal preference), and she may have no negative repercussions from it, almost everybody who takes an interest in birth realizes that C-sections as individual choices may be better, but C-sections as an aggregate tend to have worse outcomes for both mother and baby, particularly repeat pregnancies and C-sections.

Unfortunately, births don’t happen in aggregate — they happen to individuals. So, in dissecting birth as a whole, we end up trampling on individual births. This is one reason it’s so difficult to talk about many birth topics, such as C-section vs. vaginal birth, because no matter what you say, there will always be at least one person who said, “I did that, and it turned out horrible!” or “I did that, and it was the best decision I ever made!” Many women report that their C-sections were horrible, with nightmarish recoveries; and many other women report that their C-sections were a breeze; and some women who have had both C-section and vaginal births will say diametrically opposite things — that some found their C-sections to be easier recoveries, and others that their vaginal births were easier to recover from. Unfortunately, there is no 100% certainty in any decision made, no matter what, so women just have to choose what they believe to be best for them (and I hope that they will be given accurate information, and not pressured or coerced in any way).

I don’t know why Beyoncé made the choice she did, though there may have been some medical reason (I haven’t read any of the reports because, quite frankly, I don’t care; I’m not “into” pop culture, and she’s basically just a name to me, though I *think* she was in the Pink Panther movie with Steve Martin some years ago, and I did watch that). I did read this and this commentary on the blowback she has received, which, along with a few headlines, is the sum total of what I’ve read, and several people threw out in her defense that there may have been unreported medical reasons, such as pre-eclampsia or breech baby. I must admit that when I saw that she had had the baby already, I was a tad worried that the baby might be early [it seems just a month or two ago, I saw some headline about her being pregnant, so I thought at first it might be **really** early], and if she had an elective induction/section at or before 37 weeks, I was concerned on her baby’s account, because I know in aggregate, these early births are worse for the baby, though in particular, it may not be horrible for any individual baby. Also, someone suggested that they intentionally gave the wrong due date, to avoid increased press scrutiny at the time of the correct due date, and the baby may have been 40 weeks, or possibly even over 42 weeks, instead of the reported 37 weeks.

Whatever. I don’t care. I really don’t.

I don’t care why she chose it, whether there was a true medical need, too posh to push, desire for being able to schedule the birth, the belief that it was safer, the desire for privacy, or whatever her reason(s) were. [Although I must admit, that if there was a real medical reason, I hope it will be told, because I think the last thing our society needs is another high-profile celebrity having a medically unnecessary C-section, and making it look like it’s the smarter, better, easier choice.] For Beyoncé as a person, it makes no difference; for her as a celebrity with influence, it does make a difference to the thousands she may influence.

Her desire for privacy could be the sole reason for choosing a C-section, and I would understand that. I’m not a celebrity, so I can’t pretend to have the same knowledge base or experiences a celebrity has, but I have a pretty good imagination, coupled with sufficient knowledge of the paparazzi and how they work. What wouldn’t one of these people do, to get a picture of Beyoncé in labor, giving birth, having a C-section, holding her baby, or anything else related to this time? It would be pretty hard to impersonate a labor nurse or otherwise infiltrate the L&D floor, but it could be done, by someone with the knowledge and desire to do it. However, it could be easier to pay off an employee to break regulations and get such a picture. Also, put yourself into a celebrity’s place, and imagine trying to relax through the contractions, or push your baby out, with the fear that somebody somewhere had planted a hidden camera and/or microphone, and would be selling it for thousands upon thousands of dollars to some tabloid magazine somewhere. Yeah, that would make renting out a hospital floor and scheduling a C-section more appealing to me, too.

I also don’t have a problem with her renting out the entire floor — it’s her money, she can spend it as she wishes. I’d spend it differently, but that’s me; this is her choice — she can do with it whatever she wants, as long as it isn’t harming anybody else and is not illegal.

Ah, but there’s the rub, isn’t it? Her choice to take over the hospital floor *did* harm others — apparently there were many stories from parents who were not allowed to visit their babies in the NICU, because of this. She went to such lengths to choose what she felt was best for herself and her baby, but in so doing, the rights of other parents to even see their fragile newborns (most of them probably preemies, many of them with serious, even potentially lethal, conditions) was trampled on. It is my hope that she didn’t know what was happening, and when she chose to rent the entire floor so that she could have privacy, that she did not intend for other parents to be separated from their precious babies.

One of the articles I linked to above was sarcastically “Beyoncé Must Be a Terrible Mother” [it was a collection of various comments from people on facebook, reacting to the news that she had had a C-section, though no reason was stated, and that she had rented out an entire hospital floor to do so], and I agree with the blogger’s point of view — that having a C-section, even a medically unnecessary one, does not make one a bad mother. However, I would say, that keeping parents from their children does make you at best an unthoughtful human. I don’t say that’s Beyoncé’s fault; I think that was the hospital’s fault, plain and simple. Even if Beyoncé knew that many parents would be separated from their NICU babies and didn’t care (which would be pretty heartless, if true), it is still the hospital’s ultimate responsibility, so I lay most if not all of the blame at their feet, because the hospital folks should have known what the result would be, and they chose to put money and fame (having Beyoncé pick *them* to have her baby in), over principles, and also over the benefit of the many parents, who likewise entrusted their births and their babies to this hospital, and deserved more consideration.

Iatrogenic Prematurity

This month is Prematurity Awareness Month, and although I missed the “calling all bloggers” Prematurity Awareness Campaign for Nov. 17 [I just didn’t feel like writing about it — sorry — nothing “sparked” in me at the time], since that time, I’ve gotten “sparked” about iatrogenic prematurity. If you’re unfamiliar with the term, it just means “doctor-caused” prematurity.

The March of Dimes is the main organization leading the Prematurity Awareness campaign, but I have to admit to being a little perturbed that they didn’t speak more strongly about the one cause of prematurity that could be most easily changed — iatrogenic prematurity, caused by elective inductions and C-sections.

It’s possible that “iatrogenic prematurity” might include necessary or beneficial cases of babies born by induction or C-section too soon — for instance, a baby who suddenly stops moving at 34 weeks and is obviously compromised. But for my purposes, I’m restricting it to medically unnecessary inductions and C-sections.

Here is one link: Why do women deliver early? Did you catch the discussion on elective inductions and C-sections? No? Not surprising — it receives only the briefest of mentions. However, this March of Dimes article, “Why the last weeks of pregnancy count” does dwell on the topic a bit more. Elective C-sections and inductions are (thankfully!) not one of the four main causes of prematurity, but iatrogenic prematurity could be stopped tomorrow. And I think that’s important to note.

Some doctors have a laissez-faire attitude about inductions and C-sections, and have no problem with either as soon as the mom hits 37 weeks. Perhaps that attitude is changing a bit, since research has demonstrated that infant outcomes are much worse in several different areas if the baby is born unnaturally at 37 weeks, compared to 38 and especially compared to 39 weeks. [And when I say “unnaturally,” I’m meaning, by induction or C-section — babies born to women who go into labor naturally at 37 weeks do as well as those born at 38 and 39 weeks, naturally — it’s the unnaturally early births that are the problem. When the woman goes into labor, that is an evidence that her baby is actually ready, as opposed to having reached some arbitrary date on the calendar.] Some doctors may even do an elective induction or C-section at 36 weeks. I read a story some time ago about a woman who had a late-term fetal demise in her first pregnancy, so opted for an elective induction at 36 and a half weeks. She thought he was ready “enough” — that it was “close enough” to term for him to be born. Her baby was in the NICU for 6 weeks, and had long-term health problems (mostly related to his lungs and breathing), because he was not ready.

A woman’s dates can be off, which could really cause problems with her baby, if she electively induces or has a C-section at 37 weeks (or even later). What if her little one would have been born naturally at 41-42 weeks? That’s 5 weeks early. And if her dates are off, it may be even earlier. There’s a lot of brain, lung, and body development that happens in those last few weeks, that ought not be circumvented without an awfully good reason. Although rare, “superfetation” — conceiving a second baby many days or even a month after the first baby was conceived — is also a possibility, as Abby Epstein found out. What if she had gone by “I thought I was pregnant a month ago,” even though that baby died, and her later-conceived baby lived? Perhaps they were conceived at the same time, and this was just “vanishing twin,” but perhaps some of these super-long gestation times one occasionally reads about were actually due to undiagnosed superfetation with a hidden/missed miscarriage. Could happen. I remember in reading through some of the causes of death listed on the CDC linked birth-death certificates, that one hospital-born baby born at 42 weeks died due to “extreme prematurity.” It could be a typo — perhaps it should have been “24 weeks”; or maybe the code was entered wrong. Or maybe the mother’s dates were miscalculated. Or maybe she happened to skip a period prior to conception, so she thought she was at 42 weeks, when she was 6-8 weeks earlier. I wonder, though, if she was induced because she was “42 weeks” and her baby was nowhere near ready. Unlikely, but possible.

Then there’s this little gem of an article: Many Women Miscalculate Time to Full-Term Birth. One paragraph reads,

“About one-quarter of new mothers surveyed in the study considered a baby born at 34 to 36 weeks of gestation to be full term, while slightly more than half of women considered 37 to 38 weeks full term.”

Only problem is, that’s not what the question was. Here’s the actual question (also from the article):

“What is the earliest point in pregnancy that it is safe to deliver the baby, should there not be other medical complications requiring early delivery?”

It didn’t say “when is full term?” It asked “when is it safe?” Ok, so define “safe”. Most babies will do fine born electively at 34 weeks. Obviously, not all will — some will die that would have lived; of those who live, some will have long-term negative effects related to their prematurity. If safe is some sort of “beating the odds” — well, 90% of babies born at 30 weeks survive, and the odds go up every week. Many (perhaps even most) of these babies will not suffer long-term negative effects (like cerebral palsy, blindness, etc.) which used to be so common at this age, but now are more common with preemies born at earlier gestational ages; and the risk goes down with age. Even fewer babies born at 37 weeks will have problems, than those born at 36, 35, or 34 weeks. Does it mean it’s “safe” for them to be electively induced or sectioned then? Well, sure, compared to preterm babies; but not compared to 38-weekers, or 39-weekers. But again, babies are naturally born at 37 weeks all the time and have no long-term problems compared to babies naturally born at 38, 39, 40, 41, etc. weeks And if a woman goes into labor at 36 weeks, doctors will not try to stop the labor. I daresay that many people would say, “If the doctor won’t stop labor at 36 weeks, then it must be safe for the baby to be born then.” Is that a wrong supposition? Yes, if you’re talking about elective inductions; perhaps no if you’re talking about natural labor.

I will also note that the question was not, “When is the earliest point in pregnancy that an elective induction or C-section should be used?” Had this been the question, I would have answered “never” if that was a possibility 🙂 or else “39-40 weeks,” if that were the latest time frame given. However, in the question that actually was used, I probably would have answered 37-38 weeks, because that’s “term”; or possibly at 36 weeks — if the woman goes into labor at that point, the doctor won’t stop it, after all. Not because it is best for the baby to be born at that point, but because I don’t know if it totally meets the threshold of “unsafe” for the baby to be born early. Not optimum, but perhaps “safe.” Is it “safe” to drive a car? Almost everybody would unhesitatingly say “yes!” but people are injured and killed in car wrecks every day. And some people are injured or killed as pedestrians, who would have lived had they been in a car. “Safe” does not necessarily mean “absolutely no risk,” because as probably everybody over 12 understands, there is almost nothing in life that is completely risk-free.

Although there were several good parts of it, this article was irritating on a few points, including the following:

Misconceptions about what constitutes full gestation and how soon it’s safe to schedule an elective induction or cesarean delivery are contributing to increasing numbers of premature births in the United States, said lead study author Dr. Robert L. Goldenberg, professor of obstetrics and director of research at Drexel University College of Medicine in Philadelphia.

Ah, yes — blame the mother! I feel so sorry for these poor spineless doctors who just can’t stand up to the strong woman who demands an early end to her pregnancy, regardless of how much damage it does to her baby. You know how thoughtless and uncaring women are! They don’t give a rip about the baby they’ve just spent the last 8-9 months of their lives growing! Odds are, they’ll leave the baby at the hospital and just walk away!

Ok, so maybe the sarcasm was a little heavy in that last paragraph, but seriously, folks!! It makes me want to scream! Sure, some women are selfish and truly don’t care about their babies — after all, some women abuse alcohol and use illicit drugs while pregnant. But I daresay that if doctors tell most women that their baby will be twice as likely to die (or whatever the actual rate is), if born electively prior to 37 weeks, or even in the early term period, and will be 3-4x more likely to have serious morbidity, that would put a curb on elective inductions. Some women may have legitimate or quasi-legitimate non-medical reasons for induction — husband home from Iraq for two weeks, previous stillbirth in the term period, severe pregnancy discomfort, and maybe others. [The  McCaughey septuplets just celebrated their 12th birthday (I remember because they were “due” the same day my sister was due with her first child), and they were born two full months early. In an interview soon after the birth, their mother, Bobbi, said that she just couldn’t stand the nausea and other side effects of the pregnancy itself and the drugs she was on to maintain the pregnancy. She held on as long as she could, knowing that every day they were inside her, it would be better for her babies; but finally she just couldn’t take it any more. That doesn’t apply to most women.]

So, yeah, educating women about prematurity and the problems babies have when born too early (by the babies’ clocks, even if not by the doctor’s calendar!) will help, because it will likely reduce the number of women wanting an early end to their pregnancy, and those who look at their due date as an expiration date. But women could not induce if doctors did not allow it! Inductions and C-sections don’t schedule themselves. Last time I checked, women can’t call the hospital and set up an induction or C-section without their doctor’s approval. They also don’t perform themselves — doctors (and nurses) have to perform an induction or a C-section. So, why does this article have such a strong tone of “it’s all the women’s fault!”?

I’ll say it again — iatrogenic prematurity could be stopped tomorrow, if doctors wanted to.

C-sections and Type I Diabetes

In an article titled, “Mothers’ birth choices linked to rise in childhood diabetes,” the author linked C-sections to increased rates of Type I or childhood diabetes. Since this disease can cause serious problems, especially starting so young, it is something to be concerned about. The article said that about 700 children in the UK were diagnosed with this disease in 2005, and approximately 250,000 people have Type I diabetes in the UK. (For perspective, the estimated population is 61.6 million.)

Dr Chris Patterson of Queen’s University, Belfast, one of the report’s authors, said the increasing number of cases over time was so rapid that it cannot be related to genetic factors alone.

‘Environmental factors are driving this,’ he said. ‘We know children born to older mothers, for example, are more at risk. There is a 20 per cent extra risk for babies born as a result of Caesarean section, while those putting on weight rapidly during the first year of life are also at increased risk. Breastfeeding reduces the risk.

‘In addition there are other environmental issues behind the rising trend, such as children being exposed to fewer germs.

‘Type 1 diabetes is very much involved in the development of the immune system – which, in the case of Type 1 diabetes, turns on the body and stops it producing insulin. But it is still a rare disease.’

So, children not being exposed to enough germs is a risk factor, as is being born by C-section. There is a lot I could say about this, including that perhaps there is a correlation, rather than causation with all the C-section talk — for instance, older moms might tend to choose a C-section for their “premium baby” that they had a hard time conceiving, and they might also tend to overreact a lot little bit with their babies being exposed to all the “nasty” germs (which may actually help to strengthen and build up the immune system). Also, women who do not choose a C-section, but need one (or think they need one) may also be overprotective of their little baby who “almost died” during childbirth. Plus, babies born by C-section tend to have more problems breathing, needing to spend time in the NICU and all of that, so their moms may be a bit overprotective due to that. (And I’m not saying that this is necessarily a bad thing, nor that all protection is overprotection — babies who are already sickly for whatever reason probably should be kept away from the general germy public who may give them pneumonia, the flu, RSV or something. But I have seen some mommies that made me roll my eyes with how overly zealous they were about their healthy kids not coming into contact with any germs, but the kids seemed to be constantly sick anyway; whereas I don’t think I’ve ever wiped down the handle-bar of the shopping cart, and my kids are pretty darn healthy.)

However, I can see a possible causation of C-section along the lines of germs, and that is that babies who are born vaginally are colonized by bacteria in the birth canal, and babies who are born abdominally simply do not get this. Also, babies born by C-section are less likely to breastfeed than babies born vaginally, so then they also do not get the normal bacteria from their mothers’ breasts nor antibodies in the milk that also serves to strengthen the immune system. So, in the absence of normal and healthy colonization, that leaves the baby’s system wide open for colonization by possibly unhealthy bacteria, which can set up a whole load of problems.

Hmm, I wonder if moms are told of these potential problems as part of their informed consent before signing up for an unnecessary and possibly completely elective C-section?

A Terrible Dilemma

The government of Uzbekistan has forbidden doctors to perform C-sections without a serious indication. Apparently, doctors in the state-run hospitals have been performing unnecessareans because their salaries are “too low” for them to spend so much time labor-sitting. So, now the government has made a law to keep them from doing that, because it is damaging to women’s health. Yippee? Not quite so fast.

Apparently, these doctors are now turning to drugs which speed up labor (so that their main objective — as little time waiting on the baby’s birth as possible — is still reached), but of course these drugs carry threats to women’s health, as well as to the baby’s health and well-being as well! So, maybe these women aren’t getting cut open at the drop of a hat, but they’re being given Cytotec, or Pitocin at possibly dangerous levels, or some other drug which is causing fetal distress and/or uterine ruptures, and then possibly damaging both mother and child, or at least necessitating a C-section to save the baby and/or mother. And then if the C-section rate has been unnecessarily and artificially high, then there are probably a lot of women who will now be trying to have a VBAC, and we all know the much higher rate of complications from an artificially induced or augmented labor (especially with Cytotec, but even with the milder prostaglandins and Pitocin) of uterine ruptures in an already-scarred uterus! Sigh….

And to make matters worse, if a lot of women or babies become damaged or even die because of this “C-section ban,” then the anti-vaginal-birth folks will triumphantly point to the statistics that are to come from Uzbekistan and say, “SEE!! This is what happens when you try to reduce C-section rates! — women and children die!! We can’t know what a good C-section rate is, anyway, so it’s ridiculous to try to make it some arbitrary rate. And look at how many uterine ruptures there were when they forced VBACs on everyone!”

Um, no. While this may indeed happen, it will not be “VBAC” or “reduced C-section rates” per se that are the problem. The problem in Uzbekistan will be the same problem that currently exists in many hospitals in the United States — doctors unwilling to work with natural processes, and insisting on speeding up labor, or other interventions, that are not medically indicated. And of course, when medical processes are introduced without any indication for it, nor any medical benefit from it, medical risks are elevated for no good reason. And women and children are hurt, and may even die.

One organ, two functions

I’ve been kicking around this idea for a while — and I will admit that it first started in my mind because of the pro-breastfeeding people’s argument that people should not be embarrassed or offended by breastfeeding in public because, after all, nursing is a natural function of the body! I agree with that. However, breasts are also sexual. I’ve yet to see any breastfeeding advocate say that it is perfectly all right for men to expose themselves in public as long as they are urinating. If anybody reading this is of that philosophy, feel free to leave a comment! 🙂

But on another blog I read the blogger was relaying her irritation about the “breasts are for sex [not breastfeeding]” mentality, and said the same thing could be said for vaginas. I like my response, so I’m going to paste it in this post, too.

I sometimes get a kick out of the “organs used for sex” mentality, because it only seems to apply to women. Why is it that we never talk about how that the penis is used for both sex and urination? Should men have a tube cut into their bladder to preserve their penises from the non-sexual function of peeing?? Why is it that only women’s sexual/practical organs must be preserved for purely sexual use???

What say you? 🙂

Well It’s About Time!

If you’re a faithful reader of this blog and/or a fellow birth junkie, the following article will not come as a big surprise — Cesarean Sections Linked to Future Birth Risks. It warns of the dangers of placenta accreta or percreta in future pregnancies (accreta is when the placenta implants too deeply into the uterine wall; percreta is when the placenta actually grows through the uterine wall and attaches to other organs). The only surprising factor to me was that it was an article in a non-birth publication which strongly warned of the danger of C-sections. All too often, the standard argument in most mainstream articles (and by that, I mean non-birth-oriented publications) is a “balanced” picture of C-sections versus vaginal birth, with the pros and cons of both sides being presented as basically equal. There are pros and cons to both sides, but that doesn’t mean that they are balanced or roughly equal. If a mom or baby truly needs a C-section, then obviously, the balance tips dramatically in the favor of a C-section; but if the surgery is not medically necessary, then vaginal birth obviously is favored for both mom and baby.

The first mom mentioned had placenta percreta (in which the placenta grows through the uterine wall, and in her case invaded her bladder), forcing the doctors to end her pregnancy 4 months early. Her baby is still struggling to survive, and she lost her uterus. She wanted four children. She says after her first baby was born by C-section, she expected “lots of C-sections” in order to have the size of family she wanted — I guess she was told “once a C-section, always a C-section,” because it doesn’t sound like she even thought of attempted VBAC. Not that it ultimately mattered in her case, since her first post-op pregnancy cost her her uterus, but placenta accreta and percreta increase exponentially with every additional surgery, so for many women, it may be their 2nd, 3rd, or 4th unnecessary C-section which costs them their ability to bear children, and possibly the life of their baby, and even potentially threatens their own life.

The article also quotes the rate of placenta accreta as being 1/30,000 in the 1950s, but current studies show a rate of 1/2500-500! Yikes!

I’ve seen some “VBAC Consent Forms” which pretty much magnify the risks of VBAC, particularly uterine rupture, which can be devastating or even deadly for the baby. But the risk is small, especially in labors that are allowed to begin or continue naturally; and if the care providers are monitoring the mother and baby, they can usually get early warning that something is wrong (like the mother feeling the pain of her uterus splitting, or the baby’s heartbeat showing signs of distress), so the absolute risk of death or severe morbidity to the baby is low. Often the consent forms tell the mother that if she has a VBAC, her baby is the one that will be put at risk, whereas if she chooses a C-section, then she’ll be the one that has more risks (from the actual surgery, which has a higher rate of blood loss necessitating transfusion, risk of hysterectomy, infection, etc.). Put that way, most women will feel selfish for wanting a vaginal birth, so sign up for a repeat C-section. However, this article points out that even one C-section increases the risk of future placenta accreta/percreta, and each repeat C-section increases the risk exponentially, so mothers may be choosing a repeat C-section to keep their current baby from the 1/200 risk of uterine rupture (with an even less risk of death or severe morbidity), while setting up a future baby to be in the position of the first baby mentioned in the article — being born much too early, and possibly dying or having severe long-term difficulties. Plus the mother may hemorrhage and necessitate a blood transfusion (perhaps even massive), and/or lose her uterus.

Read the entire article, because it is very informative. I wonder how many women are truly given informed consent before their first C-section, or any subsequent ones. Time for a VBAC-lash!

Op-Ed Piece on Elective Cesareans

This opinion piece was written by the CEO of UnitedHealthcare of New Jersey, a health insurance carrier, on elective C-sections and NICU admissions, etc., which I’ve blogged about previously, and I’ve seen it blogged about extensively on other blogs.

I’ll pull a few quotes from here, but I urge you to read the whole thing [any bold or italics will be mine]:

It turns out that in an audit of all UnitedHealthcare-insured ba bies admitted to the NICU in one market, 48 percent of all newborns admitted to NICU were delivered by elective admission for delivery including scheduled C-sections (cesareans), many taking place before 39 weeks of pregnancy, or full term.

Note that “elective admission” includes scheduled C-sections as well as inductions of labor — inductions which may ultimately have failed and then required a C-section to complete the birth of the baby. While I find it extremely interesting, not to mention unsettling, that almost half of the NICU admits were due to “elective admission” for birth (I would assume from the language that these are all not medically necessary; although I could be wrong in that), I will point out that “full term” is not usually defined as 39 weeks of pregnancy, but rather 37 weeks — although not too many years ago it was 38 weeks. Still, in another way of looking at it, I only consider “full term” to be when labor begins spontaneously — there is so much we don’t know about labor and birth and a baby’s maturity, that to cause the baby’s birth prior to natural onset of labor is to risk prematurity — regardless of the week of gestation.

When we shared this startling data about C-sections and health problems in newborns with a pilot group of physicians and hospitals, they significantly reduced the number of elective admissions for delivery prior to 39 weeks, including C- sections. The result: There was a 46 percent decline in NICU admis sions in three months, a decline that has held stable for more than a year. That’s almost half the number of newborns with potential health problems, almost half the number of distraught parents, almost half the number of potential tragedies. The cost savings to these hospitals, the parents and the health-care system is enormous.

Reducing elective admissions prior to 39 weeks significantly reduced the number of babies that needed to have intensive care in a hospital setting. Not only does this translate into significant cost savings (which is of high importance to an insurance provider, naturally), but think of how many lives have been altered, perhaps tragically, by these unnecessary inductions and C-sections which led to many days or even weeks in the NICU, for no medical reason!

There is evidence that reducing the overall number of Cesarean deliveries would significantly reduce health risks for mothers and their newborns. More than 1.2 million C- sections are performed annually in the United States at a cost of more than $14.6 billion per year, according to the federal Agency for Healthcare Research and Quality (AHRQ). While some women do need C-sections because of fetal distress and other medical issues, AHRQ says that more than half of all Cesareans are medically unnecessary.

My thanks to Empowering Birth for originally blogging about this article, thus bringing it to my attention.