Cerebral Palsy Law Blog : Cerebral Palsy Lawyer & Attorney : Burke & Eisner Law Firm : Medical Malpractice Lawyers & Attorneys

Posted by Cerebral Palsy Lawyer, David Austin

Birth by cesarean section (C-section) is increasingly common in our society, but the procedure is not always performed for the right reasons. Some experts believe the trend has gone too far, with doctors and women scheduling C-sections sometimes weeks before the recommended gestation period.

Alarming Statistics

The American College of Obstetricians and Gynecologists recommends that delivery occur at 39 weeks or after. However, some doctors are scheduling C-sections for as early as 37 weeks for reasons that include scheduling convenience and fear of lawsuits.

According to the Centers for Disease Control and Prevention, the number of babies delivered prior to 37 weeks gestation increased over 20 percent in a 16-year period. Preterm births are sometimes due to maternal smoking, lack of adequate healthcare and multiple births. But the March of Dimes reports that 90 percent of non-multiple preterm births are due to an increase in C-sections.

"I think unfortunately what we are seeing is ... people becoming more and more cavalier of the outcomes," said Dr. Aaron Caughey, an associate professor at University of California San Francisco.

Preterm Birth: Risk Factor for CP

Nearly one third of fetal brain development occurs in the final five weeks of gestation, and babies born preterm are more likely to suffer developmental delays, cerebral palsy, breathing or feeding problems, and even death.

 

Tweet this

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Ten years ago about 1 in 5 pregnant women had a C-section; in 2006 that number was nearly 1 in 3.  C-section supporters point to eliminating rare but frightening complications of vaginal delivery.  Others point to the increased recuperation time, risks of uterine rupture and other problems during subsequent surgeries.

Another possible explanation for the increase in  surgeries is the cost of malpractice insurance.  In some states that cost may be upward of $100,000 and it could jump drastically if anything goes wrong during labor and delivery.  So doctors can avoid lawsuits by avoiding labor.  It also means that doctors and patients can organize their days much better by scheduling surgeries.

Many women seem to prefer surgical delivery.  Some do so because they either don't have time for childbirth classes or they want to schedule early enough before due date to avoid stretch marks and saggy skin.  Others may simply want to avoid the pain of labor.

So, why not C-sections?  Experts say that C-sections mean a longer hospital stay and recuperation.  Gene Declercq of the Boston University School of Public Health, in a survey of 1600 new mothers, found that more than 75 percent of them complained of pain over the next  two months and 1 in 5 was still having discomfort after 6 months..

More worrisome is the higher likelihood during future pregnancies of having placenta previa, in which the placenta blocks the cervix and detaches during labor (potentially cutting off the baby's oxygen supply), or a ruptured uterus, increasing the possibility of hysterectomy and fetal death in utero. The surgery also carries a slightly elevated risk of death for the mother because of complications from anesthesia, infections and blood clots. And scar tissue that forms at the incision site can lead to bowel obstructions years or decades later.

Another major concern is for the health of the baby.  Researchers reported in the British Medical Journal that, compared to babies delivered vaginally or by emergency c-section, babies delivered electively 3 weeks before due date had four times the risk of breathing complications and five times the risk of lung problems because of immature lung development.

There's no question that some women need C-sections, such as those with placenta previa. But the World Health Organization recommends a cap of 15 percent of deliveries -- the U.S. rate in 1978 -- based on evidence showing that higher levels don't benefit either mother or baby. Though the drama-free planned C-section certainly has its appeal, Declercq stresses that women and doctors need to "stop seeing it as just another surgery."

 

Tweet this

• Email This
• Print
• Comments (1)
• Trackbacks
• Share Link

Here is a story out of Chicago that shows how a delay in delivery can lead to a lack of oxygen to the brain.  Now that is just the "legal medical" side of this story.

The real story here is how this young man and his family used a simple book to educate his classmates about his condition and about how he was "The Same on the inside".

There is also a video that goes with the story and you can access that through the story on the website.

"The same on the Inside" Tweet this

• Email This
• Print
• Comments
• Share Link