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Cesarean delivery

Technically speaking, the cesarean section is supposed to be a life-saving procedure, resorted to only when it becomes clear that vaginal birth is not an option. By this criterion, the cesarean rate should be no more than 5 percent. In the US and around the world, the rate of cesareans is rising dramatically. This page will try to puzzle through the possible reasons for this. For example, Latin American research indicates middle- and upper-class women are often concerned with demonstrating their cultural distance from Indian and peasant women. Birth that takes place in highly-medicalized hospital environments might be a clear indication of this unconscious wish. Also, bottle-feeding instead of breastfeeding might be seen as 'modern' against a back-drop of trying to not be 'peasant-like'. [View source]

Davis-Floyd, Robbie E., "Birth as an American Rite of Passage," London: University of California Press, 1992, pg.130-131.

It seems there must be something perceived as 'good' in having a cesarean or there would not be the enormously high rates there are today (30 percent in the United States, and sometimes as high as 95 percent in certain urban areas in non-industrialized countries). Hmm. Despite the disadvantages to the mother-child bonding and breastfeeding, despite the effects of having been subjected to a full operation and days of recovery, despite the enormous expense of funding high-tech operating theatres.


Why shouldn't I have a cesarean section?

Well, here is a common-sense attempt to answer this question...

Babies born via cesarean section

Healthy babies who are born by cesarean section often need greater support in bonding to the mother and initiating breastfeeding. This means, for example, that the instinctive behaviors of rooting, nipple seeking and suckling can be suppressed by the baby's lack of exposure to labor hormones, by the absence of being squeezed and compressed from uterine contractions, and by the baby receiving anesthesia and postpartum medications. Interestingly, research indicates infants who are delivered by scheduled cesarean and who therefore have not experienced the hormones and physical changes occurring during contractions are at greater risk of inadequate lung fluid clearance, breathing difficulties, lower metabolic rate, less alertness and decreased neurological response immediately after birth. (I have to puzzle this one out. This seems to indicate some advantages to allowing labor to proceed, while risking labor turning into an 'emergency' c-section?)

So, babies need special support to start breastfeeding at the same time as their mothers are least able to care for them. Mothers don't have as much milk because of the drugs needed during and after the operation which reduce the secretion of prolactin and oxytocin, and because of their post-operative wound and their own recovery drowsiness and injury, they are less able to put the baby to the breast frequently which is needed for milk production stimulation - all of these factors impact feelings of adequacy ('can I give my baby enough milk?') and motivation to breastfeed. Added to this are common hospital policies of separating babies into a nursery and scheduled feedings. It is unsurprising that fewer mothers end up breastfeeding their babies after a cesarean birth. [view source]

Klingaman, Kristin, "Practicing Evolutionary Medicine in a Postnatal Ward: Ameliorating Iatrogenic Obstacles to Breastfeeding," Anthropology News, March 2009, pp.9,11.


Cesareans and intestinal microbes

"Here's the cesarean-asthma theory in a nutshell: we evolved right along with the bowel germs we acquire during a vaginal birth, and when unusual germs like C. difficile show up instead, our immune system doesn't like it. A low-grade, long-lasting bowel inflammation directed at these intruders can begin right after birth and last for years. To make an extremely long story short, that inflammation can make it easier to develop asthma, atopic dermatitis, and possibly other inflammatory diseases later on - even diabetes and obesity.

But hold on a moment before you head off to picket your local maternity ward. The cesarean-asthma link is not as clear-cut a case as it may seem - at least not yet. go to MarkSloanMD


Interested in more? Here are other articles:
North America child development
Breast-feeding bonding

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