The OB Speaking Out on the US Cesarean Rate

I don’t mean to be the bearer of bad news, but the reality is that in the current obstetric model you have a 1 in 3 chance of having major abdominal surgery to have your baby. Put it that way and a cesarean section doesn’t just seem like “no big deal, everyone’s having them.” Nor does it when you add to it the real risks this procedure carries over a vaginal birth.

But chances are, your OB doesn’t even know he or she is doing too many cesareans. As my guest today on Natural MD Radio, Neel Shah, MD, says, “obstetricians like me may be hardwired to operate.”

At this time 5 of the 10 most common medical interventions performed in the US are related to childbirth, and cesarean sections are the most widely performed surgery in the US. The cesarean section delivery rate has increased 500 percent since 1970. But the risk of having a baby hasn’t gone up at all.

So if having a baby hasn’t become 500 percent riskier in the past 40 years, what’s really going on that has led to this escalation in cesarean sections over the past four decades?

Join me, midwife and MD, Aviva Romm, here on Natural MD Radio for a conversation with an unusual guest, Neel Shah – an obstetrician at a major Boston teaching hospital – and learn why he’s on a mission to reduce the rate of unnecessary cesareans, why he thinks sometimes home birth may the safest place to have a baby, and why we both think moms need to know the truth for their own best health and the health of our babies.

There is absolutely no mom shaming or blaming about cesarean. We just think moms need to know the truth.

In this episode we discuss:

• When Dr. Shah realized there were too many cesarean sections being performed
• What institutional pressures are contributing to c-section rates
• Why we need to reframe our perspective on when a woman needs a cesarean section
• Why the evidence and research isn’t always applied
• How to identify labor normality
• How to talk to the different people involved in the decisions about c-sections
• The effect of the information economy
• What women can do in the moment to sort through the cesarean decision
• The importance of seamless home to hospital care for home birth moms and babies in the US

Links and References:

• Dr. Shah's book Understanding Value Based Healthcare
• Ariadne Labs
• Connect with Dr. Shah: Twitter
• Listen to Too Many Cesarean Sections: What You Need to Know