My best friend is an emergency room nurse at a large hospital in Denver, Colorado. In the past two months, two of her friends have given birth. One is a fellow nurse, and the other a dentist. Both have a solid knowledge base in medicine, and had thoroughly researched pregnancy and childbirth. Both women wrote birth plans and shared them with their doctors. In both cases, the doctors agreed to the birth plans, which included strong desires for childbirth that would be as natural as possible, with minimal intervention unless medically necessary. No epidurals, no episiotomies, no unnecessary monitoring.
When the nurse was in the midst of labor, she noticed a doctor approaching her with a needle. She asked him what he was doing, and he told her he was prepping her for an episiotomy. She reminded him that they had discussed this very procedure, and that she had specifically said she did not want one. He then told her that the hospital does them ‘routinely.’ At her insistence, he backed off and she delivered without an episiotomy, but it was only because she happened to notice the needle in his hand and still had the wherewith-all to be able to question what was going on.
The dentist had a similar story, although with a potentially more serious outcome had she not protested. When she was three hours into active labor, she noticed that the two doctors – who had agreed to her natural-as-possible birth plan – were discussing the delivery right in front of her, but without involving her at all, and talking as if she weren’t there. She heard them talking about prepping the OR. She immediately questioned why they wanted to go to the OR. They told her it was because she had been in active labor for three hours, and the baby hadn’t arrived yet, so the standard procedure was a c-section at this point. She questioned whether the baby was showing any signs of distress, and was told that everything was normal. So the only reason the docs were going to do a c-section was because the process was taking more than three hours. She and her husband protested loudly, and within a couple more hours, they delivered a healthy baby boy.
Recent data shows that over 30% of all births in the US in
2006 2005 were c-sections. This number is a 46% increase from 10 years ago. While there are absolutely times when a c-section is medically necessary, there are plenty of times when it is being used for convenience. And we wonder why health care costs are skyrocketing? Even small things like excessive fetal monitoring and episiotomies add a substantial chunk to the overall cost of delivering a baby. Tack on a c-section and the bill can easily triple. If this sort of blatant overuse of medical intervention is going on in obstetrics, one would assume that it probably goes on in other areas of medicine as well. Nearly everyone agrees that medical treatment has improved overall health and life expectancy greatly. And there are plenty of conditions that would certainly be fatal without intervention. But when c-sections are being performed after only three hours of labor, with no signs of distress from the baby, it’s a sign that we’re misusing the medical system, and adding unnecessary costs to an industry already plagued with prices rising far faster than inflation.
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