Doctors, in Switch, Oppose Repeat Caesarean Births

Doctors, breaking a 70-year-old tradition, called today for fewer repeat Caesarean section births and advised women who have undergone the surgery to try normal delivery in future pregnancies.

The American College of Obstetricians and Gynecologists issued guidelines to the medical profession to end the dictum “once a ‘C section,’ always a ‘C section,’ ” which it said has been the rule in obstetrics since 1916.

“For the first time in 70 years in this country, it is no longer the routine that patients who had a Caesarean section should have a repeat Caesarean section,” said Dr. Mary Jo O’Sullivan, a professor of obstetrics and gynecology at the University of Miami in Florida.

Unless there is a pressing medical need, normal delivery should be attempted to cut down on unnecessary and somewhat risky surgery, medical costs and hospital stays, O’Sullivan told a news conference.

A normal delivery costs about $2,000 contrasted with $4,000 for a Caesarean section.

Of the more than 3.7 million babies born each year in the United States, public health officials estimate that 24% are delivered by Caesarean and that one in three are repeat operations.

A Caesarean section involves making an incision in a woman’s lower abdomen and into the uterus, through which the baby is delivered.

“Very frequently, women select ‘C sections’ because they want to avoid the pain of labor,” O’Sullivan said but she noted, “Whenever you open an abdomen, you increase the risks.”

These risks, common to any major surgery using general anesthesia, include infection and respiratory complications. Data also indicates a slight increase in the mortality of babies delivered by Caesarean section, O’Sullivan said.