BY: Richard D. Fox | IN: Birth Injury
Studies suggest female obstetrics and gynecology physicians are less likely to perform a cesarean section (C-section) than their male counterparts. Although a recent review includes an enormous amount of information, it does not pinpoint the cause of the observed discrepancy. The decision to perform a C-section likely depends on a combination of many factors, both related to the patient’s situation and characteristics of each doctor’s background and personality.
Researchers from Dartmouth compiled and analyzed data from 26 studies performed around the world between 1992 and 2019. Fifteen of these studies reported data related to more than 1.2 million births supervised by female and male doctors. The other eleven studies used hypothetical scenarios to assess the treatment preferences of 4,911 obstetricians faced with similar labor situations. Their report was published in the peer-reviewed journal Obstetrics & Gynecology.
Overall, women treated by female obstetricians were 25 percent less likely to undergo a C-section than women under a male doctors’ care. In the birth treatment preference studies, female physicians were less likely than their male counterparts to opt for performing a C-section in a hypothetical pre-labor or labor scenario (e.g., a fetus gestating past its anticipated due date). Female physicians were less likely than male doctors to agree to a maternal request for a C-section without medical necessity, although this varied dramatically depending on geographic location and the date of the study.
Although the review indicated female OB/GYNs were overall less likely to perform C-sections on their patients, the authors did not make conclusions about the trend. The researchers noted female OB/GYNs were less likely to prefer C-sections as a delivery method but acknowledged many other factors could contribute to their less frequent use of the procedure. For example, in many countries, female doctors have only recently been allowed to specialize in the field; therefore, female OB/GYNs tend to be younger and trained in more modern medical programs when looking at global data.
A data review published in October 2000 analyzed medical staff preferences about cesarean delivery. This review of 34 studies involved 7,785 obstetricians and 1,197 midwives from 20 countries. The authors of that study concluded that the physicians’ personal beliefs, the health care system’s influence, and other physician characteristics all guided the decision to perform a cesarean delivery. Other studies have examined the influence of health system factors, including insurance coverage, the profitability of C-sections versus natural births, and whether a hospital is publicly or privately owned.
The authors of the recent study noted cesarean deliveries now comprise a significant number of births globally – a figure that continues to increase, climbing from 6.7 percent of deliveries in 1990 to 21.1 percent in 2015. In the United States, about C-sections account for one in three births. Choosing to perform a C-section can be an appropriate care decision, but the procedure has risks. A woman’s care team must consider the procedure’s pros and cons when making that decision.
If a baby is in distress or there are complications during labor, natural childbirth may be dangerous or impossible for both mother and child. Performing a C-section may be necessary to avoid serious consequences or even death. Other times, a woman’s doctor may recommend and schedule a C-section rather than waiting for natural labor to occur. This may be because of a mother’s previous C-section history (which increases some risks for subsequent deliveries), maternal medical conditions like an active infection, or specific pregnancy conditions like placenta previa or placental abruption. C-sections can reduce the risk of serious consequences and save many lives.
However, a C-section is major surgery and has consequences and risks of its own. Although some women wish to schedule a C-section for convenience, there are significant potential short and long-term consequences for both a mother and her child.
For the mother, a C-section recovery will take longer than a vaginal delivery recovery (an average of 4-6 weeks versus 1-2 weeks) because the procedure involves slicing through the abdomen’s muscles. Risks include infection, blood loss or dangerous clots, bowel problems, nausea, vomiting, severe headache (often related to anesthesia), injury to another organ (such as the bladder), and possible death.
Women who have a C-section have increased risks of issues with subsequent pregnancies, including the risk of the incision scar tearing open during a later pregnancy or labor (uterine rupture), placenta previa (the growth of the placenta low in the uterus, blocking the cervix), placenta accreta, placenta increta, and placenta percreta (when the placenta grows deeper into the uterine wall than usual).
Some studies have shown that infants delivered via C-section are more likely to need neonatal intensive care (NICU) for immature organ development. Children born by C-section also suffer increased rates of diseases throughout their lives, including asthma, type I diabetes, allergies, obesity, reduced overall cognitive functioning, and lower academic performance.
While a C-section can be lifesaving or appropriate to reduce the risks to mother or child, it comes with immediate and long-term risks. Maternal care providers should work with their patients to determine the birth plan that’s most appropriate for the situation. Performing a planned C-section without considering the long-term consequences could constitute negligence or medical malpractice.
If you or your child was harmed by an unnecessary C-section or improper labor and delivery care, or if your doctor failed to perform a C-section that may have been appropriate, call a medical malpractice attorney. Our experienced team of sympathetic advocates will fight hard on your behalf to help you recover what you deserve as compensation for birth injuries and other medical malpractice claims. Contact Sommers Schwartz today for a free, no-obligation consultation.
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Richard Fox handles personal injury cases, including birth trauma, medical malpractice, and motor vehicle negligence. Throughout his career, which has spanned over 45 years, Rick has successfully represented clients in medical negligence and other personal injury claims.