Surgery - Only If Absolutely Necessary -- MEDICA - World Forum for Medicine

Surgery - Only If Absolutely Necessary

Photo: Newborn baby under examination

Surgery without need: Births per
Cesarean section are trendy;
© Picture Desk

Claudia Schiffer, Madonna, Angelina Jolie - they all did it. Having a baby by Cesarean section is trendy - not only in the USA: Also in Germany the number of Cesarean sections are on the rise, meanwhile every third baby is born with the use of a scalpel according to a study of the legal health insurance, the German BKK. Ten years ago this applied to only every sixth child in Germany.

Women often decide for surgery because they fear natal pains and they follow beauty ideals. Or is money important? Nobody exactly knows. Obvious advantages come up for medical centres through Cesarean sections: The surgery costs about 2600 Euros, a natural birth 1400 Euros. Furthermore, it is possible to time a Cesarean section so that the child can be born when the hospital is well staffed during regular working hours. As a consequence night shift premium and weekend surcharges for staff in the delivery room can be saved.

Financial aspects less important for mothers

However, financial aspects are less important for mothers. Ernst-Rainer Weissenbach is a professor and specialist for mothers delivering at an older age at the University Medical Centre Munich. He observes that fearing pain as well as worrying about the own health and that of the child often leads to deciding for a Cesarean section. „Particularly when women are already older.” The most important factor for the rising number of Cesarean sections is the increasing age of the mothers. „Those who are already in their mid thirties do not want to take risks and avoid natal complications“, according to Weissenbach, „Therefore, many patients agree to an operation too quickly. “

Indeed, every birth is different and in some situations doctors have no other choice but to make a Cesarean section. If, for example, the pelvis of the woman is too tight for a vaginal birth, if the unborn child or the mother are in danger or if the mother expects multiples. Further babies that are heavier than four kilogram cannot squeeze themselves through the birth canal. „During a complicated birth stress hormones dominate in the body of the pregnant woman and child in the end. Before the birth becomes a complete torture a Cesarean section is often made to save unnecessary grief and distress“, explains Professor Klaus Vetter, chairman of the German Society for Gynaecology.

If no complications occur during birth, however, a surgery provides no advantages. Mothers are often not informed about pain after a Cesarean section, impediment of movement and difficulties breast-feeding. „The Cesarean section is not less painful if you consider the postal-surgical phase“, explains Vetter. Additionally, In a study of the US-national centre for Health Statistics, researchers have observed that the risk for the child to die is higher during a Cesarean section than during natural birth: After 5.7 million births in the years 1998 to 2001, 1.77 deaths occurred after a Cesarean section and 0.62 deaths with a natural delivery.

Further births can become a risk for mother and child

Experts also believe that a Cesarean section carries a risk for further births. „A Cesarean section is a considerable risk factor for every following pregnancy“, says Vetter. After the operation a scar is left behind which can break open during a new pregnancy because that part is not as stretchy any more. Besides, the placenta can adhere to the scar. During birth it may burst which results in an extremely dangerous situation: The child´s supply with oxygen and nutrients is interrupted, it could suffocate after a few minutes. „These are very risky moments which cannot be controlled well enough during a house birth or in a small hospital“, says Vetter.

Therefore, Vetter demands that women should receive better advice and information on natural births and Cesarean Sections. „An expert consultation are the nuts and bolts for getting a grip in the mother's situation, whatever her age, in order to decide whether a Cesarean section is really necessary or not.“

Kathrin Burghof