Family Centered Cesarean

This is a lovely article from NPR about Family Centered Cesarean, or gentle cesarean birth, and I wish this experience for every mom who gives birth by cesarean. But I have a few issues with a some points made in the article.

“So why has the procedure been slow to catch on? Hospitals aren’t charging more for it — so cost doesn’t seem to be a major factor. What’s lacking are clinical studies. Without hard scientific data on outcomes and other concerns like infection control, many hospitals may be wary of changing their routines”

Hard scientific data doesn’t necessarily change policy either. If it did than delayed cord-clamping and immediate skin to skin would be the norm not the exception. We would use more intermittent auscultation and less continuous fetal monitoring. We would offer fewer inductions allow more labors to progress without augmenting them. If scientific data drove policy change we would do a lot of things differently in obstetrics. The problem s that c-sections are fast and convenient for doctors and hospitals and are often not done just for emergencies but for slowly progressing labors. If C-sections become less convenient because you have to do all these extra steps than what is the point of doing so many of them vs. letting women labor and push for longer? And since cost is a concern in a hospital how can you “offer” the extras of a gentle cesarean without charging for it? But how can you ethically charge for allowing someone to see their baby be born, or having an extra nurse to facilitate skin to skin time? You can’t.

But I like where this conversation is going. When consumers demand that we implement changes that improve their birth experience it forces hospitals to look at how they do things. If cesareans become less convenient for hospital staff more effort might be directed towards improving vaginal birth, and for the moms that still need to give birth by cesarean, the resources will be available to make it a gentle and family centered experience.

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