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Are C-sections overused? Part 1: need for new guidelines

"Beware the Ides of March," goes the famous line from Shakespeare's "Julius Caesar."

When it comes to Caesarian sections, we might add two modern corollaries.

One is to beware of failing to perform a C-section when it is truly needed in times of fetal distress. The other is to beware of performing too many sections, because an unnecessary C-section subjects a mother-to-be to unnecessary major surgery and possible complications.

Obviously doctors have to strike the right balance here between too few C-sections and too many. In this two-part post, we will discuss that issue.

Failure to perform a C-section when it is truly needed can be a form of medical malpractice. It can result in serious birth injuries and even, in some cases, death - as happened, in a highly publicized fictional setting, to the character of Sybil last season on the popular PBS series "Downton Abbey."

But in some cases doctors have overcompensated for such risks by performing C-sections when women have not really been given sufficient time in labor to perform a natural childbirth.

Medical authorities have been concerned about this issue and have worked to develop new guidelines on when C-sections should be performed. The guidelines were released recently by the American College of Obstetricians and the Society for Maternal-Fetal Medicine.

The trend toward more C-sections has been increasing since the 1990s. Indeed, C-sections have increased so much in the U.S. that they now account for one in three births.

Critics question, however, whether the trend has gone too far and resulted in an overuse of C-sections. In part two of this post, we will discuss key details of the new guidelines that have been developed to address this.

Source: OPB, "Doctors Urge Patience, And Longer Labor, To Reduce C-Sections," Nancy Shute, Feb. 21, 2014

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