Wait until the NY Times finds out that c-sections have greatly increased because of high-dollar awards like the one that made John Edwards (yes the politician) a millionaire...
https://drjengunter.wordpress.com/2011/06/03/john-edwards-in...
But because of their insurance coverage, if a mother or baby dies during natural childbirth the doctor is at greater risk for malpractice. So, they will rush mother's into C-section at any excuse (it saves them hours of work too not having to sit through a long labor).
Unfortunately, money and efficiency have taken priority over natural processes.
The other factor is delivering a child naturally that gets stuck and didn't get enough oxygen but lives is probably the most expensive outcome for doctors because that child can live with severe physical or mental handicaps and need support the rest of their lives.
It's entirely plausible that C-sections are done too casually and doing them less often would result in better outcomes. It's also plausible that they are not. The cynical in me finds very plausible that the answer to that question varies widely doctor to doctor.
That is of course true, because C sections are primarily used in high-risk pregnancies and in emergencies. But what you actually care about is the counter-factual: if a given set of deliveries were "natural" rather than a C section, would mortality go up or down? It's hard to develop studies to answer that counter-factual. But there is good evidence that C-section rates are negatively correlated with mortality (i.e. they lower deaths) up to about 20% of deliveries, and have no positive or negative effect beyond that: http://www.skepticalob.com/2017/10/more-wailing-and-gnashing....
Indeed, there is new evidence that "natural" births are in the long term bad for mothers, dramatically increasing the risk of things like incontinence later in life: http://www.skepticalob.com/2018/03/what-if-c-sections-are-be.... As a practical matter, these negative effects will impact far more women than differences (if any) in morality rates.
More importantly: anyone who has had a C section before is likely to deliver all future children via C section; it's not a requirement, but a normal birth after C section is a special arrangement.
Finally: C section itself is a traumatic surgery with long-lasting health effects for the mother. It's routine, but still a big deal.
C-sections are very disproportionately used for those, though perhaps not primarily; in relation to the risk statistics upthread, is the same basic impact. You cant just compare adverse outcome rates for C-section and vaginal birth without taking into account factors associated with adverse outcomes which also make C-section a more likely event.
Medicine can certainly help improve things but if you've been through the birth process multiple times it's clear that doctors try to steer you towards C-section.
Several of them have confided to us that it's primarily because of insurance. The hospital procedures want women in C-section for a few reasons:
1. The procedure is expensive (surgeon, anesthesiologist, etc.)
2. The procedure is fast (30-45min) and can be scheduled allowing the hospital to deliver more babies with less staff
3. The recovery period is longer (2-3 day recovery period as opposed to 8-24 hours for natural birth) generating revenue for longer while only being care from relatively inexpensive nurses.
Sure, there are many times when C-section is appropriate and has saved lives, but it's currently being over prescribed because of hospital guidelines that doctor's need to follow or risk malpractice liability.
Well yes, because the author is a doctor. The maternal death rate from "natural" child birth is 1,000-1,500 per 100,000 births. In the U.S., it is just 26.4.
> Sure, there are many times when C-section is appropriate and has saved lives, but it's currently being over prescribed because of hospital guidelines that doctor's need to follow or risk malpractice liability.
The data in fact shows no evidence that it is being "over-prescribed." If it were, you would expect to see worse maternal outcomes in countries with higher rates of C sections, and you do not.
Its precisely a law trying to change money and efficiency that produces this result!
Your argument is like saying doctors make people sick because someone in a doctor's office is more likely to be sick than someone on the street.