Cesarean section or natural birth?

Caesarean section or natural birth - often a lifestyle decision?

06.09.2012

Around one third of the children in Germany today are born by caesarean section. Physicians and health insurance companies are alarmed, since the proportion of cesarean delivery births has almost doubled since 1995. Often, not medical necessities were the reason for the caesarean section, so the accusation of the critics.

Many caesarean sections at the request of the parents
The name medical term for cesarean section „Cesarean section“ is derived from the Roman Emperor Julius Caesar. This should have come to the world, according to the writer Pliny by a Kaischnitt.

For example, medical factors that support Caesarean delivery may include a particularly large head circumference of the child, transverse or pelvic fatigue, significantly increased birth weight, and acute emergency situations due to problems with the child's oxygenation. The increased risk of damage to the health of the mother and / or child justifies the so-called caesarean section in such cases. However, many of the cesarean deliveries are based solely on the wishes of the mother or parents. A development that must be evaluated critically, as Caesarean section involves risks for both mothers and children.

Primary and Secondary Cesarean sections
Although the number of cesarean sections as a desired birth has increased significantly in recent decades, most mothers still prefer a natural delivery today. Not infrequently, however, speak medical reasons against a normal delivery, reports the Federal Center for Health Education (BZgA) on the Internet portal. A distinction must be made between the reasons for a primary and a secondary cesarean section. In general, according to the BZgA, there are two different types of criteria from a medical point of view: pre-birth reasons showing that natural delivery would be impossible or too dangerous and birth complications.

For primary caesarean sections, which are performed before the onset of labor, speak from a medical point of view, for example, serious diseases of the mother, diseases of the unborn child, previous uterus operations or even in relation to the mother's very large child. Secondary cesarean sections are performed when normal delivery can not be completed because the child's head does not fit through the maternal pelvis, the maternity cakes prematurely, or the child is at risk of oxygen deficiency. Even if the births are too long and thus to be exhausted for mother and child, a so-called secondary section may be considered. As Markus Valter, senior consultant obstetrics in the gynecological clinic at the University of Cologne, opposite „World Online“ explained, there are usually very good reasons for a caesarean section. For example „a petite woman of 1.45 meters badly give birth to a 4.2-kilo child vaginally.“ It also often just has to go fast, for example, when suddenly the heart sounds of the child subside „or if the patient develops a pregnancy poisoning, a so-called gestosis with a particularly severe course“, the expert continues. Because then there is acute danger to life and it could even count every minute, emphasized Valter.

32 percent of the children are born by caesarean section
According to the Federal Center for Health Education, 32 percent of children in Germany are born by caesarean section. In fact, according to the World Health Organization (WHO), the cesarean section only makes sense at about every eighth birth. Caesarean numbers have risen sharply in recent years worldwide, with not only medical factors playing a role, but also culturally influenced ideas about childbirth, explains the BZgA. The comparison between the different European states makes it clear that in countries like Germany (32 percent cesarean births) or Italy (almost 38 percent caesarean births) not only medical reasons can be decisive for the caesarean section. Because in the Netherlands, the proportion of caesarean births is only 16 percent, although here the children and mothers are not much healthier than in Germany or Italy.

According to the Federal Statistical Office, since 1995 not only has the absolute number of cesarean births increased by around 80,000, but also their share of total births has risen from 18 percent to almost 32 percent. A development that raises significant concerns among the health insurance companies, also because of the associated costs.„We share the concern that instead of the good of mother and child as a sole criterion of decision, other reasons for a caesarean section become more important“, emphasized Rolf-Ulrich Schlenker of the statutory health insurance Barmer GEK. The critics see a comfortable one in the increasing decisions for a Caesarean section „Lifestyle“-Development. The women fear the burdens of birth or simply have a certain date of birth as desired date in the head.

Many women opt out of fear for a caesarean section
The fear of pain during childbirth also affects many women in their decision. Gynecologist Valter takes extra time for these patients to relieve their anxiety and explain the benefits of natural delivery: „In a vaginal birth, the children are prepared much better by the pressing to the independent breathing. A Caesarean child often breathes worse and has a higher risk of landing in intensive care.“

Edith Wolber of the German Midwives Association sees the uncertainty of many women as the cause of the increasing number of caesarean births: „Today, many women do not know much about the birth. Through intensive care during pregnancy, their fears can be removed.“ This is confirmed by a WHO study. In women who receive intensive care from a midwife, it is therefore much less common at birth to interventions. „In addition, most do not know that the pain in the cervix then come after birth“, explains Wolber.

The Women's Health Working Group, an initiative supported by physicians, scientists and health policy-makers, launched a call in June to have cesarean sections performed only in the case of medical necessity. Latches earned more with cutting births than with normal births, reports the working group. A lack of consistent care by midwives and time pressure would lead to rash decisions. The legal liability situation also speaks in favor of a Caesarean section: For with a caesarean section, the obstetricians are „always on the safe side“.

Markus Vater advocates natural birth, but admits that the consequences of a massive complication in vaginal delivery can be severe for both mother and especially the child. „On caesarean section, this is very rare. "(Fp, ag)

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Caesarean section increases the risk of obesity
Caesarean section increases diabetes-type-I risk
Every third child is born by caesarean section

Picture: Gemini 20016351a2cc0b08c03p>