Damn, as if childbirth wasn't already hard enough. Doc bros gotta go make them even more complicated, just to fit their schedules.
I was struck by the symmetries between two articles this week:
The first, from the NYT, is a look at the difficulties women in rural areas face when they want to have a VBAC, vaginal birth after cesarean. The story's based in Wyoming, but it's a situation that's not uncommon around the country: hospital policies that do not permit women to choose VBAC for their second kid. From a 2012 UCSD study:
many doctors are unwilling to perform V.B.A.C.s because of requirements that they be present during labor.So even when medical risks are minimized or mitigated or comparable to a natural birth, doctors' own time demands end up driving the decisions to have another cesarean."Time is money for physicians, and they don't want to have to spend their time hanging around waiting for women in labor," said Mary Barger, an associate professor of nursing at the University of San Diego, and one of the study's authors.
Which, speaking of doctor-driven c-sections, it turns out it's a macho-toxic, non-stop c-section carnaval in Brazil, where an incredible 82% of babies born in the country's private, insurance-driven hospital system are delivered by c-section. The private system is used by about a quarter of the country's population; the rest use the free, national health care system, where c-section rates are still 50%, and doctors' schedules, attitudes and practices treat natural delivery as some kind of unsophisticated, even, primitive cultural throwback.
So yeah, seems like there's a spectrum of doctor-driven and male-driven and institutionally driven complications for giving birth, and Wyoming and Brazil are both on it. And closer than we may think.
Refusals Cut Options After C-Sections [nyt]
Why Most Brazilian Women Get C-Sections [the atlantic]
