A recommendation published at the end of January recommends methods of managing normal childbirth, respecting the rhythm and spontaneous course of birth in women with a low obstetrical risk. That is to say the vast majority of pregnancies, which, it is worth remembering, is not an illness but a normal act of life. Example: caesarean section.
The issues of this HAS recommendation, are :
- Respond to women’s demand for less medical care of childbirth, respecting its spontaneous progress;
- Improve and guarantee the safety of care for the mother and her child;
- Harmonize practices.
It used to be the last resort method. Today, caesarean section has almost become a fashion. An American study shows that this is not a trivial technique. 10 essential questions…
How many caesarean sections are performed in France each year?
7% of deliveries are by cesarean, but the rate can climb to 43% in some regions. In total, more than 100,000 interventions per year.
Is it the same in other countries?
France is in the middle of Europe. With more acts in Southern Europe, but also much less in the North.
On the other hand, the United States is singled out, including by the country’s health authorities. There, the cesarean section is so popular – 20% of births – that in certain Californian clinics, it is performed half the time! An obvious abuse, condemned by the doctors, who seem however in these extreme cases, largely responsible for the popularization of the method with their clients.
Is it essential?
And in 7 out of 10 cases, it could be avoided according to the High Health Authority.
What is the impact on newborns?
A Massachusetts hospital has proven it. This establishment has implemented a policy to reduce the number of induced deliveries at the discretion of the woman and her doctors by authorizing caesareans only to women who have already given birth vaginally with a cervix. favorable at 39 weeks of pregnancy at least. Result: the cesarean section rate fell from 16% to 7% and the admission rate of newborns in intensive care from 3% to 2%.
Is caesarean section risky?
According to the HAS, caesarean section is not a trivial act: it is associated with a risk of phlebitis but also with a risk of complications for future pregnancies.
A study, the results of which are published in the online magazine PLoS Medicine, has just confirmed this analysis.
For three years, the researchers analyzed the progress of the births of more than 2,000 women, all at term. They were followed for at least one year after the delivery of their child. Researchers found that women who gave birth by caesarean section were less likely to have organ descent (prolapse), urinary or fecal incontinence.
The researchers also studied what the risks were in children. Those born vaginally were less likely to develop asthma or be obese.
Does caesarean section have an impact on subsequent pregnancies?
This same study shows, in the longer term, that a woman who has given birth by caesarean section is more likely to have infertility problems. But also at risk during pregnancy with poor placement of the placenta, which can cause serious bleeding in the third trimester. Uterine ruptures and stillbirth are other possible risks.
For these scientists, it was important to better understand the risks and benefits of this birthing technique, in order to better inform women.
Is caesarean still useful?
It deserves better than a controversy because it is a very simple intervention, which continues today to save a good number of children’s lives, for example, very premature children. This is also the case when the life of the mother is threatened by a pregnancy that would go to term – as in the case of uncontrolled diabetes or very serious hypertension.
Most caesarean sections are scheduled?
Yes, they should, which allows the choice of anesthesia that more and more mothers are choosing “local” so as not to lose any of the pleasure of the birth of their child. A birth that takes place in just under an hour thanks to a horizontal incision along the pubic hair, which will leave a very solid and very aesthetic scar. Few complications… a few infections and for some mums, especially in the case of general anesthesia, the beginning of the disturbed, badly experienced mother-child relationship. The return home takes place, in the vast majority of cases, in 5 to 6 days… almost like a normal delivery!
We used to say “once a caesarean, always a caesarean…”?
This is completely false today. More than 60% of “caesarean” women – who have a caesarean section, not to be confused with the actress who would have had a Caesarean – give birth the next time normally.
It is said that it is because he was not born by natural means that Caesar, the Roman emperor, gave his name to the Caesarean section?
The reality is much less poetic… Indeed, in Latin, caesare means… to cut! It is therefore because the skin is cut, then the uterus, that this method of childbirth has become the cesarean section…
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