I read what used to be called a tweet on the platform that used to be called Twitter, in which someone argued that scheduled elective caesarian section deliveries are a part of a woman’s right to choose.
I wrote a number of linked tweets about it because it got me thinking about the importance of labour and vaginal delivery in preparing the newborn for entry into the world. Typically for my threads on the spot marked X, it sank without a trace. Hence this post.
I had been doing some research into foals born with neonatal maladjustment syndrome.
As a prey and flight species, foals need to be up and about quickly, and the mare wouldn’t do well if the long legged, hoofed foetus was trying to gallop whilst in the womb or birth canal.
In utero, the production of a neurosteroid acts as a sedative on the foal, making it largely quiescent.
Production of that neurosteroid is switched off during the twenty to forty minutes of the second stage of labour, which prepares the foal for almost immediate standing, suckling and maternal bonding, and movement.
If delivery is too quick, or via caesarian section, the foal can remain in a sedated, dissociated state.
Vets found that mimicking the constriction of the birth canal for twenty minutes had the effect of reviving the foal, presumably by stopping the production of the neurosteroid.
Human infants are very different obviously but there’s a mass of evidence that delivery via caesarian section is associated with a range of neonatal health issues including respiratory morbidities, asthma, acute lymphoblastic leukaemia, and neuro-developmental impairments.
Add in the increased maternal risks, and some researchers and health professionals are now arguing that the trend to elective, scheduled caesarian section must be reversed.
A caesarian section may be as the result of an emergency, or scheduled when natural delivery is contraindicated for reasons of maternal or foetal health.
It is elective when there’s no physical danger but a woman, for whatever reason, elects to undergo surgery to deliver her baby.
Caesarian sections are now performed in more than 1 in 5 births globally and the rate has risen steadily in all regions since 1990 –correlating with the global rise of the neo-liberal Medical-Industrial Complex. (MIC)
I don’t have data on how many of those caesarian sections are performed because of a proven health risk to mother and/or foetus, but the fact that the increase is at a time of claimed improvements in wider maternal / foetal health parameters suggests it is a combination of: women being talked into it by private medical providers; overstretched and underfunded public health services trying to improve efficiency, eg predicting demand and reducing the hours/days pregnant women spend in the care of medical staff; and/or because of the fear of labour and the effects of vaginal delivery.
Regionally, the lowest rate of caesarean section is in sub Saharan Africa at 5%.
The highest is in Latin America and the Caribbean, at 43%.
At current rates of increase, by 2030, 28.5% of women world-wide will have a CS and the projected rise in east Asia is from a current rate of 45% to 63.4%.
The rate in the United States for all hospitals is 32.9%; and in 2005-2015 the rate rose by 50%.
Elective caesarian section rates are higher among people of colour: 36% of Black, 33% Native American, and 31%of Asian and Pacific Islander babies. (2018-20)
Brazil has a rate of 55.5% overall but 84% in private hospitals which cater to the rich.
In NZ, in 2020, it was 31%; in Australia - 38%.
The lowest rates in countries in the affluent global north are in Iceland, Israel and Norway.
All surgery carries risks which have to be balanced against the benefits. Surgery, in effect, inflicts degrees and types of harm in order to save lives, cure or slow diseases etc.
Caesarian section is known to involve an increased risk for mothers of haemorrhage, infections and blood clots.
90% of women who have a caesarian section for the first delivery will have one for all subsequent deliveries and each one increases risk of uterine rupture – scar tissue is never as strong.
Caesarian section has long been statistically associated with a range of neonatal health issues including respiratory morbidities, asthma, acute lymphoblastic leukaemia, and neurodevelopmental impairments.
The latter is thought variously to be caused by exposure to toxins from general anaesthesia, the acquisition and composition of microbiota in neonates which occurs in passage through the birth canal, and oxytocin levels.
Given the increase in autism spectrum disorder (ASD) globally since 1990, and the rise in deliveries via caesarian sections, there has been research into possible links, some of which have concluded that the correlation is compelling enough to avoid unnecessary caesarian sections.
With the rise of the medical-industrial complex which now dominates medicine, studies that might bring the MIC’s profit-centred and ethically dodgy practices under scrutiny, struggle to get funding and/or the findings are suppressed in various ways.
Thus possible links between ASD and birth via caesarian section are dismissed as being statistically insignificant, and researchers and health professionals calling for a reversal of the trend to more and more elective caesarian sections are not listened to.
No comments:
Post a Comment