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Too posh to push: are increased C-sections and induced labors a problem or a right?

 A premature baby rests inside an incubator.
A premature baby rests inside an incubator.
Paula Bronstein/Getty Images

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Changes are developing in the world of obstetrics and gynaecology (OBGYN)—and it’s not just within pregnant bellies. More and more pregnant women are looking for more convenience and less pain in their deliveries. Instead of having their baby when their baby is ready to come out, women are having their babies when they want the babies out. Studies have found that from 1990 to 2006, the rate of induced labors more than doubled—in large part due to “on-demand” induced labors. A full-term pregnancy lasts 40 weeks but induced labors are being done on-demand, meaning out of convenience rather than medical necessity, as early as 37 weeks. Sometimes it’s scheduling: the doctor the mother wants is only available when the baby is 38 weeks old, the mother’s mother can only be in town to help when the baby is 37 weeks, the father of the baby has a business trip when the baby is full-term. Other times, it’s a decision to opt out of the last couple weeks of a pregnancy because they are the most uncomfortable and debilitating. One consequence of increased on-demand induced labors has been overcrowded incubators in neonatal intensive care units. Before 40 weeks, babies are still in a critical phase of developing their brain, heart, lungs, and immune system, and these processes are jeopardized outside the womb—sometimes even resulting in infant death.

On top of increased induced labors, the rate of cesarean deliveries continues to rise. Statistics show that between 2002 and 2009, the number of rose from 27% to 34%. The practice of scheduling out of convenience has gained some popularity and acceptance as celebrities such as Kate Hudson, who had a when doctors told her she would have a long labor, and Posh spice Victoria Beckham, who recently had her fourth scheduled C-section. Some doctors believe that C-sections should only be conducted when medically necessary. Many doctors believe that, at the very least, discretion should applied when granting C-sections. Further increasing the rate of C-sections is the fact that after having a C-section, a VBAC (vaginal birth after caesarean) is risky (one of the risks is bursting the healed abdominal incision). In response to an increase in “convenient” pregnancies, several doctors, led by the nonprofit The March of Dimes, have joined in a national campaign called “Healthy Babies are Worth the Wait.” Should women be given full control to make their own decisions about their pregnancy? Or do hospitals need to put regulations in place so that women who are “too posh to push” or who have don’t put their babies—and themselves—at risk?


Robbie Davis-Floyd, PhD, senior research fellow, Dept. of Anthropology, University of Texas Austin; fellow, Society for Applied Anthropology; author of Birth as an American Rite of Passage