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Experts warn against elective Caesareans

Women are opting for potentially dangerous Caesarean births far too readily, experts say.
/ Source: msnbc.com staff and news service reports

Women are choosing to have potentially dangerous Caesarean births far too often and need to understand the risks of major surgery, experts said on Wednesday.

The guidelines warn doctors against granting Caesareans “automatically” on request, and suggested seven percent of them might be medically unnecessary.

“Of course labor is scary,” Louise Silverton of Britain's Royal College of Midwives told Reuters. “But women have got to realize this is major abdominal surgery.”

Britain’s state-backed National Institute for Clinical Excellence urged doctors to help reduce the number of Caesareans, saying 1.5 percent of all births involved the procedure without medical justification.

“There is increasingly clear evidence that the proportion of births by Caesarean could be reduced,” said Mary Newburn of Britain's National Childbirth Trust.

'Too posh to push'
But experts denied there was a rise in the “too posh to push” phenomenon, which refers to celebrities opting for Caesareans to avoid the pain and exhaustion of natural childbirth.

Overall, the procedure is conducted in 22 percent of U.K. births, said the NICE report, compared to World Health Organization guidance that the rate should not exceed 15 percent.

The dangers of the procedure include: infertility, bladder injury, and breathing problems for the baby. Caesareans can also interfere with breast-feeding.

“When I became a midwife 24 years ago, Caesareans were at a rate of 8-9 percent,” said Silverton. “Women are getting healthier and healthier, so why now do we now have Caesarean rates of over 30 percent in some regions?”

In the United States, there is also growing concern that voluntary Caesareans are becoming too common in the labor room.

In the U.S., Caesarean deliveries accounted for 26 percent of all births in 2002, according to the National Council for Health Statistics. It is the most common major surgery performed in the United States each year. Still, many doctors resist performing the operation unless medically necessary.

The American College of Obstetricians and Gynecologists says there is insufficient evidence that Caesareans decrease the risk of pelvic injury or urinary incontinence.

Caesareans require a longer stay in the hospital while recovery can take up to eight weeks for some women, experts say.