Everybody has secrets. There is not one person on this earth without something to hide. Often times those secrets have to do with numbers, numbers on a scale, numbers in a bank account, numbers in a phone. Sometimes people do not even want to know their secret numbers themselves. Because as numbers add up they become rates, statistics, and can identify patterns of behavior. Maybe the lady down the street doesn’t want anyone to know how much cash she spends at Starbucks or on gossip magazines each month. Or the guy who works in the last office doesn’t want to know how many hours he spends online playing games and looking at “other” things. Most women would prefer to keep their weight and their weight fluctuations private, if they even want to know at all. Some folks don’t even want how many diet cokes they have a day to get out.
But what happens if it’s the doctors keeping secrets? What if it’s obstetricians keeping secrets? Here’s a whopper: Guess what type of surgery is the most common one performed in the United States? Maybe most people think its knee surgery, back surgery, or heart surgery but they would be wrong. It’s a C-section. However, as shocking as that fact may be, not many people know anything about it, and OBGYNs sure aren’t broadcasting it. What else are those doctors hiding?
Whether it has to do with the hospital, the equipment, or the doctors themselves, there are many things obstetricians would rather their patients did not know. Good thing there are researchers, studies, and organizations shedding light on these facts, figures, and astonishing statistics. Buckle up because this is going to be a jarring, eye-opening ride; here are 12 birth statistics your doctor doesn’t want you to know.
95 percent of low risk women could give birth with no medical intervention. This includes births at hospitals, birthing centers, and births at home. This figure just shows that most low-risk women are capable of giving birth without forceps, vacuums, surgery, or medication. 25 percent of women want to give birth with no medical intervention. So, only a quarter of women wish to give birth with no medical intervention. While that number might seem small in comparison with the large percentage of women that are capable, watch what happens next: Only 2% of women actually do give birth with no medical intervention.
What is happening here? These figures ought to shock the pants off of most doctors and their patients. Why is there such a disconnect? When so many women are capable of giving birth without all the interventions, how come so few actually do? Some believe childbirth has become a medical condition or medical emergency. Which is very different from what nature intended, if the numbers provide any clues.
Everybody wants to believe the information their doctors provide them with is accurate, and certainly pregnant women want to leave their prenatal appointment with the accurate information about their baby and their pregnant bodies. Well, the truth is sometimes the doctors are winging it. Those lovely ultrasounds that can produce the most amazing images of babies sucking their thumbs, pick up the thud of those tiny heartbeats, and alert the parents on whether they will need pink or blue balloons, are not good for estimating weight. During the third trimester ultrasounds are on average 10-20% off at estimating the baby's weight. Meaning lots of doctors are telling people their babies will be over 9 pounds when it will more likely be around 6 or 7.
Also, those fetal monitors at the hospital are not too informative either. During labor, it’s pretty common for the umbilical cord to be get stretched or compressed leading to brief drops in fetal heart rate. While it can signal major problems (and be quite alarming), according to the American College of Obstetricians and Gynecologists, so called “abnormal fetal heart rate patterns do not necessarily mean there’s a problem”. Additionally, in one study of 6800 infants, the fetal monitors correctly identified only one third of babies needing breathing assistance at birth.
The C-section rate in the United States is off the hook. It has drastically grown in the last ten years and continues to climb. 1 out of every 3 babies are born via C-section these days, that’s over 1.3 million babies each year! The current rate in the US (around 30%) is double the recommended rate set by the World Health Organization, because they have concluded that when the rate enters above 10-15%, it is no longer associated with saving more lives. So, the risks of C-sections begin to outweigh the benefits.
Couple these facts with the research that indicates only 1% of women (according to the Listening to Mothers Survey) desire to have a C-section without medical necessity, and things get really confusing. More C-sections above a certain point do not save more lives, very few women initially want to have a C-section, but the rate of C-sections continues to climb above the recommendation each year. At some point, doctors are going to have to admit that around half of the women receiving C-sections do not need them.
Yes, this is a tough one to swallow. Pain relief is not always a sure thing. In one study of over 19,000 epidural procedures, the epidural did not work as it was supposed to 12% of the time. 46% of the ones that did not work were able to be corrected to perform accurately, and the malfunctions were due to older equipment or improper set-ups. The study concluded that after corrections, as many as 98% of women said they were able to feel some relief.
Here’s the problem, the details of epidurals are usually kept from women until they are talking with the anesthesiologist who is about to administer it, i.e. “the last minute”. Many women do not know that they may still feel pain on one side or have “holes” of pain or periods or windows of pain. Also, sometimes scarring from previous epidurals or surgeries, or even the woman’s anatomy may prevent her from fully experiencing the pain relief.
VBACs or vaginal births after cesareans are often given as an option to women who are questioning having a C-section for the first time. Doctors will often inform their patients that they need a C-section this time, but next time they give birth they may not. Ideally enough the success rate of vaginal birth after cesarean sections are high; up to 80% of women “giving it a go” are successful in their endeavor. If this is what women are told, and the rates of success are so high, why do so many doctors refuse it and hospitals ban it? More
than 40% of hospitals report they ban VBACs, and hospitals are not required to give out that information so many of the hospitals that do have VBAC bans do not willingly admit it. To be fair and very honest, there is the widely-preached chance of a uterine rupture which is indeed a very dangerous situation, but the possibility of it is unbelievably low. In 2016, research shows that a uterine rupture happened in 0.5 to 0.9 (or less than 1) percent of VBACs. So, the million-dollar question is: why aren’t more hospitals and doctors performing them?
One of the most terrible things about laboring in a hospital is the rules. The rule that is the crappiest is no eating or drinking during labor. NPO or nothing by mouth as hospitals call it is a major rule for any type of surgery. It’s even worse for the women who are admitted to be induced or to give birth before labor begins on its own - these poor women are told not to eat anything after midnight the night before. What could be worse than doing a ton of hard work with no sustenance?
There is a reason for the nothing by mouth rule and it has to do with what could “possibly” happen. It is based on the doctor’s fear that the women in labor will possibly or could somehow need general anesthesia and that she may then possibly inhale the contents of her stomach during surgery. Yes, that does sound scary but the possibility or odds of that happening is rare, so rare in fact that a pregnant woman is more likely to be struck by lightning. The number is around 7 events out of 10 million births!
C-sections are major surgeries. A Harvard study concluded that unnecessary C-sections may be responsible for up to 20,000 major surgical complications a year, including everything from sepsis to hemorrhage, to organ injury. Another almost unbelievable fact, that most if not all doctors avoid talking about, is the extremely high likelihood that their C-section patients will develop painful abdominal adhesions. Again, a C-section is a major surgery that cuts through many layers of sensitive pelvic tissue, and adhesions are fibrous bands that form between tissues and organs, often as a result from injury due to surgery.
In other words, adhesions cause organs that usually do not touch to stick together, think of a fallopian tube attached to the bladder or two ovaries sticking together. It can be extremely painful. Many women complain of chronic pain or pain during intercourse after C-sections, which goes hand in hand with the many studies that have concluded: up to 93% of people develop adhesions after pelvic surgery, especially C-sections. Okay, that’s more than 9 out of every 10 women that have had C-sections!
Back to the old ultrasound blunders. While early ultrasounds are better at estimating a baby’s due date, they are usually within 1.2 weeks or so, the later the pregnancy progresses the more off those machines get. Between the 18th and 28th weeks of gestations, the ultrasound estimates for due dates can be off by as much as two weeks before or after. After 28 weeks, just forget it, ultrasounds are usually off by three weeks or more. So, doctors sometimes play around with the numbers using the date of the last menstrual cycle and the estimated date from ultrasounds early on in the pregnancy, and sometimes they even change the due date.
The problems happen when due dates are off and then women are pushed to induce, because lots of the time inducing babies causes many more interventions than planned, or possibly needed, had the baby been given more time to trigger labor on its own. It’s also important to note that pregnancy lasts for a little more than 41 weeks in low risk first time moms. Studies have shown the facts are very different from the widely believed 40-week standard.
This one is truly painful. As hush-hush as its kept, nine out of ten, or a whopping 90%, of women experience some type of tearing in vaginal births. There is, however, a wide range of tearing that can happen. Some can be minute and a tad less painful and easy to stitch and fix. Sometimes the tearing is quite bothersome, extremely painful, and requires many stitches, and lots of pain medication.
These severe tears are called 3rd or 4th degree lacerations. A third-degree laceration is a tear in the vaginal tissue, the perineal skin, and perineal muscles that extend to the anal sphincter (the muscle that surrounds the anus). Let’s just say the forth degree laceration is even worse. While the likelihood of tears is “up there”, there are some things that can be done to prevent them. Perineal massage, laboring in water, hot compresses, avoiding episiotomies, among other labor preparations, can prevent this painful dilemma.
If a guy that works at a car dealership needs to buy a car, he is probably going to be able to get a good deal. If a woman that owns a floral boutique needs flowers for her wedding, you can bet they will be the best available. When doctors give birth, they are less likely to be ushered into surgery as a result of complications arising during labor or the failure of labor to progress, which are the two main reasons so many other non-MD women are ending up with C-sections.
Research indicates that mothers with medical degrees are 11% less likely to have unplanned C-sections in general. This suggests they may know something the average mother does not. The lowest C-section rates are found among mothers with education and training most relevant to surgery, childbirth, and infant care. Physicians also have lower total hospital charges, partially due to the lower C-section rate.
Since we have already discussed the fact that a C-section is the most common surgical procedure in the United States, it’s really no surprise that the costs of child birth have skyrocketed. Child birth in the United States is uniquely expensive and for what? Research indicates the prices are not so high because the service is so much better. There are many places in the world, where top notch hospitals are providing labor and delivery services that are just as good or better than those in the US for a fraction of the cost.
In the US, maternity and newborn care constitute the single biggest category for payouts for most commercial insurers and state Medicaid programs. And Don’t’ fret about the doctors earning more money for performing C-sections versus vaginal deliveries, the difference in their pay is usually just a few hundred dollars. It’s the hospitals that make thousands each time a baby is delivered via C-section versus vaginally. The cumulative costs of the births of about 4 million children a year is well over 50 billion dollars.
Tying back almost everything previously discussed on this list is one way to avoid some of the pitfalls of somewhat secretive doctors: doulas. A doula is not a midwife, as she is not a medical service provider, rather she is a woman trained to assist other women in childbirth and also may provide support to the family after the baby is born. So, going back to the more you know the better treatment you are likely to receive, a doula is trained in childbirth and just having one around can drop the chances of a C-section by 28%!
Doulas also decrease the likelihood of many of interventions such as forceps, or vacuums, or even pain medications. They are also well known for increasing the mother’s satisfaction with childbirth. Many of these reasons point to the fact that the use of doulas has more than doubled in the past six years.
Sources: American College of OBGYNs, Very Well.com, ConsumerReports.org, BellyBelly.com, MayoClinic.org, All About Epidurals