Caesarean section births are rising and rising in the United States — and no one knows exactly why. In the 1940s, Caesareans were rare, but they now make up nearly one-third of the nation’s births. In Puerto Rico, the rate is 47.7%.

The main reason seems to be caution. “In all the grey areas of clinical decision-making, obstetricians have moved to Caesareans. Mothers are more accepting, too,” says Eugene Declercq, of Boston University’s School of Public Health. Fear of lawsuits may be another factor, as parents often feel that Caesareans are safer. Many doctors now think that their patients have developed an extreme, almost unreasonable aversion to the smallest risk.

However, Caesareans also involve risk. This year two women died within two weeks in Pennsylvania after Caesareans. Recovery time is longer, and haemorrhage, infections, dangerous clots and rehospitalisations are more common. They also pose risks for future pregnancies. Planned Caesareans could even be contributing to the recent uptick in premature births.

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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