Almost One in Three American Women Now Gives Birth by Cesarean Section

About 3.5 million women gave birth in the United States in 2020. In 2015, the last year for which statistics are available, close to a third of them delivered their babies not in a warm, inviting, relaxed setting surrounded by loving friends and family, but via major abdominal surgery in a bright, cold operating room, surrounded by mostly strangers. Although the World Health Organization recommends that no more than 1 in 10 births should be by surgery, maternal-child health advocates worry that birth by cesarean section is becoming more and more “normal.” The increase comes despite the known increased risks for surgical complications, premature delivery, infant breathing and feeding problems, and difficulty with family bonding during the post-operative recovery period. Women who want to have a normal childbirth must work harder than ever before.

Worries about malpractice suits contribute to our high rate of cesarean section. Additionally, insurance companies pay doctors a lot more for surgery than for a normal birth—and surgery is a lot more efficient when you have a busy practice to run. Some obstetricians practically encourage women to schedule their induced labor—or even their elective cesarean section—as a matter of mutual convenience. Whatever the drivers, it’s as though the pain, risk and expense of the “cascade of intervention” interfering with a natural human bodily function are only of minor concern. Advocates of normal childbirth argue that Mother Nature didn’t create women’s bodies so they’d need surgery to get a third of their babies born—if she had, humans would have died out many years ago.

Studies consistently show that the midwifery model for prenatal and birth care results in excellent outcomes for mother and baby, a reduced need for medical intervention, and far fewer cesarean deliveries. Midwives are trained with a holistic philosophy, using skills and traditions that have been passed down from generation to generation for as long as women have been getting pregnant and giving birth—whether in the hospital, birth center, or at home.

Still, fewer than 10 percent of women giving birth in the United States work with midwives. The ones who do say they enjoy having relaxed, personal and informative prenatal care; seeing a provider who has faith in a woman’s body and who is an expert in what’s normal (and what’s not); who knows how to help her stay healthy; and who stays with her as she works to give birth. The special skills of midwives to keep birth normal and healthy are needed now more than ever.

Unfortunately, it’s the rare American woman who gets the kind of consistent, empowering education and support she really needs to develop trust  in the normal birth process.  This places her at increased risk for obstetrical interventions she might prefer to avoid and which, indeed, may be inappropriate for her or even entirely unnecessary. Every woman needs a midwife on her maternity care team if she wants to beat the odds—and she must cultivate her own inner confidence in her power to give birth in a normal and healthy way.

Every pregnant woman should be supported to move through her journey feeling confident, capable, and able to trust her body as it performs the everyday miracle of childbirth—as it was brilliantly designed to do.  

Copyright 2022 Susan Fekety