I definitely believe there have been a large increase of c-sections in the U.S. and Canada due to impatience. I know that there are definitely a need for them, when medically necessary for sure, but a third of all births is just plain ridiculous. That's exposing mum and baby to un-needed, hard and painful surgery for no reason other than the doctors want to go golfing on the weekends. (Maybe that's a bit over dramatic, granted, but it is the easiest and quickest way for doctors to deliver a baby. I can't say that OB-GYNs don't know what they're doing, but natural births do scare them, as unpredictible as they are.) Here in B.C., Canada (unsure of the rest of my country) expecting mothers have the choice of an OB-GYN or midwife (if they want both -and its not medically necessary- the mums can pay for the other as extra support) and it is covered by the Ministry. Its quite a lovely system. Midwives here often have special permissions with local hospitals and OBs just in case, but for the most part it is still a new and unknown profession. I currently work at a maternity store and am upgrading my diploma in order to attend UBC for... Midwifery! Haha. Its really exciting and I'm very much looking forward to what's in store.
C-section utilization in the United States is related to liability, not laziness. A vaginal birth is an emergent condition - there are lots of things that can go wrong and the negative outcomes associated with them are pretty dire. As a consequence, the chances of litigation go through the roof. Result? When in doubt, cut the baby out. It's also a misnomer to say that C-sections are easy. Routine I'll give you. A caesarean is a routine surgical procedure and the likelihood of in situ complications is lower than vaginal birth. Because it's a routine operation, the aftercare is likewise routine (but also not easy). Look at it this way: if your choice is to accept a variety of "risk percentage" from zero to twelve, or a solid six every time, your insurance company would much rather you go with the solid six. Good luck on your studies. My wife has delivered about 300 babies.
Also, once a woman has had a c-section, they will have them for their subsequent deliveries as well. This adds to the 1/3rd of all babies statistic that jinxedlinxed used. But yeah, it's all about liability and not about golf.
Less liability also equals a larger paycheck. Liability is expensive. So, "yes," in that regard it's about retaining and making more money. Edit: Still, you cite costs, not profits. I would guess that the doctor makes more on the c-section because they are billed as the surgeon, but still there's a big difference between stated costs and stated earnings from a procedure. I emergency delivered my son at home and until I got to the hospital, it cost me about $20 worth of towels.
Very true. I suppose I got a little too liberal with some word usage there. I, myself, will opt for midwives when my time comes (heath permitting, of course) The few midwives I've talked to around my area love that they connect with their ladies more than the OBs do/can. They are permitted to take on 60 women a year in B.C., that includes prenatal care, birth (home, hospital or birth centre) and up to six weeks of neonatal care (though that load is often shared between the head midwife and a couple part time midwives, the size of birthing centre -or working out of hospitals- changes that number). But it just makes sense to be able to make a lasting bond, and its a lot easier when there's only a few other women vying for their attention, as opposed to hundreds. And thank-you. (:
It's a sensitive issue because it's very easy for both sides to get their hackles up and stop talking and since my wife straddles the divide between "normal" and "crazy-ass woo" we both tend to get caught in the crossfire rather a lot. She has an OBGYN she relies on a lot (because some planned home births go to the hospital, and it's a good thing, too) who is obnoxiously proud of his sectioning skillz. And why not? He's a surgeon. That shit's baller. But he won't back many midwives in the area because they're antagonistic anti-hospital crazies that see the involvement of conventional maternity care as a failing, rather than a useful life-saving intervention that should be utilized freely. That 60 is an interesting number. My wife knows two or three midwives that routinely do 10-12 births a month.
Never thought I would be part of the statistic of out-of-hospital births: Now that I am though, if we have more children, they will be home births, for sure. -Just "planned" births.
You might even be able to look it up. Not sure about North Carolina, but Washington will allow you to pull down all the vital statistics data for any given year as an .xlsx, and they break birth down about nine different ways. California? Yeah, california don't report shit.