Rise in C-sections linked to aging uterus
We are in an era of middle-aged moms even though teen pregnancies are always in the limelight. This is the reason why the rate of Cesarean sections has been steadily increasing. The longer women delay in having children, the higher is the risk of having a Cesarean delivery due to impaired womb function. These findings were based on a large body of data collected in Scotland by scientists at Cambridge University.
The research team examined more than 500,000 record entries from 1980 to 2005 to evaluate the relationship between maternal age and labor outcome. Here are some of their results:
- There was a 7-fold increase in the proportion of women aged 35-39 entering their first pregnancy
- There was a 10-fold increase for women aged 40 or older also having their first pregnancy.
- The rate of Cesarean sections has also more than doubled in the same period of time.
This trend seems to be the same in many developed countries as well.
The researchers went on further and looked into the women’s womb. Samples of myometrium which is the muscle from the middle of the uterine wall were taken from 62 women who had elective C-sections.
Their analysis showed that older women tend to have impaired uterine function which results in reduced ability of the uterus to spontaneously contract as well in changes in the type of contraction. This impairment in contraction leads to problems during delivery which eventually ends in a C-section.
C-deliveries can present a lot of risks for the mother and for the child and can lead to a lot of complications, including preterm delivery and low birth weights.
Dawn says...
Wow, Science-mom, the conclusion on this study is WAY off. Here’s the logic they are trying to foist upon the public:
first-time moms are getting older. (fact)
C-sections are on the rise (fact)
Therefore, older first-time moms result in more c-sections…. (HUH?!)
The causality is faulty and does not take into account other facts that have led to increased c-sections over the years, such as:
* doctors’ fear of malpractice suits
*overcrowding labor and delivery areas, leading to doctors’ “rushing” the delivery process
*male doctors’ subconscious fear of allowing the natural birth process to take place without intervention, as women have been doing for billions of years
* and, as Robert Bradley cited years ago in “Husband-Coached Childbirth”, the (mostly male)OB’s egos getting in the way of letting them sit back and simply “catch” the baby after nature takes its course.
The study also does not explain why some hospitals have 40 degree c-section rates and others have 10. I find it hard to believe that 2 hospitals, 40 minutes away from each other on Long Island, have such a huge difference in demographics between older and younger women giving birth to account for the discrepancy.
Your last sentence seems to imply that older women shouldn’t have children because of the increased risk of (admittedly dangerous) c-sections. I hope that’s not what you’re saying.
Dawns last blog post..90 Minutes in the Morning
Science-mom says...
Dawn, I am just presenting the results a certain study and no, I am not implying that older women shouldn’t get pregnant. Sorry if that’s the message that came across.
How could I? I was almost 40 when I got pregnant for the first (and I guess the last) time. And I had C-section because of 2 factors – my age and I was carrying twins. I was one of those high-risk cases and I am overwhelmingly grateful that everything went well despite a very difficult pregnancy.
http://blogs.babiesonline.com/2008/05/08/my-pregnancy-bucket-list-things-i-would-have-loved-to-do-while-pregnant-but-couldn%E2%80%99t/
I am not convinced myself by the causality of maternal age vs rise in C-section rates. The analysis of myometrium samples is something else.
Erika says...
I think that this had to have been a biased study. If an older (elderly prima gravida) mom is healthy and her pregnancy is without any complications (as mine was, so I speak from experience), there is no reason for a C-section.
Too many doctors and hospitals do not give women enough information about the risks of C-sections and are too quick to say “yeah, let’s cut you open to get the child out instead of letting nature take the course that’s worked since the dawn of time.” And, in Western society we’re taught to fear childbirth and the medical industry treats pregnancy and childbirth the same way that they treat disease and not as a natural course of a woman’s life cycle (should she choose to have children). Yes, there are times when c-sections make sense, but to suggest that “an older uterus is a faulty one” (which is exactly what the study is suggesting) is only going to send more women to decide to have c-sections, because there’s no way that their old uterus can function properly.
How nice of this study and its researchers to add even more anxiety to a demographic of women that for the most part are scared of childbirth to begin with. Did they ever think that perhaps this “uterine dysfunction” is not dysfunction at all, but part of how an older uterus might act, and letting it do what it’s supposed to do instead of rushing for the scaple? This whole study just completely baffles me in its irresponsibility.
Erikas last blog post..When will WAHMs be counted in the discourse?
Dawn says...
Thanks for clarifying, Science-Mom.
Your post seemed to present the study as “fact.” It could be true that a higher percentage of elderly prima-gravid moms have c-sections than younger women… but I just don’t see that as the overall cause for the rise in the percentage of c-sections.
The myometrium sample findings are interesting, yes, and I’m sure it does contribute to *some* increase in c-sections. But not all.
It just doesn’t account for all the other socio-political factors at play, or the difference in c-section rates between two hospitals both drawing from the same demographic pool, such as Good Samaritan and Stony Brook on Long Island. The study is smokescreen for the true causes, once again putting the burden/blame on women (as is the case with insurance companies denying coverage to women who have had c-sections).
I’m glad you clarified your last sentence for the readers. Knowing your situation (I read your posts all the time) the statement really surprised me!
This study — if accepted as fact — is just dangerous. What next? Will insurance companies start denying coverage to women over 40 (or 35) who get pregnant because they are at increased risk for c-sections? Scary, isn’t it?
Dawns last blog post..90 Minutes in the Morning
Science-mom says...
Sorry for the misconceptions (not to mention apprehensions) that this post brought about. When I presented the results of the study, I never imagined I’m sending the wrong message.
I also want to point out that this study is based on data gathered in Scotland. And that the UK health care system (free!) is very much different from the American system.
Science-mom says...
Some more apologies: It was remiss and insensitive of me not to link this to health care issues considering our readers’ reaction to the posts on health coverage.
http://blogs.babiesonline.com/2008/06/05/mothers-denied-health-insurance-after-cesarean-sections/
http://blogs.babiesonline.com/2008/06/24/when-you-are-without-health-care-coverage/
I guess we Europeans simply take health care for granted.
Lissa says...
Hmmm.. I was 29 when I had my son and I had a c-section. I’ve known other moms in their 20s that had c-sections so I don’t fully believe this study.
Dawn Allcot says...
Great links, Science-Mom, and thanks for sharing them.
Women being denied health care coverage after c-sections is a big issue that is not getting the media coverage it deserves. It all begins with education.