April is Cesarean Awareness Month. And increased awareness is definitely what we need, not only for this month but the whole year round. Because the recent US baby boom seemed to have been accompanied by a C-section boom.

According to the 2007 statistics recently released by the Centers for Disease Control and Prevention (CDC), C-section delivers rates jumped to record high (31.8%), up by 2% from 2006. The good news is that despite this rise in C-section rates, the number of babies with low birth weight rates was slightly down (from 8.3 to 8.2%) in 2007. The preterm birth rate, defined as delivery before the 37^th week of pregnancy, was down as well. However, this decline is mostly late preterm delivery, e.g. between the 34^th and 36^th week of pregnancy. This is reduction of 0.1% is way below than the goal of 15% reduction set during the Prematurity Awareness Month in November last year.

Last year, the not-for-profit organization March of Dimes actively campaigned for prematurity awareness and cited a study showing that C-section is a major factor in preterm delivery. The latest statistics suggests that women and their doctors probably tend to wait a bit longer, beyond the 37^th before performing a C-section. The decrease in preterm delivery, albeit small, is an encouraging step towards the right direction and hopefully will be sustainable.

However, the increase in C-section rates is causing concerns. According to the International Cesarean Awareness Network (ICAN), more than half of C-sections may actually not be necessary. Timed together with the Cesarean awareness campaign this month, ICAN has scheduled the ICAN 2009 International Birth Conference on April 24 to 26 to be held in Atlanta, Georgia.

Last summer, the buzz was all about Thomas Beatie, “the pregnant man,” and his daughter Susan. Well, Beaties, step aside, now there’s something even better. A Spanish transsexual man claims he is 6-weeks pregnant with twins.

25-year old Ruben Noe Coronado Jimenez and his partner, 43-year old Esperanza Ruiz, happily announced the news to the world this week in the popular magazine Pronto. They plan to marry before the babies are born in September, and raise the children–both boys–together in Barcelona, Spain.

In every sense of the word, Coronado is still a woman. Once known as Estefania, Coronado had been undergoing the physical transformation of becoming a man. Photos of Coronado show a balding, bearded man. But Spanish law, as of last year, allows citizens to change their gender status without actually having sex change surgery (if the person is undergoing other kinds of gender-reassignment treatment, like hormones). The proud “mama” says she only retained her legal female status in order to undergo fertility treatment. Coronado took hormone treatment that would restart her periods, and then did in vitro fertilization. She plans to begin the administrative process that will legally transform her into a man this month. So, when she gives birth via cesarean section, she will actually be “he.”

Even though the pregnant soon-to-be-man announced the pregnancy via tabloid press, Coronado insists, “to protect my children I’m not going to sell my story now or in the future.” But she talked to the press in order that the world can start to see transsexual pregnancies as “normal.” But belly bumps are a different thing entirely. And since someone else will do it if she doesn’t, she may just sell a snapshot or two of “his” pregnant belly when the time comes. Can’t wait to see that one.

The obvious question in this case is, “Why didn’t Ruiz–the partner that intends to remain female–undergo the fertility treatment and carry the babies?”. And, as in the case with Thomas Beatie, there is a simple answer: the other partner couldn’t. Ruiz actually has two children from a previous relationship. But the aging mom was told by her doctor that she could not become pregnant again. So Coronado decided she would do it, even though she plans to become a man. And even though Spanish law doesn’t require it, Coronado does intend to complete the surgical sex job she interrupted. In a strange simile, Coronado compared her quasi-transgender status to having three hands. “You take advantage of them while you have them and you get rid of one of them when they get in the way.” Of course. When your uterus gets in the way, you just get rid of it.

So, are you buying it? Is transsexual pregnancy normal? And will Coronado be able to protect his children from the media?

It’s a baby boom! Government researchers just reported that in 2007, there were 4.3 million live births. That tops even the baby boom of the 1950s. After concerns on some fronts in recent years about the US population not reproducing itself, this is a sigh of relief. But the numbers are slightly misleading. According to the Centers for Disease Control, back in the 50s, there were fewer women having babies–but they had more of them (about four kids each). Today, women have 2.1 children a piece (I guess I’m just .1 away from normal. Any of you over your limit? You can have my share.) The highest numbers are in Utah. The lowest in Vermont. I wonder if that is adjusted for population? A quarter of the “women” giving birth are teenagers. And 40% of the births were to unwed parents.

Experts of every stripe are out in force today, ranging from the abortion advocates to family researchers, sociologists and economists. Each of them is weighing in on why things are the way they are. You may not even be surprised to learn that some of the issues here have been blamed on George Bush. (That’s kind of a long-standing game between my husband and I. What did someone blame on Bush today?) Economists say the trend in babymaking matches the economy. Since 2007 was a good year, there were lots of babies. Dr. Carol Hogue, a professor of maternal and child health at Emory University, thinks the birth rate will drop with the downturn in the economy. “The lowest birth rates recorded in the United States occurred during the Great Depression.”

Now the study didn’t say how many of the unwed births were unintended, nor how many of the unmarried women were in long-term relationships with the father. Still, 40% is not a good number. Why are teenagers getting pregnant? Some are saying it’s because they don’t have an abortion clinic nearby. Some say that George Bush tried to teach them abstinence-only but they didn’t get the message. For whatever reason, the teen birth rate had been going down for 15 years. Then suddenly, last year, it went back up.

I am no expert in such matters. But I have been a high school teacher for many years. I can tell you that teenagers are no longer branded by a negative social stigma when they get pregnant. So if it happens to one of them, they no longer have to face ‘outcast’ or ‘hussy’ status. Girls and boys freely discuss their sexuality in school. I also have noted that most of my students who were willing to speak up are very opposed to abortion on a personal level. They would much rather raise a baby than abort it. (This matches the fact that abortion rates have been dropping steadily. Which causes the other?) It also seems like a cultural trend to me when you consider that the numbers are not balanced among different races. The birth rate among black teenagers is twice as high as whites. Hispanic teenagers have three times as many babies as white girls. I live and teach in a community that is more than half hispanic. I don’t know all the ins and outs because I am not hispanic myself. But I do see a positive commitment to family among them. A baby is a good thing. Again, these are just my observations. Of course there are other experiences out there.

So why are older women having babies out of wedlock? Maybe for the same reasons. And, if you add in the fact that marriage is slightly on the decline, it makes sense. Again, if you look at the number breakdown, it is very much a trend within certain cultures. Almost 72% of all black babies were born to unwed mothers. A little more than half of hispanic babies were. Do you have any explanation for this other than cultural attitudes?

There were a few more interesting findings:
- One third of all births are by cesarean. (In Puerto Rico, it’s almost half of all births.) “Every pregnant woman in the U.S. should be alarmed by this rate,” said the president of the advocacy group, International Cesarean Awareness Network advocacy group. Pam Udy continued by saying that more than half of those could have been avoided. If you had a cesarean, why? Was it elective? Was it planned?
-On a positive note, there are fewer premature babies born now. Fewer infants are low-birth weight, too. Is this the result of younger mamas? Or better health care? None of the above?

What do you think of all these numbers?

A study published in the October issue of Journal of Child Psychology and Psychiatry by Yale School of Medicine researchers indicates that mothers who deliver their baby vaginally are more strongly bonded to their newborn than a mother who deliver via cesarean section.

The researchers performed brain scans on the mothers while they listened to their baby crying during a diaper change. The mothers who delivered vaginally were found (via fMRI) to have more activity in the area of the brain that regulates emotion and empathy. The researchers believe this is an indication that the process of a vaginal birth somehow “primes” the woman’s brain for becoming a mother.

While the intent of the article and its publication was to encourage women to consider vaginal births in light of recent trends towards planned c-sections, I feel that the results are questionable at best. Brain activity in the area that regulates empathy does not make a bond with a child; being a mother to the child, caring for the baby and feeding him or her creates a bond.

No mention was made as to the feeding methods for the babies. Were they all breastfed? All bottle fed? Nor was their daily care situation discussed. What percentage were at home with their baby all day? What percentage were working and left the baby with a caregiver? And how many of them had a partner to assist them in the parenting process versus those who were single mothers? All of these details can impact how a mother bonds with her baby. Ignoring them completely makes the results suspect, at best.

Source: Natural Childbirth Linked to Stronger Baby Bonding Than C-Sections via Health News Digest

I spent the last eight posts going through the story of the birth of our daughter for a reason. I wanted everyone who reads this blog to know exactly where we (my wife and I) were coming from with our anticipation (arguably trepidation) of our second.

Since that experience, my wife has seen her obstetrician several times, and discussed subsequent births. Although there was a possibility that she could have a successful vaginal birth after cesarean (VBAC), our concern was that it wasn’t necessarily the R.O.P. that was the cause of all our problems last time. We believe that there is a good chance that my wife’s pelvis may have been the issue that necessitated the c-section.

So, after much internal discussion (and admittedly some tears), we have decided? to have a scheduled c-section for baby number two. It wasn’t an easy decision, but we think it will be the best thing for us.

This decision means we will have a very different experience than last time. There will (likely) be no discussion of whether she’s feeling constipated or contractions. There will be no water breaking in the middle of the night. We will be able to prepare ourselves as well as our daughter for the baby’s arrival, and I think that will work out well for all of us in the end.

What are your feelings about VBAC, or just scheduled c-sections in general? How do you feel about the (supposed) recent rise in scheduled c-sections?