Re "The C-section epidemic," Opinion, Sept. 24
Jennifer Block claims caesarean sections are dangerous and "doctors and hospitals need to promote normal labor and delivery." Some points are probably valid. But it might be a good idea for her to look at the other side of the coin.
I represent a 30-year-old woman whose doctor promoted normal labor and delivery for her triplets. Following a massive postpartum hemorrhage, she is now in a vegetative state in a skilled nursing facility. When "vaginal birth after caesarean" was in its heyday -- before publication of data showing it to be risky -- I represented dozens of severely brain-damaged babies whose mothers had uterine ruptures during delivery. The children and their parents struggle with disability and pain every day, and will for the rest of their lives.
Before making her recommendations, perhaps Block should have paid a visit to some of my clients.
The writer is a physician and an attorney.
Block failed to mention the fastest-growing reason for C-sections: personal choice. Up to 3.5% of C-sections are simply done for the mother's personal reasons, which vary from fear of labor, convenience and predictable delivery dates to preservation of bowel, bladder and sexual function. Obviously there is total informed consent because these are elective and not emergency procedures.
Likewise, for personal reasons, many women choose to have primary C-sections for breech births or for twins. When I was a resident in the 1970s, we tried to deliver all births vaginally, but today, with fetal monitoring and the specter of lawsuits being filed at the drop of the hat, more mothers deliver by C-section. Until there is medical malpractice reform, this trend will continue unabated.
Michael L. Friedman MD