Cesarean Births

The nationwide trend of rising caesarean section rates is mirrored--and sometimes surpassed--in Southern California hospitals. Data generated by the state Healthcare Information Resource Center at The Times' request shows that Los Angeles County's 10 largest hospitals providing childbirth services all experienced increases in caesarean sections from 1996 to June 1999. In Orange and San Bernardino counties, the majority of hospitals reviewed also showed an upturn in C-sections.

THROUGHOUT her pregnancy, Susana Hellmuth, 35, felt as if she were walking on eggshells. The Culver City woman had had two previous miscarriages, one heartbreakingly late, just as she entered her third trimester. This time, as a precaution, she spent the final six months in bed. Finally, a few weeks before her due date, she asked her doctor to schedule a cesarean section. "After six months of not doing anything, the last thing I wanted was complications at birth," she says. Dr.

The risk that an HIV-infected woman will pass the virus to her baby during birth is nearly eliminated if she takes a standard AIDS drug and has a caesarean delivery, researchers have found. The benefits of the AIDS drug AZT have been known for five years. The added advantage of a caesarean, however, was suspected but not proved until a large study--whose results were relesed Thursday--was completed. The new data show that a caesarean cuts the risk of AIDS transmission in half.

In a striking departure from prior practice, doctors at Los Angeles County public hospitals have been forbidden to allow women who have had prior caesarean deliveries to undergo a trial of labor unless they sign a consent form. The new policy, which went into effect April 1, contrasts starkly with the county's approach in the late 1980s and early 1990s, when nearly all women giving birth at county hospitals were pushed to deliver vaginally.

Delivering a baby with an exposed spinal cord before its mother begins experiencing labor pains significantly reduces the risk the infant will be seriously crippled, Seattle researchers reported last week. According to the study of 200 babies with meningomyelocele, a birth defect affecting about two of every 1,000 fetuses, those born by Cesarean section before contractions began were about 55% less likely to be severely paralyzed than those delivered by Cesarean after labor began.

An angry Los Angeles County Supervisor Gloria Molina scorched county health officials Tuesday for the number of malpractice cases arising from obstetrical care at county hospitals, saying that the problems have continued long after the Health Services Department pledged to correct them.

About 10 hours into labor I burst into tears. Not because of pain, or fear, or the absolute conviction that this baby was never ever going to come and I would spend the rest of my life a freak among womankind, although I certainly felt all those things. No, my tears were a result of the realization that instead of being the countdown-breathing, drug-refusing natural laborer that I had longed to be, I was instead a large, ungainly, practically naked science project.

He was delivered by Cesarean section just after doctors performed lifesaving surgery on his mother's heart, and weighed in at a scant 4 pounds, 7 ounces. But the prematurely delivered son of Maria Luz-Duran may be home in time for Christmas. Luz-Duran, 36, of Lynwood, was recuperating in the intensive care unit of St. Francis Medical Center on Friday. "It's a miracle. They did the angioplasty and then when the baby got into trouble, they took him," Luz-Duran said.

In an effort to monitor and avoid injuries to women and babies like those caused by Los Angeles County's recent efforts to cut costs by reducing Caesarean births at public hospitals, an Assembly committee has approved a bill requiring all hospitals to report maternity ward injuries and develop procedures to correct problems.

Ahn Hyang Shim, 28, and her husband were filled with expectation as they entered Jinju Kaya Jamo Hospital on the outskirts of Pusan for the birth of their first child. They were told Ahn would need a caesarean because she hadn't produced enough water, but the doctor quickly reassured them that this was routine. That was the last time Ahn's family saw her conscious. During the caesarean she fell into a coma, and she remains in a vegetative state more than nine months later.