The Caesarean debate is on-going and often heated. The latest news to spark comment is a report published last week online by the British Medical Journal that babies born by elective caesarean are four times more likely to suffer from respiratory problems, and the earlier the operation is done, the higher the risk. With caesarean rates in this country now at almost 23%, information regarding the operation is vital. But whilst informed choice in the world of birth is essential, debating the pros and cons of a c-section is largely an irrelevant exercise. For to do so implies that the operation is and should be simply a matter of choice. This sort of thinking misses the point.
Caesareans are, undoubtedly, another way to be born. But they were developed as a life-saving operation and should remain so. They are an alternative to natural birth, but only when nature falters. To debate their merits and ills implies that they are a valid option for low-risk pregnancies, and ignores that they involve major abdominal surgery with all the risks that that entails. To argue that one of their merits is convenience ignores that timetabling could come at a huge cost. Under normal circumstances, when the mother and baby are healthy and the pregnancy has been normal, the risks of a caesarean section greatly outwieghs the risks of natural birth for both mother and child. As such they should not be considered, except in particular circumstances. Having said that, the reverse is also true. There are circumstances in which the life-saving benefits of a c-section far outwigh the risks that they might impose on mother and baby, and as such must be considered, even consented to. All too often a woman faced with the inevitability of a c-section finds nothing but horror stories and risk factors in her quest for information, yet for such a woman, these risks are rendered irrelevant by her circumstances.
We should not cease to do research and to be informed of the merits or otherwise of caesareans, but we should think carefully about changing the parameters of the debate.