Years ago, when my wife was pregnant, we decided to explore the Bradley method of childbirth, which educated women and their husbands on how to successfully deliver a child naturally. In the end, we chose a great OB, Dr. Howard Graebelle, who loved helping women have children by respecting their choices of how they wished to deliver. I was ill the night my son was born, and my wife walked around the hallways of the hospital, which helped her labor progress. When it came time to deliver him, the doctor avoided an episiotomy, a common but unnecessary procedure, and oversaw my son’s delivery. He delivered my daughter naturally as well. Recently, my daughter had her first child, and fetal monitoring was relied on. Any change suggesting fetal distress caused the nurse to change her position. Unlike my wife, my daughter was in bed with an epidural, and luckily, she had a natural delivery as well. Physical fitness and chiropractic care before pregnancy and at the beginning of your pregnancy can help you reduce risk during the delivery of your baby because labor requires a strong core and the ability to push when the time comes. Chiropractic manipulation and myofascial release can improve flexibility and joint function in the spine and pelvis, which is important and the time of delivery and afterward during recovery as well. Chiropractic care should be part of every pregnancy to improve function, reduce pain, and improve post-pregnancy recovery. An improved process can help reduce the likelihood of needing a C-section due to complications during delivery. The two common causes of high USA C-section rates Fetal monitoring is overused and increases C-section risk. There is growing evidence that the reliance on fetal monitoring to reduce risk during childbirth is actually causing unwarranted concerns and driving C-section rates higher than most countries have. Having been in healthcare and understanding the dynamics, there are usually 3-4 people in a room during the birth process, and often dozens who are watching what happens from a distance, who are family and friends. The pressure to have a successful birth is huge for everyone involved, so any sense that things are going badly may result in a C-section being performed. There are also liability concerns for both the doctor and the hospital. According to a recent article in the NY Times, the practice may be more about prioritizing business and legal concerns ahead of what’s best for patients. The American College of Obstetricians and Gynecologists updated its guidelines on continuous monitoring, sanctioning it even as some other wealthy countries have cautioned against its routine use. Remote monitoring has turned this mass market approach into a failed safety method, resulting in 1/3 of the births ending in a C-section. This increases the risk to the mother, resulting in infections, the inability to safely deliver naturally in the future, and active scars developing, which can result in a lifetime of back, neck, and other musculoskeletal conditions. Active scars are commonly seen in our chiropractic office, as most women do not know that this is why they hurt months and years later. Often, we can reduce the likelihood of an active scar causing problems by Read more from the NY Times article below The ‘Worst Test in Medicine’ is Driving America’s High C-Section Rate Financial and other physician behaviors can reduce C-sections. The financial incentives are driving more C-sections, since reimbursements are higher for C-sections. In a recent NY Times article, the average cost for a normal delivery is $11,000 vs. $17,000 for a C-section delivery. Studies show that making the reimbursement the same for either one resulted in fewer C-sections. Why should a natural process such as childbirth, which has been medicalized, cost this much to begin with? It is understood that incentives drive medical care. Doctors go where the money is, which is why so few want to do family medicine anymore. High incentives for procedures drive procedures, whether or not they are beneficial to us in the long term. This is probably the largest driver of healthcare costs in our country. Dr. Elizabeth Bostock, A Rochester, NY hospital OB, took over the department and was horrified at the 40% C-section rate and made changes over time, including: Low-risk patients began getting routed to midwives in 2021. A new checklist in 2023 required various steps to promote vaginal delivery before surgery. Perhaps most important, she said, she had uncomfortable discussions with doctors about their individual surgery rates. Our Federal government suggests a 24% as being acceptable. Dr. Bostock’s recommendations resulted in the C-section rate being reduced from 40% to 25%. Maternity care is less than objective, according to the NY Times. Two factors that do matter, she and others have found, are an obstetrician’s pay and the doctor’s personal beliefs about the surgery. Another factor was the time of day and time management considerations. Women who wanted to labor naturally were shown in another study to affect the amount of C-section decisions as well. Read more below. Perhaps, we need to rethink the medicalization of a natural process and allow others who are also trained, such as midwives, to be a larger part of the process, which can result in lower rates of C-sections. These Hospitals Figured Out How to Slash C-Section Rates