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Caesarean section or natural birth - often a lifestyle decision?
Around a third of the children in Germany are born today by Caesarean section. Doctors and health insurance companies are alarmed because the proportion of Caesarean section births has almost doubled since 1995. Critics argue that non-medical necessities are often the reason for the caesarean section.
Many Caesarean sections at the parents' request The medical term for Caesarean section "Sectio caesarea" is derived from the Roman Emperor Julius Caesar. According to the writer Pliny, this was born through a quay cut.
Medical factors that speak in favor of childbirth by caesarean section can include, for example, a particularly large head circumference of the child, transverse or breech position, a significantly increased birth weight and acute emergency situations due to problems with the child's oxygen supply. In such cases, the increased risk of health damage to the mother and / or child justifies the so-called caesarean section. However, many of the Caesarean sections are due exclusively to the wishes of the mother or parents. A development that must be assessed critically, since the caesarean section poses risks for both mothers and children.
Primary and secondary Caesarean sections Although the number of Caesarean sections as births has increased significantly in recent decades, most mothers still prefer natural delivery today. However, medical reasons often speak against normal childbirth, reports the Federal Center for Health Education (BZgA) on the internet portal. A distinction must be made between reasons for a primary and a secondary caesarean section. In general, according to the BZgA, a distinction is made between two types of criteria from a medical point of view: reasons that are already certain before birth, which show that childbirth by natural means would be impossible or too dangerous, and complications that arise during birth.
From a medical point of view, the primary reasons for caesarean sections, which are performed before the onset of labor, are, for example, serious illnesses of the mother, illnesses of the unborn child, previous uterine surgery or even a very large child in relation to the mother's pelvis. Secondary Caesarean sections are performed when the normal birth cannot be completed because the child's head does not fit through the maternal pelvis, the mother cake comes off prematurely or the child is at risk of lack of oxygen. So-called secondary cesarean section can also be used for births that are too long and therefore too exhausting for mother and child. As Markus Valter, Senior Consultant in Obstetrics at the Gynecological Clinic at Cologne University Hospital, told “Welt Online”, there are usually very good reasons for a caesarean section. For example, "a petite woman of 1.45 meters poorly could give birth to a 4.2-kilo child vaginally." It also often had to be quick, for example if the child's heartbeat suddenly subsided "or if the patient got pregnancy poisoning developed a so-called gestosis with a particularly severe course, ”the expert continued. Because then there is an acute danger to life and it could even count every minute, emphasized Valter.
32 percent of children are born by Caesarean section According to the Federal Center for Health Education, 32 percent of children in Germany are born by Caesarean section. In fact, according to the World Health Organization (WHO), the caesarean section only makes sense at about every eighth birth. The Caesarean section worldwide has increased significantly in recent years, whereby not only medical factors but also cultural ideas about birth play a role, explains the BZgA. The comparison between the different European countries makes it clear that in countries such as Germany (32 percent Caesarean section births) or Italy (just under 38 percent Caesarean section births) it is not only medical reasons that can be decisive for the Caesarean sections. Because in the Netherlands the share of Caesarean section births is only 16 percent, although here the children and mothers are not much healthier than in Germany or Italy.
According to the Federal Statistical Office, not only has the absolute number of Caesarean section births increased by around 80,000 since 1995, but their share of total births has also increased from 18 percent to just under 32 percent. A development that also raises considerable concerns among health insurance companies due to the associated costs. "We share the concern that instead of the wellbeing of mother and child as the sole decision criterion, other reasons for a caesarean section will become more important," emphasized Rolf-Ulrich Schlenker von the statutory health insurance company Barmer GEK. The critics see the increasing decisions for a caesarean section as a convenient “lifestyle” development. The women fear the burdens of the birth or simply have a specific date of birth in their minds as a desired date.
Many women choose a caesarean section out of fear The fear of pain during childbirth also influences many women in their decision. Gynecologist Valter takes a lot of time for these patients to relieve them of the fear and explain the advantages of a natural birth: “With a vaginal birth, the children are much better prepared for breathing independently by pressing. A Caesarean section child often breathes poorly and is at greater risk of landing in the intensive care unit. ”
Edith Wolber from the German Midwives Association sees the insecurity of many women as the cause of the increasing number of Caesarean section births: “Today many women no longer know much about birth. Intensive care during pregnancy can take away their fears. ”This is also confirmed by a WHO study. Women who receive intensive care from a midwife are less likely to have interventions at birth. "In addition, most people do not know that the pain in the section occurs after birth," explains Wolber.
The Women's Health Working Group, an initiative that is supported by women doctors and health politicians, launched a call in June to have Caesarean sections performed only when there was a medical need. The working group reports that clinchers made more money with section births than with normal births. A lack of continuous care by midwives and time pressure would lead to rash decisions. The legal liability situation also speaks for a caesarean section: with a cesarean section, obstetricians are "always on the safe side".
Markus Vater supports the natural birth, but he admits that the consequences of a massive complication in vaginal births can be serious for mother and especially for the child. "On the other hand, this is very rare with a caesarean section." (Fp, ag)
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