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Show ' rpHF ii 7 TRtI TH ABOUT CAESA REAN BIRTHS Too many babies are delivered by this method unnecessarily, says this obstetrical authority '" " RIVA, M. C. By Col. H. L. and Gynecology, Chief of Obstetrics Walter Reed General Hospital, Washington, D, C. as told to Theodore Irwin One night last November, Mrs. John F.Kennedy ambulance to Georgetown Univer-sit- y was rushed Hospital. Less than two hours later, word flashed around tke world that the wife of the Presi- :dent-ele- ct had given birth to a son via Caesaean section.. Millions of American wives facing childbirth have wondered: how safe is Caesarean delivery and when is it really necessary? For authoritative answers, family weekly invited Dr. Humbert L.Riva, an obstetrician, to present his views. . children born each of year in the U. S. under the management physicians, 3 to 5 percent (perhaps 200,000) are delivered by Caesarean section. In some private L0 hospitals, as many as. one out of five to births are Caesareans. ' ... Is childbirth by Caesarean becoming a fad? From Our experience at Walter Reed General Hospital, where an average of 40 babies are born each week to Army wives, we beiieve that virtually half of the repeat Caesarean sections performed in the past "have been unnecessary! , in this tech-niqinterest who express Many women fear labor and expect that surgery will solve their problem quickly and conveniently, .Other women timorous young wives especially want to be sure they will receive enough attention; at a Caesarean, they reason, a doctor will be present throughout the procedure. Another factor responsible for the trend is the busy physician. For him a Caesarean section "childbirth by appointment' is often a time-saviprocedure when compared with standing by for a regular delivery. , Most doctors have been trained to believe that if a woman previously had a baby through surgery, her next child should also be delivered this way. The dictum is no longer true, as studies at Walter Reed have shown. Or . - the more than 4,000,000 ue , ng Just what is a Caesarean section? Briefly, it of may become imperative. The greatest number these cases occur when the mother is too small in in- volves cutting through the walls of the abdomen Jllterus to femovetheTldfdm IhTwombrA Caesarean section may be done before labor has started or at some time during its course. Most women eager to take this "short cut" to avoid travail are blithely unaware of the drawbacks. First, a Caesarean mother loses three or four times as much blood as in a normal delivery. The chances of complications growing out of a transfusion are about the same as they are in acute appendicitis. Moreover, since a Caesarean requires more anesthesia, the mother is exposed to further -- to- - the-sizfe- -of -t- he-babv- ...,. - perrai to- normal process. JS Nevertheless, we maintain that in., many cases where Caesarean delivery seems to; be indicated before labor, it may not necessarily be mandatory. We have tried natural birth even for a woman who has had as many as three previous Caesareans if she shows no present signs of abnormality. With modern surgical techniques in a welUstaffed hospital, an operation Can be performebquic)dy after this trial of labor, if required. delivery iy the "; potential jeopardy. Besides, recovery is more difficult. In addition to the usual convalescence, at home, the Caesarean mother has to go through the healing process of an abdominal incision. She has to have help longer and pay more visits to her doctor. Any such operation means greater possibilities of intestinal obstructions as well as blood clots. A scar on the womb automatically makes the woman a potentially complicated case ironi that time on The "repeat" Caesarean patient becomes vulnerable to rupture or hernia later, which would call for another operation. And despite antibiotics, the danger of infection is always present. a study we undertook, womeri with previous. Caesareans were asked to enjter the hospital ap proximately a week before their expected delivery date. When we examinedtnem in labor prior to surgery, we were amazeof to find that in many instances the woman'Sbody was preparing itself for a normal deliveryAs a result, of 214 women who had had Caesareans before, three out of four were 1 m,An.t mix cntruinricinn Innrf J J.l:. without a single maternal or fetal death. By permitting trial labor whenever possible, Walter Reed General Hospital has cut the Caesare-an-sectirate in half from 2.9 percent to 1.5 percent of births and we are keeping it at this low rate today, compared with about 5 percent in many In on baby, too, does not get all the benefit it There is no sure way to estimate the exact age of the unborn; to be on the "safe" sideefor the mother, a doctor may operate too soon, bringing forth a premature baby. Such a child has less chance of survival, and the death rate is higher than for others. Those who survive the first few hours are vulnerable to certain diseases. So a Caesarean section, which" to a woman may appear to be an easy and convenient way of having her baby, can lead to unforeseen tragedy. Undeniably, under certain circumstances, a Caesarean The hospitals. To women concerned about their forthcoming confinement: if your doctor suggests that you undergo a Caesarean section for the first time, remember that the standards of the Joint Commission for Accreditation of Hospitals require consultation with at least one other specialist in obstetrics before big-ci- ty this operation may be performed. This is the rule in all first-cla- ss hospitals. After all, no one has yet been able to improve on the physiological mechanisms of the human body! September 10, 1961 COVER Photographer David Corson captures these pint-size- d football players huddling as the quarterback calls the play. There s more on "midget league" football on page 16. nmmHiftn- LEONARD S. DAVIDOW WAITER C. DREYFUS PATRICK E. O'ROURKE MORTON FRANK Board of Editor President and Publisher Vice President Advertising Director Director of Publisher Relations Send all advertising commonicatioh$ to Family Weekly, 153 N. Michigan Ave., Chicago 1, III. Address all communications about editorial features to Y. Family Weekly, 60 E. 56th St., New York 22, N. 1961, FAMILY WEEKLY MAGAZINE," INC., 153 N. ERNEST V. HEYN Editor-in-C- h icf BEN KARTMAN Executive Editor ROBERT FITZGIBBON Managing Editor MARGARET BELL Feature . Editor PHILLIP DYKSTRA Director MELANIE DE PROFT Food Editor Art Rosalyn Abrevoya, John Hochmann, Jerry Klein, Hal London, Murray Miller, Jack Ryan; Peer J. Oppenheimer, Hollywood. M ichigan Ave., Chicago 1, III. All rights reserved. |