Induced births, forceps and vacuum delivery and cesarean section can interfere with the primal bonding experience between mother and child, and set a tone of panic in the first minutes of life.
If the birth experience is so important, how did we ever screw it up so badly? Advances in medicine have made childbirth safer, but they've also changed pregnancy from a natural process into a disease, critics say.
A January 2005 report by the Centers for Disease Control and Prevention found an increase in infant mortality, from 6.8 infant deaths per 1,000 live births in 2001 to 7.0 in 2002, the first increase in the infant mortality rate since 1958. CDC analysts attributed the increase to a rise in the birth of extremely small babies, those weighing less than 1 pound, 10.5 ounces or 750 grams at birth. The majority of these tiny babies die during their first year of life.
Although multiple births are on the rise, in part due to the use of fertility treatments, the CDC said this didn't account for the increase infant deaths. The agency did peg part of the trend to changes in the medical management of pregnancy, specifically cesarean delivery.
In 2002, 57 percent of very low-birthweight infants were delivered by cesarean, up 3 percent from 2001. Improvements in fetal imaging and diagnosis and more intensive monitoring of at-risk pregnancies may have resulted in an increased likelihood that a cesarean delivery will take place -- and a low-birthweight baby would be born, a baby that stands much less chance at life after birth.
The use of induction also doubled from 1990 to 2000, increasing to 14 percent of all U.S. births. This could contribute to the increase in infant deaths, because the due date is just a guesstimate; a significant number of past-due babies turn out to be slightly premature. Preemies have higher rates of death and disability than those born at term.
By 2004, the last year for which statistics are available, the percentage of cesareans had increased to 29.1 percent, up 8.4 percent from 1996.
By comparison, in 2000, of more than 2,200 births, only 1.4 percent of births at The Farm were cesarean. Less than 0.05 percent of births required forceps or vacuum extraction.
Cesarean delivery also puts babies at risk. A 2006 study of 5.7 million low-risk births found that the mortality rate for babies delivered via cesarean was 1.77 deaths per 1,000 live births, while the rate for vaginal delivery was 0.62 deaths per 1,000.
Mortality in cesarean deliveries has consistently been about 1½ times that of vaginal delivery, but it had been assumed that the difference was due to the higher risk profile of mothers who undergo the operation.
This study, according to the authors, is the first to examine the risk of cesarean delivery among low-risk mothers who have no known medical reason for the operation.
C-sections also short-circuit the natural flow of oxytocin from mother to child. Instead of being born with a bloodstream buzzing with the hormone of love and connection, the baby comes into the world awash with nauseating and disorienting anesthesia. If the baby was pulled out by forceps or vacuum extraction, his body's first experience is pain and terror.
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