The US National Institutes of Health says that rises in rates of caesarean sections are not, in isolation, a cause for concern, but may reflect changing reproductive patterns:
Some authors have proposed an “ideal rate” of all cesarean deliveries (such as 15 percent) for a population. There is no consistency in this ideal rate, and artiﬁcial declarations of an ideal rate should be discouraged. Goals for achieving an optimal cesarean delivery rate should be based on maximizing the best possible maternal and neonatal outcomes, taking into account available medical and health resources and maternal preferences. Thus, optimal cesarean delivery rates will vary over time and across different populations according to individual and societal circumstances.
Nonetheless, some commentators are concerned by the rise and have tried to generate theories to explain it. Louise Silverton, deputy general-secretary of the Royal College of Midwives, says that not only has society’s tolerance for pain and illness been “significantly reduced”, but also that women are scared of pain and think that if they have a caesarean there will be less, if any, pain. It is the opinion of Silverton and the Royal College of Midwives that “women have lost their confidence in their ability to give birth."
Silverton's analysis is controversial. Dr Maggie Blott, a consultant obstetrician at University College Hospital, London and then a Royal College of Obstetricians and Gynaecologists (RCOG) spokeswoman on caesareans (and Vice President of the RCOG), responded: 'There isn't any evidence to support Louise Silverton's view that increasingly pain-averse women are pushing up the caesarean rate. There's an undercurrent that caesarean sections are a bad thing, but they can be life-saving.'
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