Here’s a jaw-dropping stat: if your U.S.-born children, nieces, nephews or grandchildren under the age of five came into the world on a weekday, they were almost as likely to have been born via C section as to have had a normal (vaginal) birth. And most children (81%) born in the U.S. in the last five years were born on a weekday.
A look at our data on U.S. births since 2005 sheds additional light on a recent New York Times article in which reporter Denise Grady flagged the increase in the U.S. rate of C sections (as high as 32% of all births in 2007). By tracing the relationship between the timing of a baby’s birth–specifically the day of the week–and the method of delivery, we offer some additional insights into this trend and its drivers.
Is the Rate of C Sections Finally Slowing?
According to the statistics from the National Center for Health Statistics cited by Grady, Caesarean sections, which are considered major surgeries by the medical establishment, have been on a steady climb since the mid nineties.
Our data roughly mirror this trend but go two years beyond what the NCHS can so far offer the public. Our numbers, self-reported by Circle of Moms members who took a birth survey, suggest an even higher rate of Caesareans.
We’re seeing the peak a little earlier, in 2004, at 40%. On the other hand, while Grady suggests the upward trend may well continue, our data show the rate leveling off for three years at 40% before declining in 2009 to 39%, which was the 2003 level.
Our data also point to the discretionary nature of many C sections.
A New Kind of Family Planning
Before we can get there, we have to examine the idea that birth dates are random to begin with. On some level many of us harbor a belief that the exact moment we come into the world is significant in its randomness. In recent years it’s been anything but: the stats reveal that a significant number of U.S. birth dates have been engineered.
If birth dates were truly random, the odds of being born on a Saturday would be the same as any other day. In actuality, a baby born in the United States during the last five years was 59% more likely to arrive during the hustle and bustle of a weekday as on a quiet Saturday or Sunday. And drilling down into the details, we’re seeing a astoundingly neat bell curve: a baby was 75% more likely to have been born on a Tuesday than on a Sunday, with Tuesdays and Wednesdays the most popular birth days in the week.
An Inconvenient Birth
This heavy concentration of weekday births holds true whether we look at babies born vaginally or babies born by Caesarean section. And the upward trend in weekday births over time is paralleled by the upward trend in Caesarean births.
Where we start to see a divergence is in the rate of C sections performed on weekdays as compared to weekends. On weekends, one in three births (31%) is a C section; during the week this rate rises precipitously to one of every 2.3 births (42%-43%).
Grady says in the Times that while many C section’s are medically-mandated, most are driven by doctors’ fears of lawsuits, by the desire of the family or obstetrician to shorten pregnancy or labor, or by the wish for a particular birth date, in particular the ones that do not fall on a Saturday or Sunday. C sections are not the only tool for shortening labor, scheduling a predictable birth date, and avoiding a medical malpractice suit, but they are the best way to guarantee those outcomes. Do it often enough and pervasively enough, and you’ll have the strangely neat weekly bell curve of births that we’re seeing on Circle of Moms.
Unless the stars can explain it.
This is really strange because all 3 of my girls were born on a Friday and all 3 were born C-Section.
All four of my kids were born durin the week and c sections wow wierd i also have a question how many c sections can you really have
I love how is this article it says C-section rate FINALLY slowing. Why is that women who have a vaginal delivery think they are better moms? I still carried both of my children for 9 months and had all the same symptoms other pregnant women have. I’m 5’3 and weigh 125lbs and my first child weighed 10lbs 6 oz. So, yes, I’m very very glad I had a C-section. I just get so tired of hearing that C-Section are so bad. Wow you pushed baby out of you. I’m really impressed. Just saying. Rant over.
I would be interested to see these numbers compared to the numbers of pitocin-induced births. I know my doctors did everything they could to force me to induce during the week and during “business hours”. I had wanted a natural, drug-free home birth and I ended up with a c-section(on a Tuesday at 8 am)
A C-section is MAJOR SURGERY, people! Our bodies, for the most part, let us know when labor should start. It is perfectly normal for a woman to be (gasp) overdue and have to actually wait 1-2 weeks to give birth! “But, doctor, my due date is tomorrow.” “I’m tired of being pregnant.” Lousy, lousy, lousy reasons to have your labor induced, but doctors give in, time and time again. Okay, labor is induced and BAM it doesn’t work because mom’s body isn’t ready, and BAM, there’s another stat in the C-section column. Patience, mothers!!!!
C-section loving mothers can’t be convinced otherwise; “natural” birth mothers can’t be convinced otherwise. The argument rages on.
well i had a c-section with my second and last child.. it was scary, and the doctor never explained anything.. 3 weeks later i nearly hemorrhaged to death because a piece of placenta was left in my uterus.. i had to have an abdominal hysterectomy, and now another child is never going to be an option.. not to mention i had quite a few blood transfusions.. i am 27 years old and am greatful for my 11yr old and my 1 yr old.. my first labor was natural and great.. the second was just so horrible.. the only good thing that came out of it was our son, nicolas.. and i thank God for my life every single day..
Lauren,
Amen! I totally agree with you on that one! I had my son via C-Section and if I had a choice to do it again I would! I don’t know where these people get off thinking their better moms because they pushed their baby out! Most of them don’t even do it on their own without an Epidural! I know pleanty of “mothers” who given birth naturally and their crappy moms! The way you deliever your child does not make you into the mother you are! Also just because our child is delivered Via C-Section does NOT mean we don’t go through the same things that mothers who deliver naturally go through! I had Braxton Hicks Contractions, I had back contractions, I started to dialate, my baby dropped, I lost my plug, the list can go on! The reason I had to have a C-section was because I am 4″11 and I had a narrow Pelvis and was unable to deliver! I had every intention to deliever my baby naturally and not to mention WITHOUT an Epidural! but I couldn’t! So if you want a standing applause….Go to a comedy show because you’re not getting it from me!
I had I C-section 3 weeks ago.
I am an absolute advocate of them now.
If you have not had a C section I suggest you hold your opinions off until you do have one.
I had the same syptoms of pregnancy as any other pregnant woman, I carried my baby for 9 months, I had the same contractions of my uterus post birth, the only differance was the birth of my baby was clinical and in a very controlled environment – I dont think this makes me any less of a mother.
My daughter was due to be induced because I had gestational hypertension and excess fluid, and two days before we where due to be induced, after a conversation with my obst, I elected for a C section for medical reasons.
I was up and walking the day afterwards, driving but week 2 and the only thing I cant do is run for the next 3 months. I stoped bleeding at 1.5 weeks, I have almost no pain, and when compared to woman who had a natural birth, I recovored much quicker then most of the others in my ward and I was comfortable relaxed and able to bond with my baby without being in what appeared to be from the woman I spoke to, immense pain.
Even though we elected to have a C-section for medical reasons, I would definatley consider it for my next child due to the saftey, the lack of birth trauma for my child and the controlled environment- particularly since we have very large babies in my family. It dosent leave much to chance.
True it is major surgery, but if you take the time to make yourself informed on all the pro’s and con’s and you take the doctors advice its a very swift recovory, particularly if you are religious with your pysio – you cant just blame your doctor because you didnt understand 100% the proceedure – you have to take responsibility for your own decisions.
I also wouldnt slag mums who decide to have an elective C section for what ever reason they choose, essentially at the end of the day, as long as it dosent put the baby at risk, we all have our own personal choice to make and that is just that – our own personal choice,its really not for anyone else to be judging and quiet frankly no one else but the mother and fathers busness anyway.
Last but not least, no one will give you a badge for giving birth naturally, “Well done, you did it, congratulations you are now a better mum than the rest”.
Anyone can be a mother, not everyone can be a mum – heroine addicts can give birth naturally…. and being a mum is not based on how you bring your baby into the world its based on what you do with them once they are here.
I have done it both ways, and although the recovery from my cesarean was easier, it’s an experience I hope never to repeat. I don’t think how you have a baby makes you a better mother. What matters is that you educate yourself on all the options, and most people will agree (and studies have proven) that normal, vaginal birth is safer in most cases than major surgery, for both mother and baby. There are, of course, exceptions that prove the rule. There are true medical reasons and emergencies that call for cesarean, but for 1 in 3 babies to be born by major surgery is outrageous and unnecessary. Our bodies are not so imperfect and screwed up that this many of us cannot have our children the way nature intended. The medical establishments (hospitals and ACOG) are more scared of lawsuits than anything else. Obstetrics has not been evidence-based for decades, at the expense of mothers’ emotions and babies’ well-being. Hopefully someday the tide will change and natural birth will be the norm, rather than women being looked at like their crazy for even trying.
i have a scheduled c section for april 7th because i cant have a vaginal birth becasue the placenta is covering the cervix and hasnt moved at all during the entire pregnancy….my first child was a vaginal birth…i had 3 failed epidurals so the drs tried fetinol which didnt work either so i had natural child birth and i didnt feel like i was the best mother in the world becasue i had a vaginal birth…i had placenta stuck inside which 3 weeks later caused me to hemmerorge and have an emergency dnc…i almost had to have a hysterectomy but thankfully it didnt come to that…now becasue of the mistake the dr made with my 1st child i cant have a vaginal birth and im more likely now to have to have a hysterectomy with this one…am i any less of a mother becasue i have to have a c section? if the dr didnt mess up the first time i wouldnt have to…not everyone who has a c section is lazy or wants the baby out…most drs dont just order c sections becasue your past your due date unless the baby is too big or there is a problem…its not fair to judge unless your in that situation
Sometimes C-sections are out of necessity. I have gestational hypertension and could not be induced because my baby had not dropped, therefore induction could’ve caused a prolapsed cord possibly killing my baby. Without a c-section, I could’ve had a stroke or seizures. I didn’t have one out of convenience. I also went the entire 39 weeks before giving birth and everything about my surgery was perfect for me. If your beef is with so many people pushing to “plan” their entire birthing experience, I can see the point. Birth has become a matter of convenience in many cases, but it has just as much by Pitocin inductions as by c-sections. What makes you a better mom for having a vaginal birth?
i luv this article my first baby was born through c/section n the second through natural birth….lol..dont see the difference.
all three of my children was born c-section.I have threee sons they’re the joy of my life.
Duh!! Many C-Sections are planned in advance, and those are typically not done on the weekend. Both of my boys were born via C-section. The 1st was on a Saturday, after 48 hours of labor (28 in the hospital), when I finally got over the BS guilt and realized it wasn’t that big a deal. The 2nd was planned in advance, on a Friday. Doesn’t take a rocket scientist folks!
I don’t think thy think they are better mothers because they had natural childbirth, they may think they deserve praise which I think any mother does. one advantage of giving natural child birth is the recovery is significantly less painful and its alot shorter. I would have preferred to birth my Brady naturally but it was a typical impatient doctor with other things to do…I wish I wouldve known then what I know now. but whats done is done. no use in dwelling on it. I still get sad when I think about being in the hospital and being unable to move from my bed to change my son’s diaper without first hittin the fentinol pump a few times, and by then my hubby had already begun the task. not to mention having him hose me off in the shower because I was in so much pain that i had to just hold onto the rail to keep from dropping to my knees. every woman goes through something when becoming a mother. whether its a painful labor or a painful recovery. so before you have experieced everything, there is no need to talk down to eachother. it sucks either way. the only thing that really matters is the end result.
The reason we are pleased to see the caesarean rate dropping is not because we believe in inferior or superior types of birth but simply that a caesarean done for the sake of convenience holds numerous inherent risks. These risks include:
- Problems with anaesthesia used for surgery and meds used for pain relief afterwards.
- Increased incidence of infection and need for antibiotics.
- More blood loss and increased risk of hemorrhage, which may cause anaemia and necessitate a blood transfusion.
- Longer hospitalization which increases costs.
- Postoperative pain that lasts weeks or months and makes taking care of yourself, baby and other children more difficult.
- Problems from scar tissue or adhesions inside abdomen.
- Possible injury to other organs (bowel or bladder) and risk of blood clots in leg and pelvic area.
- Increased risk of breathing and temperature problems for new baby.
- Higher rate of subsequent infertility than that of women who have had a vaginal birth.
- Increased risk of placenta praevia or retained placenta in future pregnancies.
- Increased likelihood of another caesarean in subsequent births.
This is not to say that vaginal birth is without risk. Especially where there are medical and sometimes even psychological complications. Medical reasons for a caesarean birth include:
MALPRESENTATION OR MALPOSITION: Baby’s placement in uterus is unfavourable for vaginal birth.
CEPHALO-PELVIC DISPROPORTION (CPD): Baby’s head is too large, mother’s pelvis too small or a combination of both. CPD can rarely be diagnosed before labour because baby’s head moulds and pelvic joints spread in labour to create more room.
FOETAL PROBLEMS: caesarean may reduce problems for a baby with congenital defects ie: a baby with a spinal cord defect has a reduced risk of paralysis if born by caesarean.
PLACENTA PRAEVIA: The placenta covers or partially covers the cervix. As the cervix dilates the palcenta separates from the uterus, causing painless bleeding in the mother. This could result in decreased oxygen to baby. A safe vaginal birth is not possible with placenta praevia.
PLACENTAL ABRUPTION: The placenta prematurely separates from the uterine wall. This may cause vaginal bleeding or hidden bleeding with constant abdominal pain. The separation decreases the foetus’s oxygen supply.
MATERNAL DISEASE: Heart disease or certain other medical conditions may mean that you may not be able to withstand the stress of labour and vaginal birth. Sometimes uterine fibroids are the cause of caesarean birth. Herpes sores at the time of birth or HIV infection necessitate caesarean.
I am a Childbirth Educator and although I believe a natural birth is the best possible way to have a baby, it is not the only way. If a mother elects a caesarean birth her decision should be based on evidence-based information not on what is easier for the doctor.
I have had a natural birth and a caesarean. If I am blessed with another baby it will be a homebirth and a VBAC.
Heather, yes, you’re right that the conclusions here are logical. What’s significant (we think) is that the C rate is so much higher on week days than it is on weekends. This tells us that a more significant number of labors are resolving with planned or unplanned C sections when the hospitals are more fully staffed. It would seem that if a mom wants to avoid a C section, she probably has a much better chance of holding her ground against a tide of pressure from doctors if she happens to enter the hospital when the weekend staff is already on duty: on a Saturday, or possibly even late on a Friday.
As a labor and delivery nurse, I have found the increasing rates of C-sections terrifying. Overall, the medical community has worked very hard to make birth in general sound scary and dangerous. As a result, they can justify major surgery to take care of the problem. And C-sections are MAJOR surgery. Anyone who has watched or performed a C-section knows that it is incredibly violent and dramatic. It has crazy effects on the mother and the baby.
Birth is not so dangerous and not so scary that we should be resorting to major surgery to avoid it. I’m not saying it is easy or routine, but birth is something that can be safe and healthy for both mom and baby when done right.
I think a lot of you c-section mom’s are forgetting that there are unnecessary reasons for the surgery. Fair enough it is needed for some cases but there are way too many that are done just for convenience. We need to cut this down, the baby does suffer from being born via caesarean even if you don’t, you are blind if you do not accept this fact.
I do not, nor have i ever thought i was a better mother for being lucky enough to have avoided surgical birth. What i think many natural birth advocates are concerned with is that as the percentage of csections rises above 15%, the rate of maternal and infAnt death also rises. We are not saying All babies can or should be delivered vaginally, what is being advocated is that MOST babies be delivered vaginally. Not in order to prove any superiority, but to give moms and babies the best outcomes.
OK, I had two good births, normal and well supported. I was then conned into a section to fit my new Dr’s schedule, which took me months to recover from. I knew with my fourth which was the easier option, and I had my baby at home, no pain, no stress, I had a great time – really. My 5th child, well, my placenta stuck to that previous section scar, and at 33 weeks a blood vessel in the scar tore and I haemorrhaged and collapsed. I was lucky that we both survived, we were in separate ICUs for a while, with a terrified daddy dashing between sick wife, sick baby and four scared kids at grandma’s house. We are very lucky to be alive. The cause? A section which could have been avoided with a bit of patience from the care team.
None of my births makes me a better mother, I’d just look silly if I claimed that, but it was much easier to be a patient and loving parent when I felt well than when I felt rubbish!
For a few women (research shows somewhere between 1% and 5%) surgical help will be necessary, but for the rest they and their babies are MUCH safer with a team that understand and support birth. The most dangerous place to be is trying to give birth with a team that expect women to need surgery, because they struggle to be good support for the birth process.
The risks of caesarean are not just to the baby who had the section, the risks carry over into your next pregnancies, and they are risks for you and your babies… Miscarriage, problems conceiving, still birth, all increase after a section.
Is it not worth stopping fighting over whose birth was better, and start looking at supporting all women to be as safe and healthy as possible? We all want a birth which is as safe and as trauma free as possible, for a few that will be surgical, and that needs support to make sure that the benefits outweigh the risks, for others that will be a safe and well supported birth without a cascade of intervention which increases the risk.
If it was really necessary for so many women to have major surgery, the human race would not have been successful in reaching the 21st Century. Good nutrition, clean living conditions and the discovery of antibiotics has done more to improve the safety of birth than surgery.
We are all on the same side, and all trying to do our best, and we need each other’s support to make that successful.
Well, I’ve had both a c-section and two vaginal births, so I think I’m qualified to comment.
My first birth was an induction–on a Tuesday, incidentally!–and it was a nightmare. My body over-reacted to the induction drug, cytotech. I started having contractions that were too strong and too close together, and my baby’s heart tones decelerated to a scary low level. I later learned that this is a common side effect of the drug, and that it can actually cause uterine rupture (and worse). Of course, no one told me about these risks when convincing me to be induced. I was just “overdue”. Well, my baby was “just” 7lbs, 8oz, and otherwise FINE. Had we been given a couple more days, we probably would have had a normal birth. Instead, I had an emergency c-section, didn’t get to hold him for 2 hours after he was born, didn’t get to hear his first cries, etc. All because, what? My doctor happened to be on call that day, and didn’t want to wait any longer?
My 2nd and 3rd babies were VBACs at home. No, I don’t think I’m “better” than anyone because of this. But I will say that their births were better for me, for my husband, and for my babies!
C-sections are major abdominal surgery, people! They have plenty of risks as previous posters have stated. If you need one in a true emergency, then great! I’m glad they exist!
The point of this article, however, is that many c-sections might be happening because of factors that have everything to do with doctor/hospital convenience and nothing to do with the health of the mother and baby. At least, that’s what that data seems to be showing.
Judging from my experience and from many others like me, I tend to think their conclusions are correct.
Excellent article!
I cannot see how recovering from a C-section would be easier than recovering from a normal, drug-free, intervention free birth. That seems like a bit of a daft thing to say; a C-section is major abdominal surgery, natural birth is your uterus doing some hard work (which it was designed to do) and stretching your vagina (which was designed to stretch).
People who say they “went through” all the same things with their C-section as a woman having a natural birth are wrong – the one major thing you didn’t “go through” and didn’t do for your child was allow them the passage through the birth canal which is immeasurably important for their lungs as well as their intestinal flora (which recent science is proving problems with can be connected to pretty much every single ailment we have, especially auto-immune disorders like lupus, Chrone’s disease, rheumatoid arthritis, even autism, to name just a few). Babies born by C-section carry bacteria from the room/hospital while babies born vaginally carry bacteria from their mothers’ legs and vagina (i.e. bacteria the mother has already processed and is making antibodies for in her breastmilk). Babies born by C-section are drugged, yanked in a frightening way, usually have their much needed cords severed immediately, are subjected to painful and assaulting suctioning procedures, are often late preterm with underdeveloped lungs, are often separated from their mothers for longer periods of time and I believe are imprinted by these painful and assaulting procedures, giving them the immediate and irreversible impression that our world is pain.
Furthermore, why is it about “going through” anything? I’m not “proud” that I gave birth the same way every other mammal on the planet has for millenia – that’s silly – it would be like being proud that I pooped without needing an enema. It’s got nothing to do with pride and, no, I didn’t expect a gold start afterward, either. Women choose to give birth naturally because it’s the NORMAL WAY TO GET A BABY OUT OF THEIR UTERUS and it’s the BEST THING FOR THEIR BABY’S HEALTH, not because they expect applause and accolades. I had a natural birth unassisted at home and I was able to do everything I’d done before giving birth immediately after, save for the fact that I was tired and my perineum was a little tender. The only thing that hindered me after having my baby was the extreme fatigue and there’s no way to avoid that with a newborn in the house. On top of that, I didn’t find giving birth to be a horrible, worst-pain-of-my-life kind of experience at all. Sure, there was discomfort (and I mean it, I’ve felt far worse pain than labour in my life) and sure, there was about 15-20 minutes of transitional labour where I felt I might not be able to go on but pushing felt great. Discomfort, yes, during active labour. Pain, very little. I attribute this to giving birth in an environment that was my own with only my husband there so I could choose any position that was comfortable for me, be unhindered by machines, beds, doors, staff, checks, monitoring, mandatory positioning and the eyes of strangers. I went inside myself to a “no mind” sort of state (though I remember everything) and just let my animal self take over to do its job.
Sure, C-sections save lives in a very small percentage of cases but I feel they should be reserved for those true emergency situations. When places like the Farm Midwifery practise have C-section rates lower than 2% I think we need to reexamine what’s happening in mainstream medicine.
Forgot to click notify on my first comment…
At least my c-section births were scheduled by my babies, not by my doctors. I was never induced. I went into labor on my own all four times. My second c-section may have been at 4:15pm, putting into that “time to go home” hour where you see c-sections spike, but I had been in labor for 4 days and pushing at home for 4 hours, then in the hospital for another hour. We were done.
And as for the hostility towards vaginal birth advocates, let me just say something: I’ve done it both ways. Twice. Two c-sections, two all-natural vaginal births. I’ve had big babies (biggest was 10#8oz, vaginal) and tiny babies (3 26-weekers, c-section). I fight for education and birthing rights because I’ve been there, I know the difference, and I feel nothing but heartache for women who have never had the chance to experience birth the way nature intended. I don’t feel like I was a better mom with my vaginal births. I do feel like my c-sections were very painful, and I feel blessed to have been able to have it the other way. I don’t judge you for having a c-section; rather, I wish the joy of natural birth for you. I certainly would never force it on you.
circleofmoms: ” It would seem that if a mom wants to avoid a C section, she probably has a much better chance of holding her ground against a tide of pressure from doctors if she happens to enter the hospital when the weekend staff is already on duty: on a Saturday, or possibly even late on a Friday.”
I’m not sure how you can really make that claim, but I suppose that a doctor could be quicker to suggest a c-section on a weekday morning than on a weekend afternoon. But I don’t really know. If you take out all the women who were weekday scheduled inductions and scheduled c-sections, and look only at those who had an emergency c-section after a trial of labor, then what? The article doesn’t make it clear. If a woman goes into labor spontaneously on a Tuesday morning, and goes into the hospital after labor has progressed for awhile, that’s a different situation than a woman who is going in for a scheduled induction. Is her risk greater on a Tuesday than on a Saturday? I don’t think that argument has been made.
I’m curious to know where your statistical information is coming from. I notice you didn’t cite any sources in regards to the information presented in your “weekday” graphs. I’d like to know where you found this information. Thanks.