Recently some British researchers came up with a dodgy, new spin on an old obstetric myth. They warn us that the high rate of cesarean births is afffecting human evolution. They claim the female pelvis is shrinking through evolution. They report, selection pressure from the overuse of cesarean deliveries is accelerating this evolutionary shrinking process. Consequently, more women now require cesarean births because the pelvis is too small and narrow to birth normally.
Rate of cesarean births is climbing
Researchers are baffled by how quickly the cesarean birth rate is increasing. Their best explanantion for this phenomenon is evolutionary pelvic shrinking.
This isn’t a new conclusion, folks. The size of the female pelvis has always been the scapegoate for complicated deliveries. The original diagnosis for cesarean delivery was cephalopelvic disproportion. Translation is the pelvis is too small to fit the baby.
It’s possible that high cesarean rates will lead over time to the an evolutionary smaller pelvis, but the size of the pelvis is not the cause of the high rate of cesarean births.
The pelvis is not the problem
The truth is, the size of the pelvis is not too blame for the high rate of cesarean births.
In fact cesearen rates for women who plan to birth at home in the U.S. have remained a steadily low below 10%. This proves the problem is not the pelvis.
Its imperative to lower the cesarean birth rates but not by blaming the female pelvis.
The Brits were on the right track two years ago when they announced their campaign to steer low risk women away from birthing in the hospitals.
In an effort to lower the rate of interventions and cesareans, in 2014 Great Britain’s National Institute for Health Care Excellence (NICE) recommended that women with low risk pregnancies are better served by giving birth at home.
More than half of cesareans are unnecessary
In our modern, developed countries the cesarean birth rate is more than twice what it should be. According to the World Health Organization, the ideal cesarean rate should be 10-15% for any country. The U.S. cesarean rate is 33%, meaning that more than half of the cesareans performed are unnecessary.
This is a good cause for all of our concern.
The overuse of technology is the real cause for increasing cesarean rates
The real problem for rising cesarean rates is not a shrinking pelvis, its the overuse of modern technology
While we are indebted to modern medicine for saving lives from time to time, it’s overuse is driving up cearean birth rates. In time this may indeed cause selection pressure against normal vaginal birth!
Giving birth in the hospital with all its practices and technology directly increases the liklihood of delivering by cesarean.
Interventions such as labor induction with cytotec and pitocin, Friedmans curve, continuous fetal monitors and anesthesia increase the cesarean rates when over used. Impatience of the providers, driven by production demands, also drives cesarean birth rates.
In order to decrease the cesarean rates, modern medicine needs to be used judiciously and only for delvieries that become high risk.
Planned homebirths have low cesarean rates
Planning a homebirth is the best way to avoid an unnecessary cesarean delivery. The likelihood of requiriing a cesarean delivery for a homebirth mother is under 10%, well within the World Heatlh Organizations recommendation.
A woman planning a homebirth can trust that even if she ultimately delivers by cesarean, it is necessary and life saving. It won’t result from the overuse of technology. She should also believe that her pelvis is adequate and has not shrunk through evolution.