Video: An Unnecessary Cut?

The most common operating-room procedure in the United States is the Cesarean section. The surgery accounts for one in three American births, and ninety per cent of women who deliver their first child by C-section do the same for their second. But as the American College of Obstetricians and Gynecologists noted in a recent report, the rapid increase in the number of C-sections performed in this country hasn’t led to an equivalent decline in the risk of surgical complications associated with delivery. The report registers “significant concern that cesarean delivery is overused,” and recommends that physicians more carefully distinguish between necessary and unnecessary procedures.

Most women who have delivered by C-section and choose to have more children are eligible to attempt a vaginal birth after Cesarean (V-BAC), often cited as a way to significantly reduce C-section rates. But finding an obstetrician and a hospital willing to facilitate a V-BAC can be difficult. We spent time with Chileshe Nkonde-Price, a cardiologist at the University of Pennsylvania seeking a V-BAC, during the final week of her second pregnancy. We also spoke to, among others, Neel Shah, an obstetrician-gynecologist at Beth Israel Deaconess Medical Center, in Boston, about moving the medical establishment toward a more low-intervention approach to childbirth.