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In Deutschland variieren die Kaiserschnittraten in den einzelnen geburtshilflichen Abteilungen erheblich. Während in Landau die Hälfte aller Geburten im Kaiserschnitt endet, wird eine Schwangere in Dresden mit hoher Wahrscheinlichkeit eine normale Geburt erleben. Die möglichen Gründe für solche Unterschiede wurden in zahlreichen Veröffentlichungen untersucht. Dabei wurde festgestellt, dass die Vorgehensweisen der GeburtshelferInnen einen erheblichen Einfluss haben. Diese Arbeit geht der Frage nach, wie es in manchen Kreißsälen gelingt, Kaiserschnitte zu vermeiden. In Experteninterviews benennen Hebammen, GeburtshelferInnen und ÄrztInnen die aus ihrer Sicht relevanten Faktoren, die es ihnen ermöglichen, möglichst vielen Kindern ohne Operation auf die Welt zu helfen.

Cut It Out examines the exponential increase in the United States of the most technological form of birth that exists: the cesarean section. While c-section births pose a higher risk of maternal death and medical complications, can have negative future reproductive consequences for the mother, increase the recovery time for mothers after birth, and cost almost twice as much as vaginal deliveries, the 2011 cesarean section rate of 33 percent is one of the highest recorded rates in U.S. history, and an increase of 50 percent over the past decade. Further, once a woman gives birth by c-section, her chances of having a vaginal delivery for future births drops dramatically. This decrease in vaginal births after cesarean sections (VBAC) is even more alarming: one third of hospitals and one half of physicians do not even allow a woman a trial of labor after a c-section, and 90 percent of women will go on to have the c-section surgery again for subsequent pregnancies. Of comparative developed countries, only Brazil and Italy have higher c-section rates; c-sections occur in only 19% of births in France, 17% of births in Japan, and 16% of births in Finland.How did this happen? Theresa Morris challenges most existing explanations of the unprecedented rise in c-section rates, which locate the cause of this trend in physicians practicing defensive medicine, women choosing c-sections for scheduling reasons, or women's poor health and older ages. Morris's explanation of the c-section epidemic is more complicated, taking into account the power and structure of legal, political, medical, and professional organizations; gendered ideas that devalue women; hospital organizational structures and protocols; and professional standards in the medical and insurance communities. She argues that there is a new culture within medicine that avoids risk or unpredictable outcomes and instead embraces planning and conservative choices, all in an effort to have perfect births. Based on 130 in-depth interviews with women who had just given birth, obstetricians, midwives, and labor and delivery nurses, as well as a careful examination of local and national level c-section rates, Cut It Out provides a comprehensive, riveting look at a little-known epidemic that greatly affects the lives, health, and families of each and every woman in America.

Cesarean section rates Percentage Indication Low High Failure to progress 2. 0 4. 0 Repeat cesarean section 2. 0 6. 0 Breech and abnormal lie 1. 3 3. 5 Fetal distress 1. 5 3. 0 Third-trimester bleeding 1. 0 1. 0 Totals 7. 8 17. 5 l From Quilligan, by permission of Contemporary Obstetrics and Gynecology. vaginal delivery, I have yet to meet a physician who would do something they believed would harm their patient even if they were paid ten times as much for a section. On the other hand, there are fears and misconceptions. I have heard many doctors say'I have never been sued for a section I did, but I have been sued for the section I did not do.'The fear of not having performed a section in my opinion is real, although difficult to prove, and until the public can be educated that cesarean section delivery cannot eradicate fetal death and damage, this fear will remain and will be responsible for some unnecessary cesarean sections. Bruce Flamm and I hope this book will correct misconceptions that have been responsible for many unnecessary cesarean sections. I am still frequently asked the same old question: What is an ideal cesarean section rate? I still give an answer similar to the 1983 answer, perhaps somewhat modified.

The bible of cesarean prevention. Wall Street Journal A landmark event, which will change the course of obstetric care by giving parents the informtion they need to make the decisions that are best for their own families. Comprehensive, highly readable, sensitive... should be read by everyone who cares about someone. Marian Tompson Director, Alternative Birth Crisis Coalition American Academy of Medicine Required reading for all childbirth professionals and prospective parents. Journal of Gynecological Nursing