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Cut It Out : The C-Section Epidemic in America

By: Morris, Theresa.
Material type: TextTextSeries: eBooks on Demand.Publisher: New York : NYU Press, 2013Description: 1 online resource (256 p.).ISBN: 9780814763087.Subject(s): Cesarean section -- Prevention | Cesarean section | Surgical indications | Women -- Health and hygieneGenre/Form: Electronic books.Additional physical formats: Print version:: Cut It Out : The C-Section Epidemic in AmericaDDC classification: 618.8 | 618.86 Online resources: Click here to view this ebook.
Contents:
Cover; Contents; Acknowledgments; Introduction; Part I. The Root of the Problem; 1 The Liability Threat in Obstetrics; Part II. Control Systems Embedded in Hospitals; 2 The Tyranny of the Rules; 3 Too Much Information: How Technology Raises the Stakes; Part III. The Effects of Organizational Constraints; 4 The Big Kahuna: Repeat C-Sections; 5 Women's Lack of Choice in Labor and Birth; Conclusion: A Roadmap for Change; Methods Appendix; Notes; References; Index; A; B; C; D; E; F; G; H; I; J; K; L; M; N; O; P; R; S; T; U; V; W; Z; About the Author
Summary: "Engagingly written, rigorously researched, and compellingly argued, this book [is] a must-read not only for women's health advocates and scholars of reproduction, but also for those engaged in health care policy." -Susan Markens, author of  Surrogate Motherhood and The Politics of Reproduction     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.   Theresa Morris  is Professor of Sociology at Trinity College in Hartford, Connecticut. She is the mother of two children, the first born by c-section and the second by vaginal delivery.
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Cover; Contents; Acknowledgments; Introduction; Part I. The Root of the Problem; 1 The Liability Threat in Obstetrics; Part II. Control Systems Embedded in Hospitals; 2 The Tyranny of the Rules; 3 Too Much Information: How Technology Raises the Stakes; Part III. The Effects of Organizational Constraints; 4 The Big Kahuna: Repeat C-Sections; 5 Women's Lack of Choice in Labor and Birth; Conclusion: A Roadmap for Change; Methods Appendix; Notes; References; Index; A; B; C; D; E; F; G; H; I; J; K; L; M; N; O; P; R; S; T; U; V; W; Z; About the Author

"Engagingly written, rigorously researched, and compellingly argued, this book [is] a must-read not only for women's health advocates and scholars of reproduction, but also for those engaged in health care policy." -Susan Markens, author of  Surrogate Motherhood and The Politics of Reproduction     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.   Theresa Morris  is Professor of Sociology at Trinity College in Hartford, Connecticut. She is the mother of two children, the first born by c-section and the second by vaginal delivery.

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Reviews provided by Syndetics

Library Journal Review

The United States has one of the highest Cesarean section rates in the world, and it is rising. In 2011, 33 percent of all deliveries were C-sections, a growth of 50 percent over the previous decade. The procedure carries an increased risk of medical complications and maternal death, has a much higher cost than a vaginal delivery, and necessitates a longer recovery period. Morris (sociology, Trinity Coll., CT) examines the reasons for this surge. While the literature notes that physicians are practicing defensive medicine and that women are using the procedure to schedule births at convenient times, the author posits a more complex explanation. By looking at the power structures of the medical, legal, and professional organizations involved, the politics that devalue women, the organizational arrangements and protocols of hospitals, and the professional standards used in medicine and the insurance industry, she discovers a culture that avoids risk and encourages planning to avoid adverse outcomes. This results in conservative choices in the pursuit of the perfect birth. The author interviewed 130 new mothers, obstetricians, midwives, and labor and delivery nurses and reviewed local and national C-section rates to obtain the data for this study. VERDICT A useful addition to health sciences and academic library collections.-Barbara Bibel, Oakland P.L. (c) Copyright 2013. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

CHOICE Review

Morris (sociology, Trinity College, Connecticut) addresses the probing issue of why there has there been an astronomical increase in the C-section rate in the US in the last 10 years. She considers several questions, including whether it is true that most women do not want or choose a C-section and whether most maternity providers claim not to prefer C-sections over vaginal births. Examining the health care and societal environments in which births occur, Morris challenges the belief that women's preferences and physicians' inclinations cause the rise in C-sections. A meticulous review of pertinent professional literature and interviews with women and providers lead the author to assert that the answer lies in the interpretive analysis of the explanatory understanding of social action. She concludes that health care organizations are responding to their legal, political, and economic environments with fixed rules that guide the behavior of both women and providers, leading to decisions to perform and accept C-sections in at least one-third of all births in the US. Following a careful examination of the evidence, Morris provides suggested solutions to the problem in the final chapter. References are extensive and well cited. Summing Up: Recommended. Upper-division undergraduates through professionals/practitioners; general readers. M. P. Tarbox Mount Mercy University

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