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Cesarean Section - An American History of Risk, Technology, and Consequence (Paperback)
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Cesarean Section - An American History of Risk, Technology, and Consequence (Paperback)
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Why have cesarean sections become so commonplace in the United
States? Between 1965 and 1987, the cesarean section rate in the
United States rose precipitously-from 4.5 percent to 25 percent of
births. By 2009, one in three births was by cesarean, a far higher
number than the 5-10% rate that the World Health Organization
suggests is optimal. While physicians largely avoided cesareans
through the mid-twentieth century, by the early twenty-first
century, cesarean section was the most commonly performed surgery
in the country. Although the procedure can be lifesaving, how-and
why-did it become so ubiquitous? Cesarean Section is the first book
to chronicle this history. In exploring the creation of the complex
social, cultural, economic, and medical factors leading to the
surgery's increase, Jacqueline H. Wolf describes obstetricians'
reliance on assorted medical technologies that weakened the skills
they had traditionally employed to foster vaginal birth. She also
reflects on an unsettling malpractice climate-prompted in part by a
raft of dubious diagnoses-that helped to legitimize "defensive
medicine," and a health care system that ensured cesarean birth
would be more lucrative than vaginal birth. In exaggerating the
risks of vaginal birth, doctors and patients alike came to view
cesareans as normal and, increasingly, as essential. Sweeping
change in women's lives beginning in the 1970s cemented this
markedly different approach to childbirth. Wolf examines the public
health effects of a high cesarean rate and explains how the
language of reproductive choice has been used to discourage debate
about cesareans and the risks associated with the surgery. Drawing
on data from nineteenth- and early twentieth-century obstetric logs
to better represent the experience of cesarean surgery for women of
all classes and races, as well as interviews with obstetricians who
have performed cesareans and women who have given birth by
cesarean, Cesarean Section is the definitive history of the use of
this surgical procedure and its effects on women's and children's
health in the United States.
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