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Cesarean Section

An American History of Risk, Technology, and Consequence

Jacqueline H. Wolf

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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…

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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Cesarean Section

Jacqueline H. Wolf

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Reviews

Reviews

An outstanding and fascinating contribution to the history of medicine, women's history, and modern social history. Ambitious in its chronological scope, accessibly written, and convincingly argued, Cesarean Section offers new and original insight into the history of childbirth, as well as important broader matters, such as medical power, the technologization of hospitals, and the ethics of modern medical care.

Wolf's Cesarean Section is a compelling study of the procedure in the history of medicine. Her skillfully balanced monograph makes extensive use of a number of primary sources... This book could easily be used in a history of science and medicine course due to its accessibility.

Wolf is well-known for her meticulous and extensive research, deep understanding of medical issues, and keen analysis of critical aspects of women's reproductive history. I anticipate that Cesarean Section will be a landmark book.

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About

Book Details

Publication Date
Status
Available
Trim Size
6
x
9
Pages
336
ISBN
9781421438115
Illustration Description
17 halftones, 8 graphs
Table of Contents

Acknowledgments
Introduction
1. The Epitome of Risk
2. Still Too Risky?
3. Risk or Remedy?
4. Assessing Risk
5. Inflating Risk
6. Operating in a Culture of Risk
7. Giving Birth in a Culture of Risk
Notes
Glossa

Acknowledgments
Introduction
1. The Epitome of Risk
2. Still Too Risky?
3. Risk or Remedy?
4. Assessing Risk
5. Inflating Risk
6. Operating in a Culture of Risk
7. Giving Birth in a Culture of Risk
Notes
Glossary
Works Cited
Index

Author Bio
Featured Contributor

Jacqueline H. Wolf

Jacqueline H. Wolf is a professor of the history of medicine and chair of the Department of Social Medicine at Ohio University and author of Don't Kill Your Baby: Public Health and the Decline of Breastfeeding in the Nineteenth and Twentieth Centuries. She is also the host of Conversations from Studio B, a monthly radio show on health and medicine that airs on the NPR affiliate in southeast Ohio...