Talk:Caesarean section/Archive 1

Maimonides

"It should be noted that Maimonides, the famous rabbi, philosopher, and doctor, says that it was known in ancient Rome how to perform a c-section without killing the mother, but that the medical knowledge of his day was lacking and it was not performed."

This seems to contradict what Maimonides writes on his commentary on the Mishna in Bekhorot where he apparantly states that mothers would not survive this procedure at the time of the Tannaim. I have therefor added the {{Fact}} tag for this statement. 91.104.181.215 (talk) 02:12, 1 April 2008 (UTC)

More Trivia

I just noticed that this "In the video game Metal Gear Solid 3: Snake Eater, a main character called 'The Boss' exposes a c-section scar to Naked Snake (The player's character). The scar is possibly from a blundered procedure and runs from the abdomen to the breasts, and is in the shape of a snake." was included in an already useless section (no pun intended) of this article. The alarming incidence of Trivia found in these encyclopedia articles is beginning to concern me. I vote to remove if not the whole section, then at least the pointless reference to a video game. It is something I would have added back when I was 12. Would you appreciate me making a comment about how Sailor Moon or some cartoon character or even my aunt had a C Section? Thanks, and appreciate any comments. 22:27, 20 February 2008 (UTC) Is very much compelled at this point to register an account :P.

600 BC

Wasn't Susruta performing, or promoting, caesarean sections in India in 600 BC? Carl Kenner 17:41, 16 May 2006 (UTC)

Questions

Can I ask a question? I have a few questions on c-section delivery?

Please address them to the Reference Desk. It is not possible to respond to practical questions here if they have no direct bearing on the article content. JFW | T@lk 14:40, 19 Dec 2004 (UTC)

Julius Caesar

"The caesarean is possibly named after the Roman dictator Julius Caesar who allegedly was so delivered. Historically, this is impossible as his mother was alive after he reached adulthood, but the legend is at least as old as the 2nd century AD." How does his mother being alive make it impossible? Jamesmusik 02:39, 11 July 2005 (UTC)

Especially considering that the article later discusses an African tribe which, at least in the 19th century, performed them routinely and seemingly with some success in keep the mother alive. Wahern 01:06, 10 May 2006 (UTC)

Well, if you see how it is performed from a physicians' point of view, you will understand.Even with today's high-tech surgical techniques and equipment, a c-section is accompanied by massive blood loss (which of course can be corrected easily), risk for fetal hypoxia and respiratory failure (which can also be treated) ,risk for maternal anemia and a lot more.Nowadays these complications can be predicted and treated in the vast majority of cases (low mortality) , so the risk both for the mother and the fetus is low.

 During Caesar's time , it would be almost impossible for a mother to survive such surgery ,not to

mention the fetus.In my personal opinion this operation would have a maximum success rate of 1-5% during that time ,which is not fit for a king :)--NatK 23:01, 17 May 2006 (UTC)

The etymology and history sections are inconsistent, as the former says Caesar was unlikely to have been delivered this way, given his mother's survival (her longevity seems irrelevant), the latter that he wasn't. As a matter of evidence, nobody knows either way, so it should just be assessed as unlikely.--80.6.163.58 20:44, 24 November 2006 (UTC)

Popularity

It would be nice to see some mention of the increasing popularity of the procedure. I am not competent enough to describe the phenomenon but I am noticing more women are undergoing it...some mention of the nasty scarring would be nice too. Jeffrey King (talk · contribs).

Jeff, I completely agree. JFW | T@lk 14:53, 19 September 2005 (UTC)

We really need to mention elective caesareans. violet/riga (t) 22:44, 2 November 2005 (UTC)

References

I spotted one spot that very clearly needs a reference, I put a tag in. There's a few other authors and dates given in the text, but nothing in the references section at the end about them. --zandperl 02:45, 1 March 2006 (UTC)

The cave painting picture is obviously faked. Why is it here? Is there any other evidence that c-sections were performed in ancient Madagascar, or should that whole passage come out? Vynce (talk) 03:26, 6 February 2008 (UTC)

Yes, clearly fake as the image page even links to the original untouched photo. Removed Ciotog (talk) 03:51, 6 February 2008 (UTC)

Herpes indicating a c-section

• here. "Since most neonatal infections are acquired from contact with infected maternal genital tract secretions, potential preventative strategies include: Caesarean delivery, serologic screening of pregnant women, prophylactic acyclovir and vaccination. The two strategies currently accepted by most obstetricians are Caesarean delivery for women with active lesions or prodromal symptoms and prophylactic acyclovir for women with gestational herpes." Nandesuka 03:37, 6 May 2006 (UTC)

"Movement to perform caesaren delivery on maternal request"

http://en.wikipedia.org/w/index.php?title=Caesarean_section&curid=46924&diff=57399554&oldid=57297042

With increased safety in performing a caesarean section, there has been a movement to perform [[caesaren delivery on maternal request]].

I'm reverting this change, as it's uncited, and "An independent panel of experts assembled by NIH has determined that there is not enough quality evidence to fully evaluate the risks and benefits of caesarean delivery on maternal request (CDMR) as compared with planned vaginal delivery. More research, they said, is needed." [1]. If anyone can find a reference supporting the claim, then it should go back in, but probably also with the NIH reference for NPOV. Chovain 06:52, 8 June 2006 (UTC)

Well, I am putting the sentence back because it serves as the link to new page on caesarean delivery on maternal request where the issue is discussed and referenced. Ekem 13:57, 8 June 2006 (UTC)

Woops, sorry about that. I can't believe I didn't even follow the link :-/. Chovain 23:57, 8 June 2006 (UTC)

Lex Caesarea

Roman laws were commonly named after their enacting legislator. However, the lex Caesarea originates from a law created by Rome's 2nd king, Numa Pompilius, whereby a woman who died pregnant could not be buried until her child had been delivered. It's not clear when the law was enacted but the reign of Numa Pompilius ended with his death in 673BC.

Since the Lex Caesarea, requiring all women who died in labour to have a post-mortem delivery, was introduced in the 8th century BC, then the operation cannot originally have been named for the manner of Julius Caesar's birth many centuries later - whether or not by caesarean section. However, perhaps our spelling of the law's name may have changed. It seems very likely that the original law was named from the verb caedo, to cut, as it is recorded that the phrase a matre caesus (cut out of his mother) was used in Roman times to describe this operation. The difficulty is that the word caesareus cannot be derived simply from caesus - and therefore may relate in some way to the word Caesar. Is there definitive evidence of what the ancient Roman law was called in, say, the 4th and 5th centuries BC? Did it change after Julius Caesar's reign - perhaps because writers like Pliny the Elder, after Caesar's death, linked his name (though not the manner of JC's birth) to the operation?

Remember that we are dealing with a folk etymology. "Lex Caesarea" here probably means no more than "imperial law", i.e. Roman law generally, and this description, if ever used at all, would have been many centuries after the event. If there was really a law dating from Numa Pompilius, it would not be called after the introducer, as this practice originated in the Republic.

Pliny's story was about a remote ancestor of Julius Caesar. A later urban myth made it relate to Julius Caesar himself. I am positive that the operation got its name from the story recorded in Pliny (whether Pliny was the source or he was recording an older tradition). All the stuff about "Lex Caesarea" and about caedo is later rationalization with no historical basis. --Sir Myles na Gopaleen (the da) (talk) 12:02, 10 June 2008 (UTC)

Cochrane Claim

I removed the following: However the Cochrane review of midwife continuity of care (Hodnett 2006)found no difference in the rate of caesarean delivery in midwife care on conventional medical led care.

I searched cochrane.org and was unable to find any citation of the Hodnett study that found this. There were ten articles by Hodnett indicating that there were better outcomes from midwifery care, but not the claim cited above. Could the editor please provide a better citation for the claim please. Maustrauser 00:15, 21 December 2006 (UTC)

I agree. The citation needs to point to the actual study, or be left out. Watch out for WP:3RR though. I'll revert if it comes up again in the next few hours. Chovain 02:06, 21 December 2006 (UTC)

I've reverted the change, and placed a 3rr warning on the user's talk page. Chovain 03:22, 21 December 2006 (UTC)

I placed the Cochrane reference and note the above comments. I am a first time user and am familiarisinf myself with the rules. I am still not sure how to properly reference articles quoted. If it helps the full station is "Hodnett ED Continuity of caregivers for care during pregnancy and childbirth. Cochrane Database of Systematic Reviews 2000, Issue 1. Art. No.: CD000062. DOI: 10.1002/14651858.CD000062. I am sorry for not following your rules but do believe this is the highest level evidence available on the matter of caesarean rates and model of care —The preceding unsigned comment was added by Andrusha29 (talk • contribs) 03:28, 21 December 2006 (UTC)

Thank you for your reference. It gave me enough information to properly find it. The results made NO finding about caesarean sections so I'm not sure how you managed to write what you did. These are the findings verbatim: Two studies involving 1815 women were included. Both trials compared continuity of care by midwives with non-continuity of care by a combination of physicians and midwives. The trials were of good quality. Compared to usual care, women who had continuity of care from a team of midwives were less likely to be admitted to hospital antenatally (odds ratio 0.79, 95% confidence interval 0.64 to 0.97) and more likely to attend antenatal education programs (odds ratio 0.58, 95% confidence interval 0.41 to 0.81). They were also less likely to have drugs for pain relief during labour (odds ratio 0.53, 95% confidence interval 0.44 to 0.64) and their newborns were less likely to require resuscitation (odds ratio 0.66, 95% confidence interval 0.52 to 0.83). No differences were detected in Apgar scores, low birthweight and stillbirths or neonatal deaths. While they were less likely to have an episiotomy (odds ratio 0.75, 95% confidence interval 0.60 to 0.94), women receiving continuity of care were more likely to have either a vaginal or perineal tear (odds ratio 1.28, 95% confidence interval 1.05, 1.56). They were more likely to be pleased with their antenatal, intrapartum and postnatal care. See: http://www.cochrane.org/reviews/en/ab000062.html Maustrauser 04:03, 21 December 2006 (UTC)

If you read the article rather than the abstract which makes no comment re caesarean rates (as it only mentions findings which were significantly different between the two groups) you will find there was no difference in Caesarean delivery rates (odds ratio 0.94, 95% CI 0.69-1.28)It is on page 16 of the pdf version. —The preceding unsigned comment was added by Andrusha29 (talk • contribs) 04:36, 21 December 2006 (UTC)

I'd be more than happy to write the citation for this, but it won't be until I get home in about 2 or 3 hours (where I'll apparently have free access to the library). Is everyone happy to wait?

Btw, Andrusha: The best way to sign your posts is to place 4 tildes (~~~~), instead of typing it out.

Chovain 05:29, 21 December 2006 (UTC)

Thank you, I am gradually get Wik literate Andrusha29 10:14, 21 December 2006 (UTC)

No problem, but the sig normally goes at the end of your comment ;). We all had to learn at some point. I've updated the relevant paragraph, and included a proper citation. Nice reference by the way! I'd now like to see the previous sentence's citation fixed up. I don't have a medical background: Is there any way you could help with finding which paper "Gaskin 2003" is refering to? Cheers, Chovain 10:39, 21 December 2006 (UTC)

Gaskin is Ina May Gaskin and referes to her book Ina May's Guide to Childbirth, Batam Books, 2003 Maustrauser 11:19, 21 December 2006 (UTC)

I can't say I am particularly impressed with the Hodnett study which was undertaken in 2000 and used data from two studies done in 1989 and 1995 using a sample size of 907. A more recent citation which showed a significant difference between standard care and midwifery care with regard to caesareans was published in BJOG British journal of obstetrics and gynaecology,2001, vol. 108, no1, pp. 16-22. Its findings are:

Objective To test whether a new community-based model of continuity of care provided by midwives and obstetricians improved maternal clinical outcomes, in particular a reduced caesarean section rate. Design Randomised controlled trial. Setting A public teaching hospital in metropolitan Sydney, Australia. Sample 1089 women randomised to either the community-based model (n = 550) or standard hospital-based care (n = 539) prior to their first antenatal booking visit at an Australian metropolitan public hospital. Main outcome measures Data were collected on onset and outcomes of labour, antenatal, intrapartum and postnatal complications, antenatal admissions to hospital and neonatal mortality and morbidity. Results There was a significant difference in the caesarean section rate between the groups, 13.3% (73/550) in the community-based group and 17.8% in the control group (96/539). This difference was maintained after controlling for known contributing factors to caesarean section (OR = 0.6, 95% CI 0.4-0.9, P = 0.02). There were no other significant differences in the events during labour and birth. Eighty babies (14.5%) from the community-based group and 102 (18.9%) from the control group were admitted to the special care nursery, but this difference was not significant (OR 0.75, 95% CI 0.5-1.1, P = 0.12). Eight infants died during the perinatal period (four from each group), for an overall perinatal mortality rate of 7.3 per 1000 births. Conclusion Community-based continuity of maternity care provided by midwives and obstetricians resulted in a significantly reduced caesarean section rate. There were no other differences in clinical outcomes.

Unlike the Hodnett study, this study was set up SPECIFICALLY to test whether continuity of care was better than standard care with regard to caesarean sections. Thus I think this study should be cited rather than the older and statistically less relevant Hodnett study. Maustrauser 11:01, 21 December 2006 (UTC)

But that study compared continuity of care by obstetricians and midwives with hospital based care random staff, not midwifery care with medical led care, so it is not relevant in terms of comparitive caesarean rates between midwife care and medical care. By the way the reference for the comment you are looking for is probably a book "Ina May's Guide to Childbirth, Ina May Gaskin, Bantam Dell, A Division of Random House, Inc., New York, 2003" but I haven't read it to check whether this is certain.Andrusha29 11:14, 21 December 2006 (UTC)

Steady on, Maustrauser. The Cochrane review I cited covers 1815 women randomised to continuity of care by a midwife, or conventional medical care where women see different midwives/obstetricians each visit. The fact that there is no difference in caesarean rates between these two groups is far more telling than a study comparing continuity of care by obstetricians and midwives with non continuous care by obstetricians and midwives. IE your article verifies that continuity of care achieved a lower CS rate than non continuity of care. The Cochrane review showed that care with midwives did not result in a lower CS rate compared to conventional care. I would ask that the Hodnett reference be reinsatedAndrusha29 11:25, 21 December 2006 (UTC)

---

I've reinstated the Hadnett reference. I see no compelling reason why either one should not be listed. The article now reads as though the articles are conflicting.

The wording of each study's findings sounds like it will need improvement. I'd like to suggest that the wording be discussed here on the talk page rather than in endless edits to the article. Cheers, Chovain 18:32, 21 December 2006 (UTC).

Fair enough. The 2001 study cited by Maustrauser is a good study, prospective and randomised. But it is not testing the hypothesis that midwifery care may lead to a different rate of caesarean rate to medical care. The comparison was between continuity of care (by midwives and/or obstetricians)and no continuity of care. Wikipedia document in question is not one which seeks to show midwifery care is better or worse that medical care, it is an article on caesarean section. My reference to the Cochrane review was made because the Cochrane review only includes studies with high level evidence and is considered the most authoritative evidence base to guide decisions regarding medical care. May I suggest that the apparent conflict be addressed by the following statement. Studies have shown that continuity of care with a known carer may significantly decrease the rate of caesarean delivery (Maustrauser's ref) but that there is no high level evidence of any difference in caesarean rates when comparing midwifery care to conventional medical led care. (Cochrane reference)Andrusha29 20:30, 21 December 2006 (UTC)

Thank you Chovain for the moderation. I too am happy to discuss changes here. Firstly may I apologise for my claim about sample size. I didn't add the control and non-control groups together!

With regard to the two studies, the Hodnett study is a meta-analysis whilst the Homer study set out specifically to test whether continuity of care gave a better result than medical care (I think better termed 'fragmented care'). Neither study tested 'pure' midwifery care versus 'medical care'. The two studies (Rowley and Flint) quoted by Hodnett whilst described as 'midwifery care' also used obstetricians (as you would expect from an ethical study!) Thus I think we can say that all three studies (Rowley, Flint and Homer) all looked at the same thing - continuity of care versus fragmented care.

Hodnett found no difference in caesarean rates. Homer found statistically significant differences in rates. The Hodnett study is older and was not specifically designed to test caesarean rates, and therefore I believe it is inferior to the Homer study. Therefore I cannot agree to the words 'high level evidence' - I don't think the Rowley or Flint trials were any better than the Homer study and given that they were not designed to test caesarean rate outcomes, they shouldn't be quoted as supporting the view that both continuity of care and fragmented care gives the same caesarean outcomes.

I propose the following wording. "Studies have shown that continuity of care with a known carer may significantly decrease the rate of caesarean delivery (Maustrauser's ref) but that there is also some older research that appears to show that there is no significant difference in caesarean rates when comparing continuity of care to conventional medical-led care. (Cochrane reference).

Finally, I think we need to check out the Gaskin reference properly. Clearly this argument all started because Andrusha29 wished to provide a balancing remark to the Gaskin reference. I think we need to find out whether Gaskin was talking about continuity of care with a known carer (including obstetricians) or pure midwifery care (which I doubt). If it is the first, then I'd bet that Gaskin is quoting Homer's study! Maustrauser 23:07, 21 December 2006 (UTC)

Excellent progress. I don't have any difficulty with your suggested compromise, although if you read the Hodnett paper, you will see that"Both trials compared continuity of care by midwives with routine care by multiple physician and midwife caregivers". So it truly is a comparison between midwife continuity care with routine "fragmented care" (a description which I believe is very appropriate).

As far as the Gaskin quote, I don't think it is based on any study, but is a short summary of the author's opinion expressed in her book. If based on any published work, it would be on results in pregnancies where women have selected midwife care compared to standard care, which would be expected to skew results. I have not, however, read the book, so this is my guess only. Academically speaking, I think the Gaskin quote represents a much lower level of evidence (Level 3/4) than the cochrane data (Level 1)and would prefer that the Gaskin quote be presented as opinion rather than evidence.Andrusha29 23:49, 21 December 2006 (UTC)

Don't you ever sleep Andrusha29? Splendid, I think we nearly have agreement then. My comments about Hodnett and the Rowley and Flint studies comes from pages 5&6 where under interventions it lists the obstetric care the women in the trial group received. Flint women received midwifery care + 2 visits to obstetricians and then as needed. Rowley women received midwifery care + 3 visits to obstetricians and additional visits as needed. Thus both Flint and Rowley studies used 'shared care' (continuity) as the model they were testing versus 'standard' fragmented care.

Whilst I'm not so sure that Gaskin is using anecdotal evidence (she has a good reputation as a rigorous midwife) I agree that her comments are of a lower order of evidence. Perhaps we should remove her quote as it is clear from the three studies we have above, that we have 'primary' evidence. Any view on this Chovain? Maustrauser 00:03, 22 December 2006 (UTC)

Ok, how does this wording sound (bringing in Andrusha's terminology near the end)?

Studies have shown that continuity of care with a known carer may significantly decrease the rate of caesarean delivery^[10] but that there is also some older research that appears to show that there is no significant difference in caesarean rates when comparing midwife continuity care to conventional fragmented.^[11]

Chovain 00:07, 22 December 2006 (UTC)

I think that is a good evidence based summary and would support it, as well as removing the Gaskin citation which I agree is superceded by the direct evidence citationsAndrusha29 01:18, 22 December 2006 (UTC)

Excellent. I'll do it. Maustrauser 01:29, 22 December 2006 (UTC)

I've removed Gaskin but I'm having trouble with the references. Could I ask you to do it please Chovain? The only thing your revised quote needs is to add the word 'care' after fragmented. Thanks for your help Maustrauser 01:32, 22 December 2006 (UTC)

All done. Thanks a lot guys - it's been a pleasure working with you both. Chovain 02:42, 22 December 2006 (UTC)

Ditto. It shows how debating ideas (rather than debating people) can lead to a good result. And thanks for your timely and helpful interventions Chovain! Maustrauser 03:50, 22 December 2006 (UTC)

No problem - I'm glad I was able to help even though the details were over my head. Chovain 05:02, 22 December 2006 (UTC)

Yes I must say I am impressed with the way this wikipedia concept works. As I said before I am a first time user. Do you guys do this all the time?Andrusha29 04:44, 22 December 2006 (UTC)

I do thas a little too much of the time, I suspect :). Chovain 05:02, 22 December 2006 (UTC)

Fascinating discussion, and good work everyone! But I just tried to follow the link (to the Hodnett review) and discovered that the review has been withdrawn. Could someone that is a bit more familiar with Cochrane weigh in on what happened here? Is the article simply too old, or could there be other quality control issues involved? I couldn't find any explanation on their website.. Astraflame (talk) 01:07, 12 August 2008 (UTC)

Etymology in Japanese and Korean

The ja-Wikipedia states that 帝王切開 is a direct translation of Kaiserschnitt, which is highly likely, as the Japanese imported gobs of German medical terminology during the Meiji era, and then exported it onward to their colony (at the time), Korea. No reference given though, alas. Jpatokal 09:14, 28 May 2007 (UTC)

Ordering of sections

Why is the etymology and history stuff placed ahead of the medical information? If nobody objects, I'd like to move these sections down to just before "Caesareans in fiction". Eleland 22:09, 14 July 2007 (UTC)

Lack of citations in the history section?

I am not thoroughly knowledgeable about Wikipedia's rules on sourcing information, but a number of the facts or claims in the history section strike me as being worthy of having a source to back them up. Or is the history of the C-section (first European C-section with survival of mother, routine practice in northern Africa, etc.) considered common knowledge that requires no citation? 212.99.207.5 16:15, 7 August 2007 (UTC)

These should all have references. Any help would be greatly appreciated. Mark Chovain 20:58, 7 August 2007 (UTC)

Method

An OB told me that the modern lower uterine incision method no longer requires muscles to be cut. Is this correct? --216.19.177.73 19:05, 30 October 2007 (UTC)

Edit of history section.

Changed: Caesarian section sacrificed the mother for the sake of the child;

Into: Caesarian section usually resulted in the death of the mother;

As the alternative to performing the c-section wouldn't have been the survival of the mother (stilbirth wouldn't warrant a c-section) but the death of both mother and child thus making the c-section an attempt at salvaging life and not an act of sacrificing one over another. 85.24.87.244 03:34, 13 November 2007 (UTC)

source

BBC.co.uk: Caesareans 'may harm lung growth' I dorftrottel I talk I 14:16, December 12, 2007

Edit of VBAC section

I have added a short section to the end of this section to describe the issue of VBAC bans in the United States and the ACOG guideline change in 1999 that caused it. I have included citations with links to the official guideline, a medical study from the Annals of Family Medicine and a 2005 USA Today article that discusses the issue at some length. I believe that this addition is properly placed here in the Caesarean Section article because it relates both to VBACs and a reason why some women feel pressured into having repeat c-sections.Jeanne9000 (talk) 06:16, 9 February 2008 (UTC)

Globalization tag

I have removed the globalization tag because it is unexplained. If you think that it's deserved, then please explain your concerns in detail right here on the talk page. This will help other editors figure out how to address your concerns. Thanks, WhatamIdoing (talk) 20:18, 4 March 2008 (UTC)

video talks about cesarian and jesus

http://video.google.com/videoplay?docid=4675077383139148549 go to 1 hour 36 minutes. —Preceding unsigned comment added by 76.94.193.157 (talk) 04:25, 24 May 2008 (UTC)

Cosmetic issues

Aside from a reference to the scar being below the bikini line, not much is mentioned regarding residual cosmetic effects of a C-section. Since Angelina Jolie is arguably the most notable individual in awhile to have undergone the procedure, the question might be asked as to whether the scar from a C-section can be erased via cosmetic surgery. I wonder if it's worth adding a section on this aspect, which might also be relevant to the discussion over elective C-sections. 68.146.41.232 (talk) 03:51, 14 July 2008 (UTC)

Multiple Births

Can anyone expand on why a c-section for multiple births is controversial? Either an explanation or a reference would be good imo. Chovain 07:38, 31 May 2006 (UTC)

When the "Twin Trial" finishes you will have an answer.

I'd guess each baby is smaller than in the average single birth, so vaginal delivery should be easier?--Shtove 20:51, 24 November 2006 (UTC)

Because doctors are not being properly trained in how do deliver multiples. When a woman finds out she's pregnant with multiples, many times doctors will just schedule a c section rather than allow the woman to birth on her own. —Preceding unsigned comment added by 98.229.77.158 (talk) 18:29, 15 December 2008 (UTC)

Improving technique

Did surgical techniques prior to the 19thC gradually improve the survivability of the operation, or was it only the listed stuff (uterus suturing etc) that made the difference? In other words, was a mother more likely to survive the operation in the 16/17/18thCC than her Roman counterpart?--Shtove 20:49, 24 November 2006 (UTC)

It was a combination of the two which lead to a higher survival rate. So, yes a mother was more likely to survive the operation as time pregressed than her roman counter part. But if I remember my history correctly, the proceedure was only used on a mother who was already dead or near death in order to save the child. —Preceding unsigned comment added by 206.53.144.29 (talk) 11:43, 15 December 2008 (UTC)

Removed POV claims

I removed the following from the end of "Elective caesarean sections" because it seems to endorse specific conclusions on a controversial subject. -- Beland (talk) 18:47, 15 January 2009 (UTC)

This absolves women of the idea that they are the sole reason for the rise of caesareans in this country. However, their reputation precedes them despite extensive literature showing that women are not asking for caesareans without medical necessity.

Elective caesarean section

I have deleted part of this section. It stated that doctors are actually putting themselves "more at risk" of a malpractice lawsuit because "as the rates of ceasareans rise, so do the number of medical malpractice suits." The article that this references to states that it cannot conclude that a greater rate of ceaseareans causes a greater rate of malpractice suits.

I have also deleted the statement that "failure to perform a Caesarean section has been a central point in numerous lawsuits against obstetricians over incidents of cerebral palsy"", as this has been unsourced for over two years. Chewy m (talk) 13:10, 9 March 2009 (UTC)

Indications

An Indication Section is missing. I will work on this soon. If anyone else works on it, be sure to include incidence rates of each indication. From my head: Repeat C/S 35%, Failure to Progress 30%. BabyCatcher (talk) 04:52, 18 July 2009 (UTC)

Elective caesarean sections

The section headed "Elective caesarean sections", despite linking to the correct page which defines the term correctly, is not really about elective caesarean sections, and instead is more describing caesareans on non-medical grounds. The section ideally needs re-labelling, with the link to the elective sections article preserving separately. Elder pegasus (talk) 10:20, 27 September 2009 (UTC)

Have tagged the section as possibly belonging on the Elective caesarean section page itself; however it would need editing somewhat to fit into that article, and some sort of stub summary of Elective caesareans is still needed. Elder pegasus (talk) 17:45, 25 October 2009 (UTC)

Human specific

This article is very human specific. I assume C-sections are performed on other animals? --Paul (talk) 20:58, 3 November 2009 (UTC)

"Truth About Caesaren Sections"

A c-section is very dangeros if you are a smoker and the statistics are from 2000 and need to be updated. Women who have a c-section have complcations up to 50% of the time. The hospital has the risks in the discharge papers that most people don't have time to read. If a c-section is done while a woman is in labor then it reduces the risk by 82% and 88% if done before labor ever begins. In November 2009 the death rate had a wide range that varied from hospital to hospital. The rate ranged from 18%-62%. The mortality rate of c-section births was 1.77 out of 1000 and the mortality rate of vaginal births was .62 out of 1000. The c-section rate is higher in the U.S. than any other place in the world. A c-section has a better chance of saving your child than hurting/killing them. Most doctors try to let everyone have a vaginal birth, but if the situation gets to bad or you have had too many complications during your pregnency then they will do what ever they can to save the baby. Women who have a caesaren section rarely have noticable scars from it and it is normally hidden by their pant line. If a women has haemophilia then they are at a higher risk of having complications then normal women.

Fatherofnew01 20:04, 4 February 2010 (UTC)

Risk

Unless you understand what your talking about you're better saying nothing.

I agree with this. My wife delivered by c section after labouring for 17 hours and not progressing past a 6 for dialation. Once she began to run a fever the risks of a vaginal delivery outweighed those of the c section for her and my daughter. Fortunatelt both came through just fine and neither experienced any complications. It is extraordinary that this entry only talks about risk, and not bentfits to the mother or infant. There is a lack of studies, particularly on infant/childhood comparitive outcomes and benefits. Still, to omit benefit shows a bias against an important and useful medical procedure. 198.212.228.1 (talk) 13:11, 9 April 2010 (UTC)

Some Caesarean Section errors

I have changed Complication to Indication. Complication means "a secondary disease originating from the primary disease". C-section is not a disease but a medical procedure, moreover, the contents under Complication are not complications, but reasons for a C-section, thus, the proper term should be indication.

I have also fixed the cite error link that causes the reference section to screw up. And finally I added an education video that should give medical practitioners, particularly the students, to give them an idea of what a c-section is all about. The video was taken from Layyous' (Dr. Najeeb Layyous) site - an expert c-section surgeon, and is featured on a HON code certified site.

Ursa Gamma 15:42, 21 February 2010 (UTC)

The video link is inappropriate. I have removed per WP:EL Cubathy (talk) 12:27, 26 February 2010 (UTC)

Incidence

The article says: "The World Health Organization estimates the rate of Caesarean sections at between 10% and 15% of all births in developed countries. In 2004, the Caesarean rate was about 20% in the United Kingdom, while the Canadian rate was 22.5% in 2001-2002.[28]"

Footnote 28 only mentions the Canadian rate, I believe the WHO statistic may be a gross error because WHO has an official recommendation that a rate of 10-15% may be beneficial, but believes as rates exceed that negative outcomes increase for mother and child. (see: World Health Organization. Appropriate technology for birth. Lancet 1985; 2: 436-7). I went to the WHO site and tried to find an overall rate for "developed countries" and was not able to, but everything I saw seemed to indicate rates MUCH higher than 10-15% for developed countries. —Preceding unsigned comment added by 75.1.68.30 (talk) 00:51, 30 July 2010 (UTC)

Removed section on financial cost

I removed the section on the financial cost of Cesarian sections. First off, it contained all kinds of POV words describing the high expense of the procedure. There's nothing wrong with noting that C-sections are often expensive, but one must do so without using histrionic phrasing. Second, the section lacked consistency all together. It described the cost of a C-section in Massachusetts and also in the U.S. as a whole. I can only assume that the latter figure was an average cost across the nation; it wasn't specified. If we're going to pick and choose locations, we need to be sure we have chosen an appropriately diverse group of places. But even that is problematic, as we can never name every place. Third, as we all know, costs not only differ only by location, but they also vary over time. For that reason, a section on the financial cost should not include actual numerical amounts. That type of information is too easily dated. Because these problems were so pervasive in this section, I removed in entirely. If someone wants to rewrite it, by all means, do so. But it should be substantially different from the old one and sensitive to these issues. —Preceding unsigned comment added by Ask123 (talk • contribs) 22:54, 21 February 2009 (UTC)

"section"?

Why is it called a Caesarean "section"? I'm not asking about the word Caesarean. I want to know why it's a "section". The Etymology section should explain this. I'd edit it, if I knew the answer. Neutron Jack (talk) 02:20, 15 October 2010 (UTC)

According to http://www.nlm.nih.gov/exhibition/cesarean/part1.html :

Until the sixteenth and seventeenth centuries the procedure was known as cesarean operation. This began to change following the publication in 1598 of Jacques Guillimeau's book on midwifery in which he introduced the term "section." Increasingly thereafter "section" replaced "operation."

Ciotog (talk) 20:37, 27 November 2010 (UTC)

AmE spelling

Is there any data on why Caesar doesn't become Cesar, yet Caesarian becomes Cesarian? Grassynoel (talk) 16:43, 22 April 2010 (UTC)

Caesarean derivation

There seems to be some confusion about the possibility that "Caesarean section" could be derived from the name Caesar. If Caesarean section is indeed derived from Caesar, that doesn't have to mean that Caesar was born via Caesarean section - it could have been a mistake (people might have simply rumoured that he was born this way), or it could be that a policy regarding the procedure was implemented during Caesar's rule, so it became known as Caesarean. At any rate anyone who says that Caesarean cannot have been derived from the name Caesar is applying original research.Ciotog (talk) 20:34, 27 November 2010 (UTC)

Here are a few sources that might be used:

http://stason.org/TULARC/languages/english-usage/83-Caesarean-section-Word-origins-alt-usage-english.html

http://www.bbc.co.uk/dna/h2g2/A974333

http://www2.merriam-webster.com/cgi-bin/mwmedsamp?book=Medical&va=Caesar

Ciotog (talk) 21:21, 27 November 2010 (UTC)

The claim is not made that the name does not derive from Caesar. The claim is made that the name does not derive from Caesar's birth - which even your own source says was not caesarian because in ancient times that was only done to dead or dying mothers. Nor is the lex caesarea attributed to Julius Caesar. Here is a definitive description:

"Lex Caesarea (caedere = to cut), promulgated in 715 BC, declared that in the event of maternal death during pregnancy, the unborn child should be removed through an abdominal incision in the hope that it might be viable. That is how cesarean section got its name."

μηδείς (talk) 21:41, 27 November 2010 (UTC)

I am neither a Latin authority nor a doctor but I have not forgotten my high school Latin teacher explaining that the word Cesarean has nothing to do with Julius Caesar but in fact is a derivative of the Latin word for "cut". When spelled correctly, there is no connection with Caesar. Other things attributed to the Roman Emperor are usually called Julian, except for Caesar salad, which probably got its name for some other irrelevant reason. [User:Dennis 17 April 2011] — Preceding unsigned comment added by Dburnham (talk • contribs) 01:37, 28 April 2011 (UTC)

Most of the reputable sources I've come across are careful to say that it's "unlikely" Julius Caesar was born via Caesarean - not impossible.

Could you provide the source for the definitive description? Unless they have a time machine, I really don't think any source can be described as definitive. At any rate this is alluded to in the last sentence of the first paragraph of the etimology section - it could certainly have been worded better. Ciotog (talk) 23:16, 27 November 2010 (UTC)

The etymology section is looking somewhat better, although maybe the wording is a little muddled. I still find it hard to accept the phrase "they invariably resulted in the mother's death", since I haven't found a single source that said the rate was known to be 100% - in fact most of the sources referenced in this section seem to go out of their way to say it was highly improbable. To pick a single source that might suggest it was absolutely 100% is putting undue weight on that source.

Since many highly credible sources provide a number of possible etymological origins for the term, then it is this encyclopedia's duty to provide all these possibilities as they're mentioned and without bias. You yourself may be completely certain about one or another of the theories, but that isn't how encyclopedias work. Ciotog (talk) 02:37, 29 November 2010 (UTC)

There is no classical record of a woman surviving a Caesarean. The Oxford Classical Dictionary says "could not survive the trauma" (see the footnote in the article) and the NIH source says there is no report of a woman surviving a c section before 1500. μηδείς (talk) 03:17, 29 November 2010 (UTC)

That there is no classical record doesn't mean it didn't happen - only that it wasn't known that it happened. That's why credible sources don't say things in absolute terms. Ciotog (talk) 04:32, 29 November 2010 (UTC)

Please read the sources. Oxford says could not survive.

The unreferenced NIH brochure is not a definitive source of what is not known. If you want to say "according to an NIH brochure" the truth is not known, that is fine. I am reverting to remove the unprovable "no one knows" claim as weasel worded and as a very stron POV in itself, not in opposition to listing the other theories, since they have been held. There is no problem saying that there are certain theories and providing them. Just try listing them without the editorializing. To say that no one knows is to chose skepticism as the default POV. Simply listing the alternatives does not have that same fault.μηδείς (talk) 04:45, 29 November 2010 (UTC)

Did you read my last edit? I removed the word invariably to which you objected.μηδείς (talk) 04:47, 29 November 2010 (UTC)

Sorry, I don't see that edit. At any rate, I'm not objecting to the idea that no mother ever survived a c-section prior to 1500 or so, which is likely true, just to the idea that it's a proven fact - which it can't possibly be. Quoting one source that says that says "definitely could not survive" but ignoring all those that say "most likely could not survive" is choosing a particular POV over the others. It's not weasly to say "no-one really knows for sure" when that's the case, even when one person claims to know. If anything you could say "the Oxford dictionary claims..." but that's about it. Ciotog (talk)

You're right, the edit seems not to have taken, I am redoing it and will add in a comment on caedo and caesones.μηδείς (talk) 05:31, 29 November 2010 (UTC)

císařský řez

Císařský řez is a Czech term of meaning "imperial cut" (like in Polish) not South Slavic. I am not sure how to correct it but it is wrong. Zeppa2 (talk) 19:08, 12 March 2011 (UTC) Finally tried a way, hope it is better so. 19:31, 12 March 2011 (UTC) — Preceding unsigned comment added by Zeppa2 (talk • contribs)

WP:MEDRS and the Pai article

A number of surprising medical claims in this article were sourced to an unlikely source: "Pai, Madhukar (2000). "Medical Interventions: Caesarean Sections as a Case Study". Economic and Political Weekly 35 (31): 2755–61. This is not a biomedical journal, is not a peer-reviewed source at all. and is a poor source when used to support medical claims. I have cleaned up most usages of this source in the article, although I left a few that dealt primarily with incidence and frequency of c-sections. Nandesuka (talk) 04:25, 23 June 2011 (UTC)

File:Caesarean section of dog.JPG Nominated for speedy Deletion

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In government hospitals; History of C-section in Norway

Here is a link in Norwegian about Caesarean section at Government hospitals (in Norway).

(... and those who want C-section, mainly they have understandable arguments) og de som ønsker keisersnitt har stort sett forståelige argumenter

If there are any questions about C-section in Norway, that might influence text in this article, then I would like to hear them — so that I can google for references in Norwegian.

At "Norwegian Government hospitals" C-sections are also available for nearly "anyone who has a fear of giving birth". I do not have any references if a Doctor's Certificate (legeattest) is mandatory, regarding "recipients" for "such C-sections".--85.165.229.54 (talk) 10:23, 5 December 2011 (UTC)

In Norway

If someone has notable text or notable links for an article about Caesarean section in Norway, then please let me know.--85.165.229.54 (talk) 10:23, 5 December 2011 (UTC)

Picture

i would like to request to use another image for the Caesarean section. With all the feelings persons link with giving birth to a child, i find that this picture creates a false association, i dont know if its about the light, the lifting up of the newborne showing in the light or the place where there picture has been taken itself, but i know that for example http://newbornbaby.com.au/files/2010/03/c-section-300x205.jpg this picture would be a better presentation of the Caesarean section within an Encyclopedia. Thank you. — Preceding unsigned comment added by 188.101.24.56 (talk) 05:25, 7 January 2012 (UTC)

Not necessarily in answer to the above, but would this picture be a good addition to article, or replacement for either of the current pictures, I note some of them it's a bit harder to see what's going on because of the angle, distance, etc, link 09:13, 8 May 2012 (UTC)

Why is Wikipedia pushing the misogynist notion that a woman with pubic hair is unnatural? Absence of pubic hair in the markup of vertical and horizontal incisions actually decreases context. — Preceding unsigned comment added by 99.34.42.210 (talk) 01:26, 23 June 2012 (UTC)

Etymology

It's highly likely the Caesarean section was named after Roman Emperor Gaius Julius Caesar Augustus Germanicus "Caligula" and over time it has been confused with Julius Caesar.

Caligula forced his favourite sister Julia Drusilla to live with him as his wife. Following the practice of the Egyptian pharoahs, it was said that when Drusilla became pregnant, Caligula couldn't wait for the birth of their god-like child and disemboweled her to pluck the unborn baby from her womb.

Cutting a baby from the womb as described above is exactly what a Caesarean section is.

122.148.82.40 (talk) 09:52, 31 May 2012 (UTC)

Inconsistent spelling

This article uses four different spellings: Caesarean, caesarean, Cesarian, cesarian. I have no position on which one of these is preferable. But we should certainly be consistent and use a single spelling throughout. Does anyone have a preference? Omc (talk) 22:25, 11 August 2012 (UTC)

King Robert 2nd of Scotland

This article claims Robert the Second of Scotland was delivered by C-Section where is the reference and proof? Also the inspiration for Shakespeare's Macbeth? Sounds flimsy. Robert's mother Marjorie Bruce was 19 and late in her pregnancy when she had a severe fall from a horse and went into premature labour. Her Wiki entry does not say the child was delivered by CS. Marjorie died some hours after the child was delivered. If someone can proove it was a CS, or quote a contemporary source then fair enough but if not then the claim is conjecture or myth and not fact. C Sections in the early 13th century were only performed if the mother actually died in attempting to give birth and there was deemed a chance to save the child. — Preceding unsigned comment added by 92.26.104.178 (talk) 23:13, 4 March 2013 (UTC)

Murdoch Cameron

Surely the pioneering Murdoch deserves a mention. He performed the first successful C-Section under modern antiseptic conditions at Rottenrow, Glasgow in 1888. — Preceding unsigned comment added by 92.26.104.178 (talk) 21:52, 4 March 2013 (UTC)

the controversy over caesarean sections

Why is this not included? it's been 10 years since Naomi Wolf's book Misconceptions and I'm sure there are ample other books and articles covering the over use of the procedure. This only misleads women who may be searching for all the facts, not just the history and medical establishments versions of it.174.49.236.221 (talk) 19:12, 18 May 2013 (UTC)

Dubious

While searching for "citation needed" tags in medicine-related articles, I encountered this article which contains a dubious tag. I searched Google Books for something to support and found this which supports the "Lex Caesarea" origin but it never mentions if it was used after "Lex Regia". To satisfy my curiosity, I searched if the following reference (Caesarean section?: etymology and early history) mentioned this but it did not. I hope we can resolve this issue, SwisterTwister talk 05:13, 12 November 2012 (UTC)

What edit or passage are you talking about? 159.1.15.34 (talk) 17:36, 27 November 2012 (UTC)

What do you propose as an action? --Nouniquenames 22:59, 4 December 2012 (UTC)

I started this thread because (1) I wanted to resolve the "dubious" issue and (2) I want to know if the source I provided would be somewhat sufficient and if other users could find better sources. SwisterTwister talk 04:44, 5 December 2012 (UTC)

Since you established the term, you could use that cite to provide reference, and then change the phrase to be:

"The Roman Lex Regia (royal law) and Lex Caesarea (imperial law), of Numa Pompilius..."

Tiggerjay (talk) 23:13, 6 December 2012 (UTC)

Actually, I found evidence that Lex Regia was used before Lex Caesarea here and here and other useful references here and here. Additionally, I initially believed the article's Pieter W. J. van Dongen reference supported this but I couldn't find a link but now I have found the original link. Sorry, I should've extended my search and found these useful links. SwisterTwister talk 07:25, 7 December 2012 (UTC)

Excellent, great work! Thanks for the research and closing the RFC. Tiggerjay (talk) 17:11, 7 December 2012 (UTC)

I think if you look at the page on Julius Caesar this is clarified, but it's not simple. Firstly, you have to understand Roman names. Julius Caesar's first name was Gaius. "Julius" is the family name. Caesar is a sort of nickname, used by a branch of the Julius family. One theory (from Pliny the Elder) is that the nickname came from an ancestor, the original Julius Caesar, who was cut from the womb, deriving the name from some variant of the Latin word for cut (you can see the similarity to the English word, "incisor"). This is just a theory, but it is the origin of the myth that Gaius Julius Caesar was delivered by Caesarean section, which is a much simpler version, but apparently totally wrong.--Jack Upland (talk) 20:19, 22 June 2013 (UTC)

Risks for the child?

Why does this section list risks for the child at 41 weeks and so on when a typical 9-month prengancy is 36 weeks, not 40 weeks? Whoever wrote this seems to think that a typical pregnancy lasts 10 months and not 9. Can someone more knowledgeable than me check into this? I'm positive I'm right, I did the math, but I'm not a doctor. 24.63.232.35 (talk) 02:24, 16 July 2013 (UTC)

To answer your questions about pregnancy duration, see Pregnancy > Duration. Quercus solaris (talk) 02:02, 17 July 2013 (UTC)

Misspellings

Throughout this post and the one on EXIT procedures, cesarean section is misspelled. The origin of the word cesarean comes from the Latin word cadere, which means to cut. Some people mistakenly believe it comes from Julius Caesar (this spelling it Caesarean, with a capital C) because in Shakespeare's play, "Julius Caesar," he refers to him being from his mother's womb, untimely ripped. But if Julius Caesar's mother had given birth in what we commonly refer to as a cesarean section (small C), in that time in history, she most certainly would have died, medical care being what it was, and we know that Caesar's mother lived for many years after. — Preceding unsigned comment added by 173.8.25.62 (talk • contribs)

Do you have sourced to back this up? The sources in the article certainly spell it caesarean. - Aoidh (talk) 16:35, 26 January 2014 (UTC)

Good-faith effort, 173.8.25.62, and your desire to apply critical thinking is commendable. Nonetheless, your analysis isn't complete, as explicated below. It's not true that the ae digraph is a misspelling (see American and British English spelling differences, especially the section on ae and oe). Regarding the cap-vs-lowercase distinction, both have considerable currency (see eponym > orthographic conventions). Regarding the etymology, the truth is that the caedere ("to cut") and Julius Caesar ideas are both relevant, simply because even if the Julius Caesar idea is a false etymology, it has been very widely believed (a factor that influences what achieves normative status in natural language). If you look at the Merriam-Webster Collegiate entries for cesarean and cesarean section, you see all of these points touched on (note where these entries say "often capitalized", "Variants of", and "from the legendary association"). Because of (1) the e-vs-ae digraph variation, (2) the related ae-vs-æ typographic ligature variation, (3) the cap-vs-lowercase variation, and (4) the -ean-vs--ian suffix variation, these factors cross-multiplied in a table cause this word to be one of the very few words in present-day English orthography to have many different normative spellings or orthographic stylings—from 4 to 12, depending on how you agree to define "spelling". If you don't want to call the cap-vs-lowercase difference a "spelling difference" (saying, "it's the 'same' letter"), and if you don't want to call the ae-vs-æ typographic ligature difference a "spelling difference" (saying, "it's the 'same' digraph"), then there are 4 different normative spellings. But there are 12 different normative orthographic stylings from the point of view of character encoding—12 different character strings that are all accepted as normative orthographic representations of this one word. And that, my friends, is the kind of undesigned complexity that drives some people to become passionate about spelling reform, which some national languages, including Spanish and German although not English, have undergone at the level of national language academies looking to standardize on a standard language. Here's the table:

Multiplication table

×	C + e	c + e	C + ae	c + ae	C + æ	c + æ
ean	Cesarean	cesarean	Caesarean	caesarean	Cæsarean	cæsarean
ian	Cesarian	cesarian	Caesarian	caesarian	Cæsarian	cæsarian

Quercus solaris (talk) 18:40, 26 January 2014 (UTC)

"See Also" abortion? and no childbirth?

I have a problem with the "See also" section. First, I don't see how it's appropriate to direct a person to the abortion page for more information, from a page about a procedure used primarily for live delivery either on account of some election or due to complication. Second and connected, there is no link directing the reader to the childbirth page. Childbirth and even pregnancy are far more appropriate than abortion, since C-sections are an option in childbirth, often related to complications or issues in pregnancy. The only connection I see between caesarean sections and abortion is that one rare form of late-term abortion uses similar procedures; this warrants the hysterotomy abortion page having a link to the C-section page, but it does not seem to warrant the C-section page having a link to general abortion. — Preceding unsigned comment added by 76.30.50.240 (talk) 16:59, 27 February 2014 (UTC)

Move of content from here to elective caesarean section

I just moved most of the content from the "elective" section to the "elective caesarean section" article. I did this because content was being forked, as the section here and that article were be developed independently. I would propose that as a good start, the lede of that article could be placed here along with a link to that article, so that the basic information on the topic is here but people go to that article as the single source of most information on the subject. Blue Rasberry (talk) 19:28, 19 May 2014 (UTC)

Which text in the ref supports:

1. "An often overlooked aspect of maternal health is the psychological risks and benefits that a Cesarean birth can have (depending on whether it's an emergency or planned C-section). "
2. "On the other hand, a planned Cesarean by definition avoids the possibility of the more traumatic difficult vaginal birth (especially agressive obstetric interventions, such as forceps birth"

Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:26, 25 May 2014 (UTC)

Unsure the meaning of

"but the risks are different (see below)" thus removed [2] Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:39, 19 August 2014 (UTC)

Lots of Improvement Needed and Ref Question

After I finish the comprehensive exam portion of my dissertation (which is on cesarean section), I am going to commit to fixing this page. It is not well organized, written, or sourced in a number of parts. No offense to whoever wrote this, but it is not based on the current, most robust literature out there.

I had a question regarding this comment - "One surgeon's opinion[who?] is that there is no consistency in this ideal rate, and artificial declarations of an ideal rate should be discouraged."

I'm pretty sure this is the citation that the sentence refers to: Cyr, R. M. (2006). Myth of the ideal cesarean section rate: commentary and historic perspective. American journal of obstetrics and gynecology, 194(4), 932-936.

If this is the citation that this individual refers to, I suggest that the sentence be reworded. Firstly, Dr. Cyr is an Obstetrician (who performs cesarean section surgery, but is not a surgeon by trade). Secondly, Dr. Cyr does not comment that there is no consistency in the ideal rate, but that it is inappropriate to adhere strict evidence-based guidelines in an artificial study environment to the practice of obstetrics, which relies most on spur-of-the-moment decisions that protect the health of the mother and fetus. Thirdly, Dr. Cyr mentions that the focus should instead be on how to motivate policy (to limit the environment of liability that physicians incur that encourage the performance of C-section with any potential inkling of harm to the mother or more likely, fetus) to encourage obstetricians to make the most appropriate clinical decision for each patient. Whoever is actually summarizing these articles needs to be very careful in how they depict them - there are a lot of inaccuracies or overgeneralizations in this article that need fixing at some point. WiiAlbanyGirl (talk) 10:48, 31 August 2014 (UTC)

"Misgav Ladach" section is terrible. It appears to fulfill some specific agenda rather than describe normal practice in obstetrics. It may not be relevant to this article at all, but if it is, it definitely needs to be rewritten. — Preceding unsigned comment added by 76.181.79.144 (talk) 05:07, 12 September 2014 (UTC)

Moved section from planned c-section

I just moved content from the Elective caesarean section article to here. It is unsourced, but includes some information not covered here. It was inappropriate for that article because this content is about general risks of a c-section, and not risks specific to planned ones. Blue Rasberry (talk) 20:56, 16 September 2014 (UTC)

Technique and classification

I just rearranged the technique section based on a system presented in this source.

• Althabe, Fernando; Torloni, Maria Regina; Betran, Ana Pilar; Souza, Joao Paulo; Widmer, Mariana; Allen, Tomas; Gulmezoglu, Metin; Merialdi, Mario (2011). "Classifications for Cesarean Section: A Systematic Review". PLoS ONE. 6 (1): e14566. doi:10.1371/journal.pone.0014566. ISSN 1932-6203.{{cite journal}}: CS1 maint: unflagged free DOI (link)

While this source is good for suggesting section headings, the content I placed into those sections does not match the information presented in this source. This article says that people have tried to classify caesareans in three different ways - by urgency, women characteristics, and surgical technique. After learning that, I rearranged the article's content by how I thought it fit with those classifications, and I put it under these headings. It is my opinion that the article's content fit nicely into this system, but whereas the original author intended this system for formal scholarly defined systems, I am applying this system to content which is not part of a systematic classification system but which seemed to fit these headings.

I think this works well enough, but I thought I would comment on what I have done to see if others have opinions on how this looks. The previous strategy for presenting this article content was not talking about classification much at all, or rather, grouping all classification systems together without acknowledging them. Before I moved things around, things like scheduled surgery were contrasted with certain types of incisions, when in fact, in this system I cited a surgery could be classified as "planned" "for twins" and "with a conventional incision" simultaneously. I think this is better but I do feel out of my domain in moving so much around so boldly. Blue Rasberry (talk) 16:11, 18 September 2014 (UTC)

Summary of technique

There seem to be multiple techniques for performing this surgery. No single technique is described well in this article right now. I found a source which purports to summarize the basics of the procedure.

• Dahlke, Joshua D.; Mendez-Figueroa, Hector; Rouse, Dwight J.; Berghella, Vincenzo; Baxter, Jason K.; Chauhan, Suneet P. (2013). "Evidence-based surgery for cesarean delivery: an updated systematic review". American Journal of Obstetrics and Gynecology. 209 (4): 294–306. doi:10.1016/j.ajog.2013.02.043. ISSN 0002-9378.

I tried to integrate the summary from that source into the article, but I do not understand what I was reading so I have limited faith in what I wrote. If anyone could write this in more plain English then that would be helpful. Blue Rasberry (talk) 19:41, 19 September 2014 (UTC)

Dates

It would be nice to see a date on the statistics here. — Preceding unsigned comment added by 151.200.39.113 (talk • contribs) 16:08, 29 July 2004‎

Distribution of overuse

In the lede I wrote

In many countries, caesarean section procedures are used more frequently than is necessary, and consequently governments and health organizations promote programs to reduce the use of caesarean section in favor of using vaginal delivery. The countries which report overuse of this procedure are not finding ways to decrease use of the procedure as much as they would like.

This is supposed to be a summary of Caesarean_section#Society_and_culture. Overuse is reported in the United States, the United Kingdom, China, and some other places, and also it is reported that curbing overuse is difficult. The problem with my statement is that even though all these places are reporting something similar, it is original research for me to say that the problem in all these places is comparable. I think it is, but I have no single source which says "all the global overuse of c sections are comparable in some way". I wish I could cite a source in the lede, but nothing is quite appropriate. I put this general statement in because previously some specific numbers about specific countries were in the lede, and I felt those statements were not a summary of the article's content. Blue Rasberry (talk) 21:32, 19 September 2014 (UTC)

Correlation of certain diseases to c sections

This article fails to mention the correlation between C-section births and various diseases, such as asthma, type 1 diabetes, celiac disease, and allergies. For example, a quick search brought up a number of studies that have done.

http://www.medicalnewstoday.com/articles/256915.php
http://www.defeatdiabetes.org/c-section-delivery-increases-risk-type-1-diabetes/
http://www.medicalnewstoday.com/articles/273321.php
http://www.celiaccentral.org/research-news/Celiac-Disease-Research/134/month--201005/vobid--2645/
http://www.everydayhealth.com/digestive-health/c-sections-put-infants-at-higher-risk-of-diabetes-asthma-1466.aspx

I think it is important to mention these risk factors to the child. I'm not familiar enough with this literature to write anything authoritative - I'm not sure how strong the evidence is for these correlations, but perhaps someone who is could write something. — Preceding unsigned comment added by 192.0.149.100 (talk) 17:26, 20 October 2014 (UTC)

We need better sources than these. Please read WP:MEDRS Best Doc James (talk · contribs · email) 00:14, 3 November 2014 (UTC)

Reference here [3] . And a lot of others studies exist Christian75 (talk) 08:03, 3 December 2014 (UTC)

Move: Vaginal birth after caesarean → Delivery after previous Caesarean section

I made this request at Talk:Vaginal birth after caesarean#Requested move. It would give us a common fork for both the sections Caesarean section#Subsequent pregnancies and Caesarean section#After previous Caesarean, availing for clearing up a lot of duplicates. Mikael Häggström (talk) 16:11, 1 December 2014 (UTC)

I performed the move now. Mikael Häggström (talk) 19:50, 3 December 2014 (UTC)

Can anyone add data about Cesarean on animals?

Seems to be routine enough, judging from Google.

Yes you may Doc James (talk · contribs · email) 23:23, 16 February 2015 (UTC)

Passage from Maimonides (in Society and Culture)

I reversed the position of Maimonides, since the original author had apparently not checked what he had to say. Rather than providing the first historical reference to a woman surviving a C-section, he explicitly states that such survival strikes him as abundantly strange. I don't have an online source for it, but this is the full quote: מה שאפשר להיות בזה שתהא האשה מעוברת משני וולדות ונקרע דופנה ויצא א׳ מהן ואח״כ יצא השני כדרך העולם ומתה אחר שיצא השני אבל מה שאומרים המגידים שהאשה חיה אחר שקורעים דופנה ומתעברת ויולדת איני יודע לו טעם והוא ענין זר מאד... The Mishna on which the Rambam is commenting concerns a child cut out of the side of his mother and a second child born to her afterwards. It's a hypothetical scenario and need have no basis in the reality of the time in which it was written (early 3rd century). The Rambam's comment, in my translation, is as follows: "What is possible in this scenario is that a woman is pregnant with twins, that her side is cut open and the first is removed, that the second child comes out in the usual fashion, and that she dies after the second child has come out. That which people say, that a woman might survive having her side cut open, get pregnant again and have another child, is something I cannot understand. It is exceedingly strange." Aniboker (talk) 22:18, 22 June 2015 (UTC)— Preceding unsigned comment added by 124.170.233.10 (talk) 22:14, 22 June 2015 (UTC)

cesarean delivery, cesarean section

From the AMA manual of style: cesarean delivery, cesarean section: According to the American College of Obstetricians and Gynecologists, the preferred terms are cesarean delivery (or cesarean birth) or abdominal delivery (to differentiate it from vaginal delivery). Cesarean section is incorrect, as are the spellings Caesarean and caesarean. juanTamad 06:40, 13 July 2015 (UTC)

We use spelling from different parts of the world. The current is the British spelling. Thus it is correct their. Doc James (talk · contribs · email) 19:58, 13 July 2015 (UTC)

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