Older women who undergo in vitro fertilization could face a higher risk of complications, but Levine said C-sections are generally considered safe surgeries.
"I tend to discourage my patients from having an elective primary C-section,” Levine said. Quoting her father, also a surgeon, she said, "Surgery is like Christmas presents. It's better to give than to receive.”
Another problem when the first baby is delivered by elective C-section is that subsequent deliveries will be C-sections.
It is risky for a woman who has previously had a C-section to try to deliver vaginally, doctors say. The contractions of natural labor can cause a C-section scar to rupture, possibly leading to hysterectomies, blood transfusions and brain damage in the baby. The National Institutes of Health says these complications occurred in less than 1 percent of 18,000 women.
"It's difficult to find somebody who has the insurance coverage to offer vaginal delivery after a Cesarean section.” Levine said.
"Oklahoma liability insurance doesn't cover that, so I can't offer that to my patients,” Stone said. "So, you don't want to get somebody started on C-sections if they're thinking they're going to have several children.”
According to Our Bodies Ourselves, a nonprofit women's health education organization, the rising number of C-sections may be attributed less to women requesting C-sections and more to physicians' concerns about malpractice lawsuits. Lawsuits against doctors are common when a baby is born with cerebral palsy, a disease that causes various impairments. Experts say that physician errors during delivery can sometimes cause cerebral palsy, leading some doctors to opt for C-sections to cut the risk of being blamed for cerebral palsy.
"A lot of it is because of legal concerns,” Stone said. "I mean, if you see somebody that's brought a lawsuit for a bad pregnancy outcome, almost 100 percent of the time the attorney that brings the lawsuit will say, ‘If only you had done a C-section here, then this baby would be OK.' It's not true.”
C-section appeals to some women because the procedure offers more control than vaginal deliveries. And many women believe they should have the right to choose how their babies come into the world, whether they choose a vaginal delivery after a previous C-section or want to have all their children by C-section.
"Your body is designed to have a baby. If there's a reason that the baby is not going to come out that way or is trying to bypass the vagina by acting up during labor or facing the wrong way, fine, let's do a C-section,” Levine said. "There's nothing wrong with that. But just doing it because you don't want to go through labor or because it's more convenient, that's not really my policy.”
Stone said, "I really worry that we're going to tamper with Mother Nature.”