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Friday
Mar202009

ICAN Press Release: 2007 Cesarean Rate

Cesarean Rate Jumps to Record High

1 in 3 Pregnant Women Face Surgical Delivery

More Women Forced into Surgery; Few Mothers Recognize They Can Reduce Their Risk of Surgery

 

Redondo Beach, CA, March 18, 2009 – The National Center for Health Statistics has reported that the cesarean rate hit an all-time high in 2007, with a rate of 31.8 percent, up two percent from 2006.

“Every pregnant woman in the U.S. should be alarmed by this rate,” said Pam Udy, president of the International Cesarean Awareness Network (ICAN). “Half or more of cesareans are avoidable and over-using major surgery on otherwise healthy women and babies is taking a toll.”

A major driver of cesarean overuse is underuse of vaginal birth after cesarean (VBAC). The VBAC rate currently hovers around 8 percent, far lower than the Healthy People 2010 goal of 37 percent. Driving this decline is the growing practice of hospitals banning VBAC.

In February,
ICAN released the results of a new survey showing a startling increase in the number of hospitals banning VBAC. The survey showed a near triple increase (174%) from November 2004, when ICAN conducted the first count of hospitals forbidding women from having a VBAC. In 2004, banning hospitals numbered 300. The latest survey, conducted in January 2009, counted 821 hospitals formally banning VBAC and 612 with “de facto” bans (1). Full results of the research can be seen at the VBAC Policy Database. Between formal and de facto bans, women are not able to access VBAC in 50% of hospitals in the U.S.

Research has consistently shown that VBAC is a reasonably safe choice for women with a prior cesarean. According to an analysis of medical research conducted by Childbirth Connection, a well-respected, independent maternity focused non-profit, in the absence of a clear medical need, VBAC is safer for mothers in the current pregnancy, and far safer for mothers and babies in future pregnancies (2). While VBAC does carry risks associated with the possibility of uterine rupture, cesarean surgery carries life-threatening risks as well.

“The choice between VBAC and elective repeat cesareans isn’t between risk versus no risk. It’s a choice between which set of risks you want to take on,” said Udy.

Studies from the National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network, one most recently published in the February 2008 issue of the Journal of Obstetrics and Gynecology, demonstrate that repeated cesareans can actually put mothers and babies at greater clinical risk than repeated VBACs (3).


In October 2008, Childbirth Connection released a report called “Evidence-Based Maternity Care: What It Is and What It Can Achieve ,” (4) showing that the state of maternity care in the U.S. is worrisome, driven largely by a failure of care providers to heed evidence-based care practices. For most women in the U.S., care practices that have been proven to make childbirth easier and safer are underused, and interventions that may increase risks to mothers and babies are routinely overused. The authors of the report point to the “perinatal paradox” of doing more, but accomplishing less.

“All pregnant women are faced with important choices in their pregnancies. It is critical for women to understand what their choices are, and learn to spot the red flags that can lead to an unnecessary or avoidable cesarean,” said Udy.

Women who are seeking information about how to avoid a cesarean, have a VBAC, or are recovering from a cesarean can visit
ican-online.org for more information. In addition to more than 110 local chapters nationwide, the group hosts an active on-line discussion group that serves as a resource for mothers.

For women who encounter VBAC bans, ICAN has developed a guide to help them understand their rights as patients. The resource discusses the principles of informed consent and the right of every patient to refuse an unwanted medical procedure. The guide can be found
here.

 

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Original press release with boiler plates and references found here.

 

Click here to search for a local ICAN chapter.

 

 

 

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Reader Comments (4)

Thanks for posting that! I posted it on my site too. Very interesting!

March 21, 2009 | Unregistered CommenterDiana J.

Birth choices today remind me of that tear-jerker that Meryl Streep played in called "Sophie's Choice". For those who haven't seen it, the movie was about a Polish mother of two in occupied wartime Europe who was sent with her children to a concentration camp. Her choice came when she was told that one of her children would be immediately put to death and the other housed, and she would have to choose which one would live and which would die. Her choice turned against her in the end, but I won't spoil the movie.

Anyhow, the system women are encountering during birth is very much the same. We are told that if we don't do what the doctor says then our baby will die, which is not really a choice at all. Then, the doctor's decision turns out to be just as harmful and we are left with our regrets.

Sophie's children would have benefitted from either fleeing the country even though they were Polish and not Jewish, or having the allied troops intervene before she was detained. Even more profound is the fact that the N---'s were not being forced to participate in the Holocaust, they chose to.

Women today need to understand that all is not right with birth practices. We are not immune from unnecessary interventions (especially laboring and birthing on our backs), or VBAC bans, or being dropped from our insurance because of c/s; these practices cut across all demographics. We could hire private midwives if we have the money, but only if we are aware that we need to get outta Dodge. We could wait until the various arms of state mobilize and save the day, but for far too many, it will be too late. Or, profoundly, doctors could choose to follow evidence based medicine and uphold customer and parental autonomy.

March 23, 2009 | Unregistered CommenterAnon

Did you find anything in this report that mentioned what the primary c-section rate is? I know it's lower than the overall rate, but I couldn't find what it was.

Keep up the awesome work on your blog and website!!!

March 24, 2009 | Unregistered CommenterDiana J.

Thanks Diana. =) No, no breakdown of primary and elective repeat c/s in this report.

March 24, 2009 | Unregistered CommenterUnnecesarean
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