Women's Health Care Professionals Issue Warning About Cesarean Section on
Demand
WASHINGTON, Nov. 19 /PRNewswire/ -- The American College of Obstetricians and
Gynecologists' (ACOG) recently released opinion that deems physicians
ethically justified to perform elective cesareans without a medical reason has caused
alarm for major women's health organizations. The opinion may deny women
access to fully informed consent regarding one of the most controversial
obstetrical procedures. With a U.S. cesarean rate exceeding 26 percent, and no
definitive study on the benefits of cesarean delivery, it is startling to give
physicians the go-ahead to perform non-medically justified surgery on women with
normal pregnancies.
A group of women's health care organizations, including Lamaze International,
American College of Nurse-Midwives (ACNM), Doulas of North America (DONA),
Coalition for Improving Maternity Services (CIMS) and the Association of Nurse
Advocates for Childbirth Solutions (ANACS), believes this opinion downplays the
risks to mother and baby when non-medically necessary cesareans are
performed. "No evidence supports the idea that cesareans are as safe as vaginal births
for mother or baby, and pregnant women should be given all of the facts they
need to make an educated decision," said Barbara Hotelling, president of
Lamaze International.
"The World Health Organization recommends no more than a 15 percent cesarean
rate. With a million women having cesarean sections every year, this means
that 400,000 to 500,000 may be unnecessary," warned CIMS Executive Director Rae
Davis.
Research shows that the risk of maternal death following cesarean section is
five to seven times higher than vaginal birth. Complications during and after
the surgery may include injury to the bladder, uterus and blood vessels,
hemorrhage, anesthesia accidents, blood clots in the legs, pulmonary embolism,
paralyzed bowel and infection.
Citing additional concerns about the risk of placenta previa, placenta
accreta and uterine rupture during subsequent pregnancies, prominent
obstetrician-gynecologists Ingrid Nygaard and Dwight Cruikshank stated, "Given the absence of
rigorous scientific evidence, we believe that it is currently ill-advised to
routinely give all prenatal patients the choice of their desired mode of
delivery."
The American College of Nurse-Midwives stated, "Regrettably, the opinion
issued by the ACOG Committee on Ethics may lead to an increasing level of distrust
between health care professionals and the women who seek our services. The
purported benefits of cesarean section on demand are unproven and the known
risks place the woman's life and reproductive future on the line. This is the
message women must receive."
The baby also is at risk. With planned cesareans, some babies are
inadvertently delivered prematurely. Studies show that babies born even slightly before
they are ready may experience problems breathing and are five times more
likely to be admitted to intermediate or intensive care. Premature babies also
have more difficulty breastfeeding.
"Contrary to the ACOG statement, fear of pain in labor need not force women
to have cesareans. All women benefit from emotional, physical and most
importantly, educational support in labor and when making decisions about the birth
of their child. Studies have shown the value of doula services in lowering the
cesarean section rate," added DONA President Ann Grauer.
Lamaze, ACNM, DONA, CIMS and ANACS believe that all caregivers should respect
the birth process and not intervene without compelling medical indication.
Carolyn Rafferty, executive director of ANACS reported, "A growing number of
obstetric nurses are deeply concerned at the prospect of placing increasing
numbers of women at unnecessary surgical risk. We implore obstetrical nurses around
the country to speak up for women and fulfill the nursing obligation of
patient advocacy."
Collectively, Lamaze, ACNM, DONA, CIMS and ANACS speak on behalf of nearly
15,000 childbirth professionals and reach approximately three million expectant
parents each year. For more information, visit www.lamaze.org, www.acnm.org,
www.dona.org, www.motherfriendly.org or www.anacs.org.
SOURCE Lamaze International
CO: Lamaze International; American College of Nurse-Midwives; ACNM; Doulas
of North America; DONA; Coalition for Improving Maternity Services; CIMS;
Association of Nurse Advocates for Childbirth Solutions; ANACS; American
College of Obstetricians and Gynecologists; ACOG
ST: District of Columbia
SU: WOM
Web site: http://www.lamaze.org
http://www.prnewswire.com
11/19/2003 08:15 EST
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