Increase Fueled By Rise In Elective Cesareans
In its statement, ACNM calls upon all obstetric providers to provide thorough information on the impact of all birth options to the mother during prenatal consultations. The current trend suggests that some obstetric providers are abandoning the most cautious approach under the guise of questionable science, convenience, and fear of lawsuits.
"As we move forward into the 21st century, the national cesarean section rate is rising fast enough to get the attention of the American health care system and ignite a furor over the move toward an assembly line model of childbirth," remarked ACNM Executive Director Deanne Williams, CNM, MS. "Despite the NCHS figures showing that one of every four women will have major abdominal surgery to deliver her child--some people are alarmed and, inexplicably, some are not."
Stories of cesarean sections performed for motivations other than maternal or fetal well-being have been making headlines in recent years. They reflect a rise in elective cesareans for reasons such as avoidance of labor pain, patient or provider convenience, legal concerns of the provider or questionable assumptions about the origin of incontinence in women. There is no question that lives can be saved by the judicious use of cesarean section; but, in a nation with seemingly endless resources, easy access to information and multiple sites for clinical training as can be found in the United States, a national cesarean rate of 24% is not a sign of progress, but rather misplaced priorities.
"The list of reasons women must not think that surgical birth is safer than vaginal birth is long and ranges from the increased incidence of drug resistant infections, to the potential for life threatening complications from blood transfusions," according to ACNM President Mary Ann Shah, CNM, MS, FACNM. "Women risk permanent damage to abdominal and urinary tract organs, longer recovery times, little-to-no chance for a subsequent vaginal birth and a premature end to their ability to safely bear children. Technology is an alluring panacea for ills, but blind devotion without critical evaluation, places women at great risk."