The American College of Nurse-Midwives (ACNM) released a response to recent data from the National Center for Healthcare Statistics (NCHS) showing a national cesarean section rate of 24.4 percent -- an all-time high. 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: "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. "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 percent 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. "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."
Statement by the American College of Nurse Midwives
Cesarean section rates are off the charts and women are being duped into thinking that this is all right; in fact they are being enticed to consider C-sections on demand based upon questionable promises.
A woman considering cesarean section should be told that, compared to vaginal birth, she has an increased risk of infection, hemorrhage, damage to abdominal and urinary tract organs, and complications from anesthesia/narcotics. She needs to know that the incidence of drug-resistant infections is increasing and blood transfusions can lead to life-threatening complications. She should also be told that she will probably not be allowed to attempt a vaginal birth in the future and that the risk of complications from cesarean section increases with each subsequent surgery. Recent studies note higher rehospitalization and draw a direct link between chronic pelvic pain and cesarean section. These complications can ultimately limit a woman's ability to have the number of children she desires.