On-Demand Cesarean Section May Not Be a Safe Choice

The recently released opinion of the American College of Obstetricians and Gynecologists (ACOG) 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 surgery that is not medically justified on women with normal pregnancies.

A group of women's health care organizations, including Lamaze International, the American College of Nurse-Midwives (ACNM), Doulas of North America (DONA), the 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 cesareans are performed without being medically necessary. "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.

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