The Pros and Cons of Elective Cesarean Birth

The American College of Nurse-Midwives (ACNM) Opinion on Elective Cesarean
The American College of Nurse-Midwives agrees that lives can be saved by appropriate use of cesarean section. But the ACNM urges women to understand the potential risks of cesarean and notes that "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. According to the World Health Organization, no region in the world is justified in having a cesarean rate greater than 10 to 15 percent."

Strategies to Reduce Your Risk of Cesarean Section
-- Plan your pregnancy and get into the best shape possible before conception. Make an appointment for a preconception visit, which should include a risk assessment for genetic problems, a thorough health history and physical examination, plus tests for vaginitis; sexually transmitted infection; HIV; urinary infection; varicella (chicken pox), mumps and rubella (German measles) immunity; and hepatitis B. A Pap smear should be performed.

-- Learn about nutrition and exercise. Understand reproductive hazards and the dangers of smoking, alcohol, medications and street drugs.

-- Investigate childbirth options in your community. Homebirth, birth centers, hospital birth centers and traditional hospital obstetric units are examples of settings that may be available to you. Care-provider options may include MD (obstetrician or family-practice physician), osteopath, certified nurse-midwife, certified midwife or direct-entry midwife ("lay" midwife).

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