International Cesarean Awareness Network

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Cesarean Rate Reaches (Another) Record High

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32.9% of Births Resulting In Major Abdominal Surgery; 13th Consecutive Year to Show Increase
Redondo Beach, CA, December 21, 2010 – The Centers for Disease Control and Prevention’s National Center for Health Statistics has reported that the cesarean rate hit another record high in 2009, with a preliminary rate of 32.9 percent. The findings reflect the 13th consecutive year of increase. This rate roughly equates to 1,359,105 out of the 4,131,019 births in the United States in 2009 resulting in a cesarean.
“Cesareans are far from the niche occurrence of yesteryear. Every woman in her childbearing years MUST sit up and take notice of this alarming and astonishing rate of surgical delivery,” says ICAN President Desirre Andrews.
The primary cesarean rate continues to rise, meaning that even women without a prior cesarean and those with prior vaginal births are affected by the climbing cesarean rate. For those who have previously had a cesarean, access to VBAC (vaginal birth after cesarean) support continues to fade regardless of this year’s statements from the NIH and ACOG supporting VBAC as a safe option. “The rising cesarean rate and the resulting consequences are not going to go away on their own,” says Andrews. “Now more than ever, women and babies need access to evidence-based care.”
Evidence shows that cesareans place women and babies at increased risk for morbidity and mortality immediately and long term. Cesarean sections are being overused in the United States and the rate continues to rise, placing women and babies under these risks avoidably.
In addition to over 130 local chapters throughout North America and Internationally which provide in-person support, ICAN offers a variety of information and support online about cesarean prevention, recovery, and VBAC through their webinars, forums, and blog.
About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems, and lacerations. Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death. https://ican-online.org/ican-white-papers
Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean.

32.9% of Births Resulting In Major Abdominal Surgery; 13th Consecutive Year to Show Increase

Redondo Beach, CA, December 21, 2010 – The Centers for Disease Control and Prevention’s National Center for Health Statistics has reported that the cesarean rate hit another record high in 2009, with a preliminary rate of 32.9 percent. The findings reflect the 13th consecutive year of increase. This rate roughly equates to 1,359,105 out of the 4,131,019 births in the United States in 2009 resulting in a cesarean.

“Cesareans are far from the niche occurrence of yesteryear. Every woman in her childbearing years MUST sit up and take notice of this alarming and astonishing rate of surgical delivery,” says ICAN President Desirre Andrews.

The primary cesarean rate continues to rise, meaning that even women without a prior cesarean and those with prior vaginal births are affected by the climbing cesarean rate. For those who have previously had a cesarean, access to VBAC (vaginal birth after cesarean) support continues to fade regardless of this year’s statements from the NIH and ACOG supporting VBAC as a safe option. “The rising cesarean rate and the resulting consequences are not going to go away on their own,” says Andrews. “Now more than ever, women and babies need access to evidence-based care.”

Evidence shows that cesareans place women and babies at increased risk for morbidity and mortality immediately and long term. Cesarean sections are being overused in the United States and the rate continues to rise, placing women and babies under these risks avoidably.

In addition to over 130 local chapters throughout North America and Internationally which provide in-person support, ICAN offers a variety of information and support online about cesarean prevention, recovery, and VBAC through their webinars, forums, and blog.

About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems, and lacerations. Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death. https://ican-online.org/ican-white-papers

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean.

ICANers in the News About VBAC

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As news about the American College of Obstetrics and Gynecology’s (ACOG) revised VBAC guidelines garner attention from press outlets like the New York Times, ICAN leaders are being sought for comment.

ICAN President Desirre Andrews was quoted in WebMD Health News:

The new guidelines got a favorable response from the International Cesarean Awareness Network (ICAN). In a statement, ICAN’s president, Desirre Andrews, says: “ACOG’s updated recommendation for VBAC are much more in line with the published medical research and echo what ICAN has stated for years. Less restrictive access to VBAC will lead to lower risks to mothers and babies from accumulating cesareans.”

But the health care environment may need to catch up with the guidelines, according to ICAN. In a 2009 survey of more than 2,800 hospitals, ICAN found that 30% had formal policies forbidding VBAC and 20% had no doctors on staff willing to accept a woman planning VBAC.

Barbara Strattion, Chapter Leader for ICAN of Baltimore, was cited by the Associated Press, as reported on Salon.com:

“I feel like ACOG has really listened to how their previous policies have impacted women,” said Barbara Stratton of the International Cesarean Awareness Network’s Baltimore chapter, adding that she’ll advise women seeking a VBAC to hand a copy of the guidelines to caregivers who balk.

But she called for reducing overuse of first-time C-sections, too, so that repeats become less of an issue.

Cesarean Rate Jumps Again To Record High: 32.3%

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For Immediate Release

Cesarean Rate Jumps Again To Record High; 32.3% of Births Resulting In Major Abdominal Surgery
12th Consecutive Year to Show Increase

Redondo Beach, CA, April 6, 2010 – The National Center for Health Statistics has reported that the cesarean rate hit another record high in 2008 with a rate of 32.3 percent, up 2.6 percent from 2007.   The findings reflect the 12th consecutive year of increase.

“Every U.S. woman in childbearing years should have deep concern over this rate,” said Desirre Andrews, president of the International Cesarean Awareness Network (ICAN). “With the cesarean rate showing no signs of decreasing and VBAC access being limited in many areas across the U.S., women need to be well educated and well versed in self advocacy during pregnancy and birth.”

With the preliminary number of 4,251,095 U.S. births reported in 2008, a 32.3% cesarean rate results in approximately 1,373,103 women undergoing surgical deliveries. This total is equivalent to the entire population of Philadelphia, Pennsylvania or the combined populations of Alaska and Washington, DC. “This real life comparison highlights how serious the near 1 in 3 percentage of pregnancies resulting in major abdominal surgery is,” said Andrews.  “Evidence shows that cesareans put women and babies at increased risk for morbidity and mortality immediately and long term. Cesarean sections are being overused in the United States and as the rate continues to rise, mothers and babies are exposed to these risks avoidably.  The repeat cesarean rate of over 90% is undoubtedly helping to drive this record setting data.”

ICAN has a variety of educational, advocacy and support options on-line through webinars, forums, blog, twitter and white papers at www.ican-online.org.

About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved.  Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems, and lacerations.  Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death. https://ican-online.org/ican-white-papers

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean.  There are over 130 ICAN Chapters across North America and internationally, which hold educational and support meetings for people interested in cesarean prevention and recovery.

Contacts:

Desirre Andrews
719-331-1292
president@ican-online.org

Gretchen Humphries
517-745-7297
advocacy@ican-online.org

Cesarean Rate Jumps to Record High: Up 53% Since 1996

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For Immediate Release

Cesarean Rate Jumps to Record High:  Up 53% Since 1996

More Women Facing Surgical Delivery; All Ages and Ethnic Groups Affected

Redondo Beach, CA, March 23, 2010 – The National Center for Health Statistics reports that the cesarean rate in 2007 is the highest ever reported in the U.S., with a rate of 32 percent, up 53 percent from 1996.   The most significant increase is among women under 25, up 57% since 2000.

“This report confirms the alarming trend affecting all age and ethnic groups of childbearing women,” said Desirre Andrews, President of ICAN. “With every state showing an increase of cesarean deliveries, this concerns all women across the United States today.”

In light of the NIH Consensus Panel recommendation statement , the overuse of cesarean and dramatic underuse of vaginal birth after cesarean (VBAC) must be addressed. Currently, the VBAC rate is less than 8 percent, with evidence showing that 60%-80% or more of women having a VBAC trial of labor will be successful.   This decline is driven by the continually growing number of hospitals banning the VBAC option.

ICAN’s VBAC Policy Survey, originally conducted in May 2005 and updated in January 2009, surveyed a total of 2878 hospitals. 1654 hospitals “allow” VBAC, 824 have an official ban, and 400 have a de facto ban in place.   Full results of the research can be seen at https://ican-online.org/vbac-ban-info.  Between formal and de facto bans, women are not able to access VBAC at over 40% of hospitals in the U.S.

Research consistently shows VBAC is a reasonably safe choice for women with a prior cesarean, consistent with the recent NIH Consensus Panel findings.  While VBAC does carry risks associated with the possibility of uterine rupture, this event is rare. Cesarean surgery carries life-threatening short-term risks, as well as long term risks to future fertility and pregnancies.

Women are often told it is safer, less painful and easier to have a cesarean, even though cesareans are generally shown to have greater risks and have longer recovery times than VBAC. The choice to have a non-medically indicated surgical procedure is based on a false representation of the risks and consequences of a scheduled repeat cesarean and an inflated representation of the risks and consequences of VBAC.

“Women are subjected to a provider’s lowered risk threshold for practice and do not receive complete informed consent regarding the risks of a cesarean delivery,” said Andrews. “Women and their babies are forced to take on increased medical risk during pregnancy and childbirth so that providers can feel they’ve decreased their own non-medical risks in practice.”

For women who encounter VBAC bans, ICAN has developed a guide to help them understand their rights as patients.  This resource discusses the principles of informed consent and the right of every patient to refuse an unwanted medical procedure.  The guide can be found at https://www.ican-online.org/vbac/your-right-refuse-what-do-if-your-hospital-has-banned-vbac-q.

Women who are seeking information about how to avoid a cesarean, have a VBAC, or are recovering from a cesarean can visit www.ican-online.org for more information.  In addition to more than 130 local chapters worldwide, the group hosts an active on-line discussion group that serves as a resource for mothers.

About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved.  Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems, and lacerations.  Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death. https://ican-online.org/ican-white-papers.

Mission statement: The International Cesarean Awareness Network (ICAN) is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean.  There are over 130 ICAN Chapters worldwide which hold educational and support meetings for people interested in cesarean prevention and recovery.

Contacts:

Desirre Andrews, President 719-331-1292

Gretchen Humphries, Advocacy Director 517-745-7297

president@ican-online.org

National Institutes of Heath Releases Statement on VBAC

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Access to VBAC is Limited by Non-Medical Factors and is Safe for Most Women

REDONDO BEACH, CA, March 11, 2010.  The National Institutes of Health (NIH) finished the Conference on Vaginal Birth After Cesarean (VBAC) March 8th-10th, 2010, evaluating issues surrounding VBAC and seeking to quantify why VBAC rates have plummeted in the U.S. over the last decade.  The final report will provide consumers, health care providers and the general public with data currently available on VBAC.  Audience members included members of birth, health, and women’s rights organizations, including ICAN President Desirre Andrews and numerous other ICAN representatives.

“The final statement from the NIH concludes that a VBAC is a reasonable option for most women.  Over 75% of women who attempt VBAC will be successful.” says Desirre Andrews, ICAN President. “Currently less than 10% of women who have had previous cesareans deliver vaginally in subsequent pregnancies, leading to significant and preventable illness and death.”

The NIH made clear that the major driving factors behind this are non-medical reasons including but not limited to perceived convenience, insurance and liability concerns.  Proper execution of the informed consent and refusal process is not routine, and would be one factor in addressing non-medical concerns.

“NIH took the American Congress of Obstetricians and Gynecologists (ACOG) and anesthesiologists to task, calling on them to change the language in their official recommendations on VBAC.  ICAN has understood for years that this language plays a large role in the lack of access to VBAC in the U.S.” continues Ms. Andrews. “We hope ACOG rises to the challenge and also hope they will finally be willing to work with ICAN and other advocacy organizations to improve maternal and fetal safety.”

A survey conducted by ICAN in 2009 showed approximately 45% of hospitals in the United States formally ban VBACs either explicitly or through unsupportive policies and procedures.   Many women are never counseled that they are good candidates for VBAC and thus undergo more risky and expensive repeat cesareans.  The NIH report acknowledges that this represents a serious breach of medical ethics.  ICAN supports every woman’s right to select the care provider, birth setting and birth plan of her choice.

Lacking in the NIH statement is support for a woman’s right to refuse a cesarean section as this was felt to be beyond the scope of the current mandate.  It was acknowledged, however, by many expert presenters that forcing a pregnant woman to undergo an unwanted surgery is medically indefensible, unethical and immoral.  ACOG’s own statement on ethics states that a woman should neither be coerced nor punished for not following a recommendation.  Further exploration of the issue of patient autonomy in the pregnant woman will require vigilance by all concerned parties to make sure the discussion is an informed one.

ICAN encourages health organizations, care providers and consumers to continue to work towards improving the model of maternity care in our country to better reflect evidence-based practices and respect towards consumer rights of informed consent and refusal.  The NIH VBAC statement is available at http://consensus.nih.gov/2010/vbacstatement.htm

The International Cesarean Awareness Network (ICAN) is a non-profit organization that works to improve outcomes for mothers and babies by preventing unnecessary cesareans through education, supporting those recovering from birth and promoting access to vaginal birth after cesarean (VBAC).

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