International Cesarean Awareness Network

Education, Support, & Advocacy for Birth Justice & Healing

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.

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

ACOG Spokesman: C-section Rise "not going to be good for anybody"

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An article in today’s New York Times discusses the report released yesterday by the National Center for Health Statistics (NCHS) on the continued rise in cesareans. The article quotes Dr. George A. Macones:

The continuing rise “is not going to be good for anybody,” said Dr. George A. Macones, the chairman of obstetrics and gynecology at Washington University in St. Louis and a spokesman for the American College of Obstetricians and Gynecologists. “What we’re worried about is, the Caesarean section rate is going up, but we’re not improving the health of babies being delivered or of moms.”

Macones goes on to cite fear of malpractice suits as a significant driver of cesareans for many OBs:

“The threshold for doing a Caesarean section is going down, and one of the major factors is professional liability, ending up in court,” Dr. Macones said.

In an article last month in the journal Obstetrics and Gynecology, the obstetricians’ college reported that a poll of 5,644 of its members found that 29 percent said they were performing more Caesareans because they feared lawsuits. Eight percent said they had quit delivering babies, and nearly a third of those said it was because of liability issues.

The declining trend of VBAC is also noted.

An expert panel convened earlier this month by the National Institutes of Health said there were too many barriers to vaginal birth after a Caesarean and suggested ways to reduce them. It urged the obstetricians’ group to reassess its guidelines on “immediate availability,” and it urged hospitals to publicize their rates of vaginal birth after a Caesarean, so women could make informed choices about where to give birth. It also acknowledged the problem of malpractice suits but did not make a specific recommendation about how to solve it.

Dr. Macones said the panel’s advice made sense, but he added: “The first thing we should be trying to do is lower the primary C-section rate. Then we wouldn’t get into this trouble.”

Unfortunately, Dr. Macones also perpetuates the myth that maternal request for cesareans is a key factor. However, research shows that the percentage of true maternal request cesareans is very low – less than 1%.

Even so, it seems that even ACOG can no longer ignore the fact that the rising cesarean rate is not producing better outcomes for mothers and babies. As ICAN President Desirre Andrews notes in ICAN’s press release on the report:

“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.”

All I want for Christmas is…an induction?

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The graph below shows how births vary by day of the week and even by holidays using data on births from the CDC during the months of November, December, and January from 1994 to 2001. The blue lines depict the actual number of births, while the red lines show the average number of births by day of the week. The important part to notice is where they don’t line up.

The graph’s creator explains:

An obvious pattern for births by day of the week is seen: Weekend births (around 8000 per day) are significantly lower than weekday births (about 11,000 to 12,000 per day). This is due to scheduled births (both induced normal births and non-emergency caesarian births) taking place during the week, not on weekends. This daily pattern is consistent for most weeks of each three month period in this chart.

And…

It is obvious that births on 1 January are markedly lower than would be expected for the day of the week. Births on 25 December (Christmas Day) are also lower than expected for the day of the week, by an even greater amount than the New Year’s Day variation. In fact, the day of the year with lowest number of births is Christmas Day. Thanksgiving also shows a pronounced decrease in births compared to typical Thursdays, and perhaps more of an effect than New Year’s. The day of the year with the greatest number of births is either the Tuesday before Thanksgiving (as in 2000), the Tuesday before Christmas (1999), or the Tuesday before New Year’s (1998).

The author’s interpretation:

It is evident that more births are induced just before these three holidays, so the patients and doctors are not tied up during the holidays.

Happy holidays! (Tongue firmly in cheek…)

Read the full article here. Thanks to Henci Goer for pointing the way.