Answers prove elusive as C-section rate rises
Answers? Want answers to the problems around birth? Privatize the whole thing, loosen up the laws around midwifery and birth centers, and let the market (Parents) decide which professionals will stay and which will go down. It is the only answer.
Anything less than a Free Market answer to this issue will simply make things worse.
My responses to the article are in Italics.

“No question, says maternal/fetal medicine specialist Catherine Spong, the safest way for most first-time mothers to give birth is via an uncomplicated vaginal delivery.”

Then why don’t doctors explain that fact to first time mothers and then do everything in their power to make it so she can have a vaginal delivery?

“But in childbirth, as in life in general, there are no guarantees.”

I am absolutely sure that if I give birth in a hospital I will be bullied into using drugs to speed things up, and will most likely have a surgical cut somewhere on my body.

“The problem is we don’t know who’s going to have an uncomplicated vaginal delivery,” says Spong, chief of the pregnancy and perinatology branch of the National Institute for Child Health and Human Development.

90% of healthy first time mothers who are well nourished and don’t smoke are likely to have a great first birth if taught the mechanics of labor and encouraged to birth without drugs or inductions. So, the odds are pretty good MOST women will have an uncomplicated birth.

If a woman has delivered one baby vaginally without much trouble, chances are good she’ll be able to deliver another baby the same way.

Please define “trouble”.

But what if the woman is a first-time mother with no childbirth track record? Is scheduling a cesarean section a safer bet than planning to deliver vaginally?

No, No, A Thousand Times NO!!!

Apparently, some pregnant women think so, and they’re reportedly asking for C-sections even though there is no medical reason for one.

And whose fault is that?

How much so-called maternal request cesareans have contributed to the soaring C-section rate isn’t known, but growing numbers of women are delivering their first babies via surgery, researchers say. And for virtually all of them, once a C-section, always a C-section. Last month, the government announced the U.S. rate hit another all-time high in 2006.

As this article in Medical News today reports, many of those surgeries were coerced. Very Very few women are ASKING for C-sections these days. But with gun to your head obstetrics becoming the norm, young first time mothers are being bullied into surgery.

As the rate has risen, so has the rate of pregnancy-associated deaths in 2003 and 2004. Data on the maternal mortality rate for 2005 and 2006 aren’t yet available. The rate hit 13 per 100,000 live births in 2003, the first time it had topped 10 per 100,000 since 1977. The rate rose to 14 per 100,000 in 2004, or 540 reported pregnancy-related deaths.

The OB’s seem so willing to cave to the pressure to “let” a mother have a c-section by choice….”well, this is what these mothers want”….so I guess we just have to let them. But when a mother WANTS to give birth naturally or at home….well that is when Dr. Jeckel comes creeping into the scene….”WHAT you want to give birth without drugs and surgery? WHAT, you want to give birth in your own bedroom? What are you thinking you irresponsible nut job crazy woman. Who CARES if the maternal mortality rate is going UP, up, UP??? We know what is best for you and as long as what you WANT is what we would love to SELL you, then you may have freedom of choice. HOWEVER, no choice is allowed if you don’t want what we have to sell. End of discussion.

National Center for Health Statistics researchers, who reported the maternal mortality trend in August, attribute the increase mainly to better reporting of pregnancy-related deaths, not greater actual numbers. But activists opposed to the growing use of C-sections and some doctors say the increase is probably the result, at least partly, of the increase in surgical deliveries. In 2006, 31.1% of U.S. births were by C-section, a 50% increase over the previous decade.

Wrong, activists for years have been pointing to the fact that the numbers are in fact under reported and no federal law exists even today that mandates proper reporting of these deaths.
The rest of the USA Today article quotes several doctors calling for a long term C-section study, comparing planned sections with unplanned, etc….
I can already see the results from those studies in my minds eye. They will probabaly “find” that C-section carries no greater risk of maternal death, Mothers who give birth this way find the experience to be extremely satisfying, and the final recomendation of the study will be that every woman should simply schedule her section around her doctors golf games and vacation schedule.
Jenny Hatch
Maternal Mortality in the USA
A Fact Sheet
The World Health Organization reported in 2003 that 30 other countries have lower maternal death rates than the United States.
The Centers for Disease Control (CDC) report that there has been no improvement in the maternal death rate in the United States since 1982.
The CDC estimated in 1998 that the US maternal death rate is actually 1.3 to three times that reported in vital statistics records because of underreporting of such deaths. (1)
The CDC reported in 1995 that the “magnitude of the pregnancy-related mortality problem is grossly understated.” (2)
The rate of maternal death directly related to pregnancy or birth appears to be rising in the United States. In 1982, the rate was approximately 7.5 deaths per 100,000 live births. By 2003, that rate had risen to 12.1 deaths per 100,000 births.
The CDC estimates that more than half of the reported maternal deaths in the United States could have been prevented by early diagnosis and treatment. (1)
Autopsies should be performed on all women of childbearing age who die if there is to be complete ascertainment of maternal deaths.
Numerous studies have found that in 25 to 40 percent of cases in which an autopsy is done, it reveals an undiagnosed cause of death.
In the 1960s, autopsies were performed on almost half of deaths.
The United States now does autopsies on fewer than 5 percent of hospital deaths.
Reporting of maternal deaths in the United States is done via an honor system. There are no statutes providing for penalties for misreporting or failing to report maternal deaths.
In the United States, the risk of maternal death among black women is about 4 times higher than among white women.
Most countries with lower maternal death rates than the United States use a different definition of “maternal death”, which, unlike the United States’ definition, includes those deaths directly related to pregnancy or birth which take place during the period between six weeks and one year after the end of pregnancy.
Complete and correct ascertainment of all maternal deaths is key to preventing maternal deaths.
The Confidential Enquiry into Maternal Deaths in the United Kingdom (England, Scotland, Wales, Northern Ireland), which has functioned since 1952, is the system believed to have achieved the most complete ascertainment of maternal deaths while guaranteeing utmost confidentiality.
The maternal mortality rate for cesarean section is four times higher than for vaginal birth and is still twice as high when it is a routine repeat cesarean section without any emergency. (3,4)
There is currently no federal legislation mandating maternal mortality review at a state level.
Fewer than half of the states conduct state-wide maternal mortality review.
Hospitals do not release reports of maternal deaths to the public; hospital employees are required to keep such information to themselves.
The Healthy People 2010 Goal is no more than 3.3 maternal deaths per 100,000 births.
Notes
Morbidity and Mortality Weekly Report, September 4, 1998, Vol. 47, No. 34.
Atrash HK, Alexander S, Berg CJ. Maternal mortality in developed countries: Not just a concern of the past. Obstet Gynecol 1995;86:700-5.
Petitti D et al. In hospital maternal mortality in the United States. Obstet Gynecol, Vol 59, pp. 6-11, 1982.
Petitti D. Maternal mortality and morbidity in cesarean section. Clin Obstet Gynecol, Vol. 28, pp. 763-768, 1985.
The Confidential Enquiry into Maternal Deaths in the United Kingdom http://www.cemach.org.uk
Prepared by Ina May Gaskin, MA, CPM
Coordinator for the Safe Motherhood Quilt Project
41 The Farm
Summertown, TN 38483
http://www.rememberthemothers.net
http://www.inamay.com
931 964 2519