INTERNATIONAL
CESAREAN AWARENESS NETWORK (ICAN)
Contact:
Tonya Jamois, ICAN President
(760) 744 5260 home
(760) 207-1260 cell
president@ican-online.org
December 12, 2005
Consumer Reports Questions
Cesarean Frequency
Consumer Reports has named cesarean section number three
on its list of “ 12 Surgeries You May Be Better Off Without .” The
recommendation, based on research at the non-profit Rand
Corporation, encourages consumers to “check out safer alternatives” before
having any of the 12 listed “invasive procedures.” See http://www.consumerreports.org/mg/free-highlights/manage-your-health/needless_surgeries.htm
The number three ranking of cesarean surgery appears just
above episiotomy (#4) and hysterectomy (#5) and below angiography
(#1) and angioplasty (#2). The recommendation from Consumer
Reports Medical Guide comes on the heels of the Centers for
Disease Control report showing that the primary cesarean
rate in the United States has reached a historical high of
20.6 percent and an overall rate at 29.1 percent in 2004.
The latest overall rate reported in Canada is 22.6 percent.
“Women need to be selective consumers and study their birth
options ,” says Tonya Jamois, president of the International
Cesarean Awareness Network (ICAN). “The priority should be
to avoid that first cesarean, and if you have a scar on your
uterus, educate yourself about vaginal birth after cesarean
(VBAC). Twenty years of research shows VBAC to be safer for
mother and baby than repeat cesarean surgery.”
According to Consumer Reports Medical Guide, most cesareans
are performed because labor is progressing too slowly. The
Guide notes that a number of less invasive procedures may
be enough to stimulate labor. Consumer Reports encourages
women to ask “what percentage of normal deliveries as well
as births following a prior cesarean the physician delivers
by C-section. Ideally, look for rates below 15 percent in
women who haven't had the procedure and about 60 percent
in those who have.”
The guide also states that physicians perform cesareans
in the vast majority of women who have already had one. But
ACOG, the American College of Obstetricians and Gynecologists
(as well as SOGC, the Society of Obstetricians and Gynaecologists
of Canada) has published research showing most women could
safely try for a VBAC, which would succeed about 70 to 80
percent of the time; and if it does not, a cesarean can always
take place. Unfortunately cost concerns and fears over liability
have lead physicians and hospitals to place VBAC bans and
force women to go to another hospital or accept a cesarean.
The recommendation by Consumer Reports is for pregnant women
to be informed about the cesarean rate of their physicians
and hospitals, and to look for rates below 15 percent in
women who haven't had the procedure and about 60 percent
in those who have. Another recommendation is to ask about
the doctor's willingness to try non-surgical steps first.
Alternatively, Consumer Reports also recommends women consider
giving birth in a hospital with a certified nurse-midwife,
if available, since their births have lower cesarean rates
than births with obstetricians.
“Giving birth in a free-standing birth center or at home
with a midwife is another option that women should study.
Midwifery care has been proven over and over to be a safe
alternative for most pregnant women”, says Jamois. “Countries
where the majority of babies are born into the hands of midwives,
such as The Netherlands, have cesarean rates below 10 percent,
and they boast the best maternal and infant health outcomes
in the world.”
Women who are seeking information about preventing the first
or next cesarean, or are recovering from a cesarean, can
visit www.ican-online.org for
more information. In addition to more than 70 local chapters
in North America , the group hosts an active online discussion
group that can serve as a resource for mothers.
About Cesareans: ICAN recognizes
that 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 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
rate of maternal death.
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 more
than 70 ICAN Chapters across North America , which hold
education and support meetings for people interested in
cesarean prevention and recovery.
For women who have experienced a cesarean, who are
working towards a VBAC, or simply want to know how to prevent
a first cesarean, the local ICAN chapter of the Edmonton
VBAC Support Association/ICAN of Edmonton is available
to provide resources and support. Contact them for more
information on how to get involved .
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