C-section crisis demands congressional review

April is Cesarean Awareness Month and the American College of Nurse-Midwives (ACNM) is renewing its call for Congressional hearings into the nation’s rising Cesarean section rate and the impact on women’s health and the overall health care system. Recent data indicates that as many 4 women in 10 gave birth by Cesarean in 2003, with an increasing percentage of first-time Cesareans being performed with no medical indication.

“Women concerned about their future childbearing potential need to educate themselves about the troubling long-term implications of that first cesarean,” said Katherine Camacho Carr, CNM, PhD, president of ACNM. “Cesarean section remains one of the most frequently performed surgical procedures done in this country, but when that procedure is done electively, there is little research to substantiate that practice. Likewise, the majority of pregnant women do not experience medical complications that would justify a cesarean section. These evidence-based facts about the rise in unnecessary surgeries should alarm the health care community into some action, but, perplexingly, the c-section rate continues to rise year after year.”

Dr. Carr continued, “The debate over elective cesarean section is being driven by fear over litigation, a lack of understanding about the science (or lack thereof) and a false sense of security about the risks and/or benefits of surgery. Women need unbiased, individualized information concerning their birth options – not more confusion or scare tactics.”

Midwifery care remains a viable option for consumers and policymakers to consider. One New Jersey hospital recently credited its dropping Cesarean section rate to the certified nurse-midwives caring for women. Plainfield Health Center, a federally-qualified health center that predominantly serves a low-income, high-risk community, employs nurse-midwives to deliver the majority of care to pregnant mothers in the area. When those expectant mothers are ready to deliver, they are attended by nurse-midwives at Muhlenberg Regional Medical Center, which reported a Cesarean section rate of 22%, compared to New Jersey’s statewide average of 33%.

In January, ACNM called on Congress to hold hearings on this matter, so that the American people can better understand the dramatic and damaging effects Cesarean sections are having on women in this country, as well as the fiscal implications on publicly-financed health care systems such as Medicaid.

Women interested in the most complete review of the medical literature on this subject should read “What Every Pregnant Woman Needs to Know about Cesarean Section” from the Maternity Center Association, available for download at www.maternitywise.org/mw/topics/cesarean/booklet.htm. Also, visit the International Cesarean Awareness Network online at www.ican-online.org for more information about Cesarean Awareness Month.