The March issue of the journal Obstetrics and Gynecology has a feature article entitled “Safe Prevention of the Primary Cesarean Delivery” in which the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) issued a consensus statement listing ways to lower the increasing incidence of cesarean delivery. While surgical births can often be lifesaving for the baby and mother, the fact that 1 in 3 women now give birth in the United States by surgical delivery has caused increasing concern. These two leading obstetrical organizations are now coming together with science-based and safe guidelines with the hope of lowering the necessity for surgical deliveries. This is the first such joint effort in many years and has the birth community buzzing. Here are a few of the new recommended guidelines in an effort to the move towards fewer surgical births:
- Birth attendants will not pay such close attention to the time clock for labor. As long as labor is progressing, then there will be less rush toward surgical delivery even though some mothers may have a longer-than-usual labor.
- Since cesareans are done because of worrisome tracings on electronic fetal monitoring, there has been redefinition of which tracings are concerning and which are not. Some tracings that were previously thought to indicate fetal distress have been shown to be a normal variant and unrelated to fetal heart rate problems.
- Also in the recommended guidelines is the reassessment of whether or not surgical delivery is always necessary if mother goes beyond 41 weeks.
- The obstetrical organizations underscore that continuous labor support, preferably by a professional labor support person, is one of the most effective ways to decrease the need for cesarean birth. They encourage all mothers to utilize this valuable resource.
- Finally, the guidelines recommend less of a need for surgical delivery of twins.
In our new book, The Healthy Pregnancy Book (the only pregnancy book that is co-authored by an obstetrician, midwife, pediatrician, and mother-child childbirth educator), there is a large chapter on science-based and time-tested ways to increase the chances of having a vaginal birth.
Here is the link to the full article: http://www.scienceandsensibility.org/?p=7958