In about an hour I will be interviewed for a local news station regarding Montana’s cesarean rate. I don’t know much more than that. The reporter has a young child. The reporter is supposed to be meeting with a local hospital official. Other than that, who knows what her focus will be. In anticipation of this interview, I decided to review some things that I have read and wrote regarding cesarean rates.
With regard to rates, it is important to consider that the US cesarean rate (2006, preliminary) is 31.1%. The rate has increased by 50% since 1996. The rate recommended by the World Health Organization is 10-15%. Once the cesarean rate exceeds 15%, the risks (statistically speaking) outweigh the benefits. The Montana cesarean rate (2006, preliminary) is 28%, nearly a 3% increase from the year prior. According to a source at the local hospital, our local rate is around 31%. I was told that only 16 VBACs took place in 2006 at my hospital. (A local CNM questioned the accuracy of the VBAC figure, suggesting that VBACs were under-reported.)
I can list many contributing factors to the continued increase in the cesarean rate:
Medico-legal concerns on the part of doctors, hospitals, and insurance providers (it’s HUGE, actually)
“So and so had a cesarean . . .”
Hollywood stars having elective cesareans
Young and underpriviledged mothers are more at risk for cesarean surgery
An unchecked trust in care providers – most women do not seek second opinions when it comes to maternity services
Sensationalization of birth – Baby Story and OR Live come to mind
Society – our view of birth has changed; the culture of fear has spread to childbirth
Cesareans ARE more safe now than they ever have been
Of course I’ll direct the reporter to resources such as:
Cesarean Awareness Month (CAM) is an internationally recognized awareness month which sheds light on the impact of cesarean surgery on mothers, babies, and families worldwide. Cesarean birth is major abdominal surgery for women with serious health risks to weigh for both moms and babies. Cesareans may be safer now than they ever have been, but this surgery is being conducted more frequently than is prudent or safe. The acceptable rate established by the World Health Organization (WHO) is 10-15% – what is your community’s cesarean rate?
The blogosphere is atwitter about Cesarean Awareness Month. Here are some posts I found today that deal directly with CAM:
How do you plan to honor Cesarean Awareness Month? How can you let people know that natural birth is an important issue for you and for them? I promise that there is some way, no matter how small it may seem, that you can have a positive impact on your birth community. Even wearing a cesarean awareness ribbon several days this month will help. If you need ideas, feel free to ask.
Amy Bucher, the director, with Mary Olive Smith, of “A Walk to Beautiful,” was at the Hooker Dunham for the first showing of the film. The house was packed, and she thanked us for “leaving your beautiful houses on a Sunday night to see a film about childbirth injuries.”
I encourage everyone to read this . . . it’s difficult but necessary. With everything that we endure here in America as women, there are so many places – like Ethiopia – where conditions are so poor and harsh and women don’t have easy access to necessary care.
Last Friday one of my students presented me with a potted mini rose bush. I assumed it was a gesture related to my recent miscarriage, but actually it was a gift in celebration of International Women’s Day (3/8/08). International Women’s Day? I had never heard of such a thing, but in my student’s home country, it is customary to present women with flowers on IWD. I was glad she chose a potted flower!
My last post listed the top 10 countries for being a woman according to the UN Development Programme. The US (12) did not make the list, but neither did the UK (16), Mexico (52), my student’s Ukraine (76), or Germany (22).  In the course of looking up the data I found Kemal Dervis’s statement for International Women’s Day. The theme is “Investing in Women and Girls.” Dervis states that this theme “is about changing the systems and attitudes that discriminate against women and prevent them from fully participating in and benefiting from the economies and societies in which they live.” How do we plan to honor this goal in the US? How can we tackle important women’s issues in our communities? How will we positively influence local, statewide, and national political trends to discuss and improve the lives of women and girls in the US?
Are you “unseen” in your community or recognize women at risk in your community? Do something proactive! Whether it’s starting a support group, mentoring teen moms, taking a meal to a family or friend in need, picketing City Hall, raising legislative awareness, or even simply smiling at a woman or girl who looks like she needs it, you can make a difference.
 UN Development Programme, Human Development Report 2007/2008, GDI Rank
This is one of those days that I shouldn’t have gotten out of bed and need to crawl back into bed. Luckily my students are sick, so I am off the hook, so to speak. I don’t feel well myself – in addition to pregnancy fatigue I must be fighting some version of the flu that is going around. I’ve had chills, a migraine, dizziness, and shortness of breath.
Gretchen of Birth Matters posted an important notice from the American Association of Birth Centers. The short of the long of it is that the AABC will not be conducting a follow-up study on VBAC in birth centers. Most AABC accredited birth centers do not allow VBACs. VBACs are evidently not considered to be “high risk” or “low risk”. Rather, we’re an insignificant subset who is someone else’s problem. Instead of conducting a study to correct the faulty conclusions of the previous study (Obstetrics & Gynecology, 2004), they are focusing on maintaining a credible visage for normal birth. (CYA much?)
My sister-in-law has been diagnosed with carrying the “fragile x” gene. As far as I know, the genetic testing took place without informed consent. I resent that my SIL has to spend her entire pregnancy worrying about her future child’s mental and physical well-being. She is only 9 weeks pregnant, so this is a big burden to bear for such a long time. Let’s get back to the “rub”. She did not request genetic testing and was not told that genetic testing was part of the OB’s standard blood work-up. She and my BIL are the picture of health, so there would have been no obvious need for genetic testing. This is a huge problem in a number of ways, and this OB should be hunted down and burned at the stake for what she has done.
The VBAC ban project is finally up and running! What is this you ask? Well, simply put, we are going to call every hospital in the U.S. and find out what their policy is on VBAC. The International Cesarean Awareness Network did this a few years back and found out that over 300 hospitals officially “ban” VBAC (even though this is patently illegal). Needless to say, we are sure the situation is much worse now. But, the cool thing is that ICAN is about to launch a fantastic new website and included on that website is a map of the U.S. upon which every one of the hospitals we call will appear….with information about that hospital and its policies on VBAC. AND, there will be a way for anyone to leave feedback about that hospital, so you can see what other women experienced there. But, in order for this to happen, we need people to call! So if you are interested in helping out, please email me at email@example.com and I’ll get you set up and going.
Help ICAN shine the light into the oppression that so many hospitals are inflicting on women.
For twenty plus years WBI and Barbara Harper have been here guiding mothers and their providers, providing education and birth pools all over the world. We are facing the hard truth that the Gentle Birth World Congress – a fabulous success in every way for international , as well as local attendees – drained all of our resources. We may have to close the doors permanent by January 31st.
We need to raise $200,000 in donations to cover the debts from the Congress and move on to keeping waterbirth alive as an available option.
Can you help us stay open to take the next phone call?
- to convince the next obstetrician to incorporate waterbirth into his/her practice
- to work with the nurse midwives to install pools in their facilities
- to educate an entire hospital on the benefits of allowing women freedom of movement in the water
How much is it worth to see waterbirth become the norm in the US, like it is in the UK? I think we only need a few more years to make that happen. Women really do want waterbirth to be an available choice in every hospital. They need choices now, more than ever. If we need to call every single waterbirth parent personally, we will. We don’t want 25 years of pioneering work to end and the vision of safe and beautiful waterbirth to go away.
Please do the following:
~DONATE any amount you can
~Become a member of Waterbirth International ~Buy a birth pool for your local midwives
~Buy a birth pool for yourself ~Buy a birth video and donate
~ Post this message on other sites and blogs
For more information on Waterbirth International, please visit their website. Don’t let 25 years of service to women and babies around the world come to an end in this manner. Thank you for your consideration!