2006 Cesarean Statistics Released – it ain’t good

Today I was informed that the CDC released preliminary vital statistics for 2006 which includes state-by-state cesarean birth information.  Here in Montana the 2006 cesarean rate was 28%, earning us a rank of number 37 (of 51).  The national cesarean rate was 31.1%, an all-time high.  Although Montana was 3 percentage points below the national average, the rate still exceeded World Health Organization (WHO) recommendations by 13-18%!  The WHO determined that when cesarean rates exceed 10-15%, the risks of the surgery outweigh the benefits.  It is my understanding from a recent discussion with a hospital administrator that Community Hospital’s (Missoula) cesarean rate exceeded 30% in 2006.  Missoula’s cesarean rate is headed in the wrong direction. 

As a woman with one cesarean scar, these statistics are frightening.  Is cesarean birth becoming “normal” birth?  If one out of three babies is born through major abdominal surgery, then yes, I’d say the norm is swinging that direction.  You need to know that the percentage of birth by cesarean has risen 50% in the past decade.  This is straight from the horse’s mouth!  You also need to know that Montana’s VBAC (vaginal birth after cesarean) rate in 2005 was only 1%. 

For the second year in a row, ICAN has compiled a list of research from the past year that shows cesarean surgery should be used more judiciously and that VBACs should be routine/normal.  Currently, more than 300 hospitals across the U.S. ban women from having a VBAC, essentially coercing them into unnecessary surgery and feeding the growing rate of cesarean.  Very few Montana women have access to vaginal births after cesarean sections.  Only a handful of hospitals across the state allow VBACs – one of those hospitals is Community Hospital in Missoula

In August, the Centers for Disease Control released a report showing that, for the first time in decades, the number of women dying in childbirth has increased.  Experts note that the increase may be due to better reporting of deaths but that it coincides with dramatically increased use of cesarean.  The latest national data on infant mortality rates in the United States also show an increase in 2005 and no improvement since 2000.  “At a time when maternal and infant mortality rates are decreasing throughout the industrialized world, the United States is in the unique position of having both a rapidly increasing cesarean rate and no improvement in these basic measures of maternal and infant health.” says Eugene Declercq, Ph.D., Professor of Maternal and Child Health at Boston University School of Public Health.

Another report released in October by the World Health Organization, the United Nations Population Fund, the U.N. Children’s Fund, the U.N. Population Division and The World Bank, and published in the Lancet shows that the U.S. has a higher maternal death rate than 40 other countries.  “Women in the U.S. think they’re getting top notch care, but our death rate for mothers shows otherwise,” says ICAN’s President, Pamela Udy.  The U.S.’s maternal death rate tied with that of Belarus, and narrowly beat out Bosnia and Herzogovena.

Research from 2007 also shows that VBAC continues to be a reasonably safe birthing choice for mothers. “The research continues to reinforce that cesareans should only be used when there is a true threat to the mother or baby,” said Udy. “Casual use of surgery on otherwise healthy women and babies can mean short-term and long-term problems.” For women who encounter VBAC bans, ICAN has developed a guide to help them understand their rights as patients. The resource discusses the principles of informed consent and the right of every patient to refuse an unwanted medical procedure. Click here for a pdf copy of this important resource.

Women who are seeking information about how to avoid a cesarean, have a VBAC, or are recovering from a cesarean can visit www.ican-online.org for more information, to find a local chapter, and to receive support.

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 percentage of maternal death. http://www.ican-online.org/resources/white_papers/index.html 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 94 ICAN Chapters across North America, which hold educational and support meetings for people interested in cesarean prevention and recovery. 

Threatened Miscarriage Update

I don’t have anything new to report, really.  Active bleeding has subsided.  I *think* my cervix is closed, but I’m not very experienced with self cervix checks, so perhaps I’m wrong.  The fact that my cervix was closed Sunday night during active bleeding and Tuesday morning before extreme bleeding and probably is closed today is a good sign, I hope.  Well, that’s all in how you look at it:

SCENARIO ONE – Miscarriage

If I should be miscarrying and my body is not actively expelling the fetal tissue, then this is not good.  My hcg levels can still rise with miscarriage in the near future.  The cervix staying closed means that doctors will be concerned that my body won’t reject the pregnancy on its own.  I am not considering a medical miscarriage at this time.  [Look at my previous posts on this miscarriage for the reasons miscarriage is expected.]

SCENARIO TWO – Subchorionic Hematoma

I myself am not convinced that I have a blighted ovum.  My body still thinks it is pregnant, and I have to hold onto hope.  Had the ultrasound technician at the hospital found a fetal pole, I would assume that I’m suffering from subchorionic hematoma, a scary event that may or may not result in terminated pregnancy.  And indeed I was diagnosed with threatened miscarriage and a subchorionic hematoma.  In my opinion, based on a lot of reading over the past few days, 5w4d might have been a bit early to even find the fetal pole or the fetus might have been hiding.  Until I see that ultrasound on Monday, I am staying hopeful that my pregnancy is still intact.

I regret that I need a follow-up ultrasound.  I’m not confident in the safety of ultrasound in pregnancy.  I had three ultrasounds in my first pregnancy – one at about 11 weeks because the CNM didn’t detect a heartbeat with the doppler and I was nervous; a “big” one in the 2nd trimester; one around 32 weeks to see if the low-lying placenta was going to be an issue in labor and delivery.  My daughter is fine.  But transvaginal ultrasound is more suspicious, in my opinion as the transducer is so much closer to the fetus.

Well, that’s enough for now.  I have a few more posts in the making . . .

Currently Reading and Researching

Since I am at home bleeding with nothing else to do . . . I have been doing a lot of reading and research.  I don’t have the mental fortitude to break it all down into individual posts, so here is the “cluster eff” from yesterday and today:

Homebirth: Safety & Benefits, courtesy of Ronnie Falcao, LM MS – even though her site isn’t stylish, the information is good

Misdiagnosed Miscarriage Site and Forums – lots of food for thought here . . . and very good examples of why women should not do a D&C unless they are unable to miscarry naturally. . . and why women shouldn’t take cytotec to induce abortion.  Check out their Blighted Ovum FAQ.

Please watch this video on the awful things that cytotec induction (in labor and delivery) can do.  Cytotec is an ulcer medication and is contraindicated for pregnant women!!!

Related – “Drugs, Knives, and Midwives: The U.S. maternity care system is in crisis. A grassroots movement to save it is under way” by Elizabeth Larsen, Utne Reader, March/April 2007.  I’ve looked it over but will read it thoroughly today.

I liked this “Helping a Friend Through a Miscarriage“.  Please consider reading it if you’re helping a loved one deal with this tragedy.

I’m certainly more wary of ultrasound these days and regret that I had to have one of Sunday.  (Some may rightly say that I didn’t have to have one on Sunday, but they’re not walking in my shoes right now.)  Yesterday I read Rodgers’ “Questions about Prenatal Ultrasound and the Alarming Increase in Autism” from Midwifery Today, and that scared the crap out of me.  Today I will read Wagner’s “Ultrasound: More Harm Than Good?” and Beech’s “Ultrasound: Weighing the Propaganda Against the Facts”.  I recommend anyone considering ultrasound during pregnancy to look at Kmom’s compilation (2003).

Read some of these testimonials from women who suffered through subchorionic hematoma!  I’ve found this thread very encouraging.

I’m also trying to locate a copy of Lesley Regan’s miscarriage book.  Too bad the local library and the University library don’t have this book.  If anyone I know can loan me a copy . . . I’d sure appreciate it.  Also, feel free to share your favorite miscarriage resources in the comments section.