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Too Many Cesarean Sections?
Although a Cesarean section can be a lifesaving technique for
mother and infant,
it is a major surgical procedure with substantial risk to both
parties. Cesarean
sections are now performed in nearly 25% of all deliveries in
the United States
- a dramatic increase from only 20 years ago.
Lack of progress in labor is a predominant reason for Cesarean
delivery in the
U.S., accounting for one third of the nearly one million Cesareans
performed
annually. Is this number too high? Yes, according to the American
College of
Obstetricians and Gynecologists' (ACOG) published diagnostic criteria
for abnormal
labor patterns and guidelines for proceeding to Cesarean delivery.
In a recent
study, ACOG criteria were compared with actual clinical delivery
practices involving
733 women in California and Iowa from 1993-1994.
A review of medical records and a postpartum telephone survey
were used to gather
data on proportion of unplanned Cesareans performed for lack of
progress in labor;
cervical dilation at time of Cesarean; length of second labor
stage; and other
variables. Results showed that lack of progress was a dominant
reason for Cesarean
delivery, even during the latent phase of labor or when labor
was not prolonged
(second stage).
The authors emphasize that "these practices do not conform
to published diagnostic
criteria for lack of progress." In other words, too many
Cesarean sections! Consult
with your team of health care professionals during pregnancy to
ensure a smooth,
safe delivery.
Gifford DS, Morton SC, Fiske M, et al. Lack of progress in
labor as a reason
for cesarean. Obstetrics & Gynecology, April 2000: Vol. 95,
No. 4, pp589-95.
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