Friday, January 9, 2009

Cesarean Articles, 20/20 Links, + Final Birth Stats

The week the Wall Street Journal published an article about research on elective cesareans before 39 weeks having significantly increased risks for babies. There was also an article in the National Partnership's newsletter that is based on the WSJ article. There has been "surprise" expressed that OBs have not followed ACOG's own recommendation to wait until 39 weeks for elective cesareans. There are also a number of incredible assumptions about patient choice being a driving factor behind elective cesareans (in the WSJ article it is stated that all these cesareans are about women wanting to make sure "their" OB does the delivery).

An article called "Elective C-sections performed too early 36% of the time" was also published in USA Today this week.

For those of you who didn't get to watch the 20/20 segment about "Extreme Motherhood" that included some content from the film Orgasmic Birth, here are some links to access clips (click the videos within the articles):

Unassisted birth and homebirth with midwives
: The homebirth segment was only about 5 minutes and little distinction was made between homebirth and unassisted birth.

And a clip about Orgasmic birth.

There is a good analysis of the overall "Extreme Motherhood" show on this blog.

There was also an article in Huffington Post about Orgasmic Birth: The Natural Reality Beyond the Hype. Some of the comments have been about the dangers of birth and how it "best takes place in the hospital." One commenter remarked that watching the 20/20 segment felt like being in a "parallel universe." I appreciated the author's response to these comments: "I'd agree that you're a parallel universe; you're in one where every pregnancy is life threatening and painful and dangerous...and you see woman for whom birth is safe and enjoyable and even sexy. What's sort of weird is that you want to take these happy women out of their universe and bring them into yours, especially when they don't seem that interested in going. Have you considered that they might know something that you don't, not vice versa?"

The final birth stats for 2006, including a national cesarean rate of 31.1% were released by the CDC this week:

Results: "In 2006, births and fertility rates increased for most states, age groups, and race and Hispanic origin groups. A total of 4,265,555 births were registered in the United States in 2006, 3 percent more than in 2005, and the largest number of births in more than four decades. The crude birth rate was 14.2, up slightly from the previous year; the general fertility rate was 68.5, up 3 percent. Birth rates increased for women in nearly all age groups, with the largest increases for teenagers and for women aged 20–24 and 40–44 years. Teenage childbearing increased, interrupting the 14-year decline from 1991– 2005. The mean age at first birth for U.S. women was down in 2006, to 25.0 years. The total fertility rate increased to 2,100.5 births per 1,000 women. All measures of unmarried childbearing reached record levels in 2006. Women were less likely to receive timely prenatal care in 2006. The cesarean delivery rate climbed to 31.1 percent, another all-time high. Preterm and low birthweight rates continued to rise; the twin birth rate was unchanged for the second consecutive year; the rate of triplet and higher order multiple births declined 5 percent."

Finally, I wanted to link to Lamaze International's excellent press release: Best Practices in Maternity Care Not Widely Used in the United States.

CfM Blogger
(P.S. as of this posting, the NCHS website linked to above with the 2006 birth stats report appears to be down)

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