Wednesday, April 09, 2014

The NFL Expert Speaks Out On…… Cesareans?

NFL analyst Boomer Esiason couldn’t have picked a worse (or better) month in which to say “Quite frankly, I would have said ‘C-section before the season starts’” in regards to New York Mets second baseman Daniel Murphy’s decision to miss Opening Day of baseball to take paternity leave.

April is annual Cesarean Awareness Month, and while Mr. Esiason feels like a cesarean should take priority over physiologic birth, the American Academy of Family Physicians and ACOG have a different thought about scheduling an early delivery:

  • Babies will miss essential development of fat stores in week 37 and 38 that help them regulate their body temperature.
  • Brains and lungs are also still developing in week 37 and 38.
  • Early babies are more likely to develop breathing and eating problems, jaundice, cerebral palsy, sensory development issues, and require intensive care.
  • The risk of infant mortality is also higher.
  • The mother is more likely to develop postpartum depression. Specialists advise this is most likely as a result of the baby spending additional time in intensive care and not being able to bond more immediately with the mother.
  • Early induced deliveries are more likely to be risky and complicated as the mother’s body is not naturally prepared for delivery, so cesarean sections are increasingly more common.
  • Cesarean sections are major surgery. Any time a patient goes under anesthesia, not to mention undergoes surgery, there is risk for incident not only during surgery but in the recovery that follows.

The latest revised guidelines by ACOG may focus on the rising cesarean rate in the US, now standing at 31.3%.  However, in a press release on2/27/14, International Cesarean Awareness Network president, Christa Billings said ““There has been a disconnect between what medical research says and the way that hospitals and providers have practiced medicine for a long time.  These guidelines support what ICAN has been educating women on all along.  While this report is encouraging, it fails to address the nationwide problem of hospital and provider vaginal birth after cesarean (VBAC) bans.  With the primary cesarean rate at a high level, many women are seeking VBAC’s.  This important issue needs to be addressed by ACOG.”
The press release continues:
‘Part of ICAN’s stance, as outlined in their Statement of Beliefs, is that “It is unethical for a physician to recommend and/or perform non-medically indicated cesareans (elective). Women are not being fully informed of the risks of this option in childbirth, and therefore make decisions based on cultural myth and fear surrounding childbirth.” These new guidelines, as set forth by the ACOG and Society for Maternal-FetalMedicine (SMFM), are on track to help make sure that “non-medically indicated cesareans” happen less frequently and that women are given more opportunities to experience the natural process of labor and birth.
Since 2012, AWHONN (Association of Womens Health, Obstetrics and Neonatal Nursing) has promoted “Go the full 40” Campaign encouraging the natural onset of physiologic labor.  The March of Dimes has a similar campaign titled “Healthy Babies are Worth theWait.”

This demonstrates that we, as maternity health care professionals, STILL have a long way to go to reach the general public (as well as the medical establishment) with the evidence-based information.

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