Do We Really Need Another Childbirth Revolution?

The answer from Des Moines Register reporter, Rekha Basu, is yes.

Citing the late Elizabeth Bing’s  and Sheila Kitzinger’s monumental contributions to maternity care, Basu states that with the cesarean birth rate up 500% since 1970 and our infant death rate higher than most countries, fear and lack of education seems to be the causes.

Like the obstetrical community, the media is slow to change.  But with this article, dated May

30, at least the media seems willing to listen.

The World Health Organization states that 85% of the time, birth is an uncomplicated life event.  Only 15% of births truly are in need of a cesarean birth.  Cesareans are responsible for saving countless lives, both mothers and babies.  However, when Consumer Reports published, “The Risks of C-sections: What hospitals don’t want you to know” in February 2015, people sat up and took notice.

According to the Consumer Reports article, “In the U.S. far fewer babies are born on holidays such as the Fourth of July or days around Thanksgiving or Christmas, we found when we examined three year's worth of data on births compiled for us by the Centers for Disease Control and Prevention. That could be because hospitals tend to schedule C-sections for times when they are well staffed—or because doctors, and even some mothers, may not want deliveries to interrupt their holidays. That level of control requires increased use of interventions such as inducing, or starting, labor before a woman’s due date, which might increase the risk of cesarean delivery, or just scheduling a C-section from the start.”

With other new articles being published, new ACOG Guidelines, and childbirth organizations such as ICEA, Lamaze International and Childbirth Connection speaking out, both professionals and parents have a lot of quality information at their fingertips.  For example, hospitals around the country are examining their cesarean rate and making changes.  One of the leaders in this effort to reducing unnecessary cesareans is Denver Health Medical Center, where the cesarean rate is 7.9% (the estimated US cesarean rate is 32.8%).  Firm policies about the use of interventions that could cascade into a cesarean situation and an active midwifery care are two of the implementations DHMC has undergone.

So does the US need another childbirth revolution?

I think we are in the midst of one.  While it is slow moving, there are many things professionals can do to facilitate such a revolution:

Childbirth educators should:

Commit to teaching an evidence-based curriculum.

Make online resources available for the new parents in the classes.

Update current knowledge by becoming active in their certifying organization and attend an annual conference.

Labor and delivery nurses should:

Advocate for 1-1 nursing care of laboring moms.

Embrace doulas to assist in the physical and informational support.

Attend workshops that focus on non-pharmacologic pain relief skills.

Parents should:

Seek out certified childbirth educators for classes.

Be selective and interview their care providers, physicians and midwives.

Create birth plans that demonstrate forethought and education.

Yes, the answer is YES!