OB says US C-section Rates Could Be Lowered

Did you hear about this study? Apparently the Chair of Obstetrics at Cal-Pacific Medical Center led an examination of some 41,000 births at Sutter Health hospitals in Northern California. What did they learn?

"This Sutter Health study is the first of its considerable size to clearly show how two very common hospital practices are important contributors to Caesarean birth risk," said Elliott Main, M.D.

Doulas, mothers, childbirth educators: what would YOU guess are the two common hospital practices that contribute to Cesarean birth?

Induction, you say? RIGHT!

Active management of early labor? RIGHT AGAIN.

Two for two. Anecdotal experience has informed us of what the doctors were able to prove by examining labor histories.

"First-time mothers often go straight to the hospital as soon as their contractions start," said Dr. Main. "Our study shows that women can reduce their risk of an unneeded Caesarean birth if they are admitted into the hospital only when they reach active labor, when their cervix is at least three centimeters dilated."

Steering clear of an elective induction of labor also helped avoid higher rates of Caesarean births. "Some women may like the idea of scheduling their delivery date, but inducing labor in first-time mothers should be done only when it's medically necessary and not for convenience," added Dr. Main.

I think I'm going to print copies of this article and give it to my clients. They really don't get that connection between a seemingly small intervention and the cascade it can cause.

Incidentally, the survey found out one more thing that probably won't surprise the "alternative" childbirth community:

Our study finds that infants born in hospitals with higher or lower Caesarean birth rates had the same outcomes," said Dr. Main.

I'd love to provide the link to the full study. Alas, it's available by subscription only in the July 2006 issue of Obstetrics and Gynecology.