Monday, July 16, 2007

NIH to study C-Section Rates and Appropriateness

This caught my eye last week. The NIH is gathering data to help doctors decide when to opt for a Cesarean section over prolonged labor.

I was not able to find out anything other than what was in the article, so I'm not sure how to read this. It could be good news or bad news, depending what slant they bring to the survey.

I did not find this quote encouraging:

"The main thing they're looking for is how long should a woman stay in labor who gets stuck," said Dr. James Fanning, Summa's chair of obstetrics and gynecology. "If the cervix starts to open up and then stops, or if she starts pushing and gets stuck, when should we quit? When should we say enough is enough, let's go with a C-section?"

It indicates a certain predisposition to think of labor as a linear progression without stops and starts. Who knows how they are conducting the survey (I tried to find info on it at the NIH website and couldn't), but it seems very vulnerable to bias. Unless objective third parties are present, all "assessment" of labor could be prejudiced. What one person might consider part of normal labor, another might consider being "stuck."

And it does not indicate that nurses or doulas or others who could work on fetal repositioning and other ways to change labor will be present.

I guess the more I write, the more convinced I am that this study will merely become more fodder for the "be safe, be surgical" line of thinking.



Blogger mamaloo said...

Perhaps we should be gifting copies of The Labor Progress Handbook to every nurse and OB we come into contact with? If the insurance companies gifted a copy to every medical birth professional in the US, it'd be a massive cost savings over a lot of those early interventions.

10:20 AM  
Blogger Brown Berry said...

After 2 C-sections, this is a topic close to my heart. Thanks for the awesome information you provide here to get/keep us thinking.

11:13 AM  
Blogger kristina said...

The part that got me that they claim the downside of waiting too long to perform a cesarean birth was the risk of "unnecessary pain". There are so many things wrong with this statement that I don't know where to start. There is no mention of other ways to mitigate pain (narcotics, epidural, and of course natural methods like water/massage/positioning etc). Also what about the unnecessary pain of recovering from potentially unnecessary surgery?

I was hoping that they would actually be studying risks to mother and baby, which would have been a very valuable study. It might have dispelled the myth that labor must follow a timeline to be safe. Harrumph.

11:44 AM  
Blogger Holly said...

From the NIH? Yeah, will be "conservative" in their conclusions. Makes me so angry.

2:37 PM  

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