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FOR IMMEDIATE RELEASE
November 11, 2003
Childbirth And Postpartum Professional Association (CAPPA)
issues response to the recent ACOG Statement on Ethical Cesareans.
On October 31, 2003, the American College of Obstetricians and
Gynecologists (ACOG) addressed the controversy of elective cesarean
delivery and deemed it ethical to offer the surgical delivery option to
women whether or not any medical reason was necessary.
ACOG states
that evidence to support the benefit of elective cesarean is still
incomplete and is urging its membership to contribute to data that will
support this swing in practice standards.
Although this debate was
initiated by physicians, many feel it ultimately stems from the lack of
clear wording on the ethical response by a physician when presented with a
patient requesting elective cesarean surgery.
The current statistic
for cesarean surgery in the United States is approximately 25%. 1 in 4
women having a baby today will do so by surgical means. The World Health
Organization has handed down strong wording to the United States to lower
the cesarean rate to 15% or less.The statistic handed down by the WHO is
based on strong, scientifically supported evidence of short term and long
term benefits of vaginal birth for both the mother and the
baby.
The risks of cesarean surgery include higher incidents of
maternal death, more postpartum infections, more blood loss, risks of
injury to the baby, more breathing problems in the newborn, delayed milk
production in the mother, and increased risk of feeding difficulties in
the newborn. The more obvious problems with surgery versus a natural event
are higher costs and increased hospital stay.
CAPPA believes that
women's bodies are designed to give birth to their babies. Research shows
that the risks of damage to the pelvic floor are dramatically increased
through the use of forceps, vacuum extraction, episiotomy, and even the
lithotomy position for delivery. Without these interventions, the majority
of pelvic floor damage would be avoided in vaginal delivery. Physicians
have an ethical responsibility to disclose this fact to their
patients.
CAPPA believes that if women were given true informed
consent, in other words, if the physician were to give honest risks of
cesarean delivery vs. waiting to go into labor and delivering vaginally,
women would choose vaginal birth. Women must be informed of ALL the risks
of surgery before making a decision.
CAPPA challenges women to
become fully informed of their childbearing choices, and the long-term
consequences of their decisions. CAPPA supports the Midwifery Model of
care for most healthy women. CAPPA also supports a woman's right to choose
a caregiver with whom she feels physically safe. If a woman chooses a
physician to provide care during the childbearing year, this decision
should support a healthy outcome in compliance with WHO standards of
lowering the cesarean section rate.
CAPPA challenges ACOG and other
pro-surgery proponents to carefully study the benefit of vaginal birth to
the mother, the baby, and the maternal-child bond. Elective surgery cannot
be viewed as a simple means to meet patient demand. It is the ethical
responsibility of the physician to assure proper patient education,
support, and information so that the pregnant woman will have a healthy
pregnancy outcome, both in the short and long term.
For more
information and to find out how you can help CAPPA educate the public on
normal birth, please call 1-888-MY-CAPPA, visit our web site at http://www.cappa.net/ or contact us via
email at [EMAIL PROTECTED]
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