If you're in the "birth scene," you probably know by know that ACOG, or the American Congress of Obstetricians and Gynecologists, has issued a new recommendation. The headline alone burns me up every-time I see it come through my newsfeed on Facebook. I had a ton of thoughts flood through my mind when I first read through the new recommendation, and honestly needed a little while to process those thoughts. So here's a few of them. Okay, my thoughts: On one hand, this is just a recommendation which is good, not a mandate. And I totally agree with the recommendation based on the fact that too many cesareans are done unnecessarily, but you probably already know that. On the same hand: Putting this recommendation out there could serve as a great reminder that cesareans should be avoided unless an absolute medical necessity. On the other hand lies the confusion between maternal human rights, informed choice and doctor knows best. I'm concerned that by putting this out there with the terminology of "maternal-request," that doctors will: A. Only think this concerns "maternal-request" cesarean deliveries. B. Use this as a crutch in their doctor-knows-all mentality. C. Use this to further the lack of choice given to mothers in their own care and that of their child. D. Use this to go even further and use more coercion and other forms of abuse or violence to force the mother to make a doctor recommended decision. Other thoughts: The article states: "Cesarean deliveries done at the request of the mother without a medical indication represent an estimated 2.5% of all US births." What about the other 97.5%? What about the fact that our national average for cesarean deliveries is wayyyy above the WHO's recommended allowance? Why does this have to be about "maternal-request" cesareans? Why is it pitting this on the mother? Why can't we talk about the greater issues at hand? It also goes into another issue: "Some women request cesareans because they fear childbirth pain, while others believe a cesarean will prevent urinary incontinence or preserve sexual functioning." They are probably very right in this assumption, but have no evidence here to back up the claim. Others request cesareans because they've been in labor for days. What about the moms who request a cesarean because they know their baby is a stillborn? I personally think most, if not all, moms should attempt a vaginal delivery. That's what evidence based care tells us. But I also believe in women's autonomy to make her own informed decisions. Clearly, ACOG believes there is an educational issue here, as well. Why not address that? Why not suggest prevention of moms requests cesareans? Or better yet, why not suggest prevention of OB/GYN's suggesting/coercing cesareans over vaginal deliveries? Why not teach them that natural childbirth is normal WHILE IN SCHOOL?!?!?!?!? Edited to add: I didn't realize at the time of this posting that ACOG also introduced another recommendation and I'm quite happy to see come through: "Suspecting a large baby is not a medical reason to deliver before 39 weeks, according to new recommendations issued today jointly by The American College of Obstetricians and Gynecologists (The College) and the Society for Maternal-Fetal Medicine (SMFM)." What are your thoughts on this new recommendation?
2 Comments
Lara
3/26/2013 04:53:08 am
I disagree completely with the recommendations. It is a woman's right to choose however she wants to give birth- be it a scheduled c-section, a home birth, a VBAC, a medicated birth or an all-natural childbirth. As long as it's an informed choice, nobody should be able to stop her from making it.
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