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Mothering › Pregnancy Articles › America's C-Section Rates Out of Control, but ACOG Refuses to Take Action

America's C-Section Rates Out of Control, but ACOG Refuses to Take Action


You may have noticed the press release with the winking ACOG eyeball can no longer be found on this Website.


As reported by Babble.com, the press release first appeared on CNN.com’s iReport but was pulled after it was discovered to be a prank.


As this post from another Babble.com blogger indicates, the subject of the press release–America’s skyrocketing C-section rate which is in violation of women’s fundamental rights–is anything but funny.


As the press release circulated via email and Twitter, bloggers have been writing about it:


*the Deranged Housewife “It’s clear to me that when it comes to the birthing choices of women, ACOG doesn’t really give a crap.”

*C-section Recovery Kit blog, and

*Owning Pink.


Yes, the press release was a prank.


I know because I wrote it.


Is it really a surprise that ACOG didn’t suddenly decide to advocate that women have their babies in the safest way possible?


Here’s how the real press release should have read:


For Immediate Release: ACCORDING TO BIRTH ADVOCATE JENNIFER MARGULIS, PH.D., ACOG HAS NO PLANS TO STOP ELECTIVE C-SECTIONS


The American Congress of Obstetricians and Gynecologists (ACOG) has made no announcement that it is devising a comprehensive plan to lower C-section rates in the United States. Instead, Greg Phillips, Associate Director, Office of Communications, The American College of Obstetricians and Gynecologists, has said that the April 1 press release indicating the organization would be spearheading a campaign to end elective C-sections “did not come from us and is clearly an April Fool’s joke.”


C-sections in the U.S. have gone up 700% since they were first measured in 1965, when the C-section rate was only 4.5 percent.


The nation’s C-section rate has been rising steadily for the last eleven years. It’s now over 31 percent. This is a deplorable situation that harms women and their newborns, but one that ACOG has continually downplayed or ignored.


Advertising itself as an organization that advocates for quality healthcare for women, ACOG has no plans to ask obstetricians to halt elective C-sections.


Though many birth advocates, obstetricians, gynecologists, nurse practitioners, midwives, and women’s rights advocates believe that C-sections should only be a last resort and should never be performed for the convenience of the doctor or for financial or liability reasons, C-sections are routinely done in this country when there is no medical necessity for them, often for the convenience of doctors or for fear of lawsuits.


Though the use of electronic fetal monitoring has been shown to increase unnecessary C-section rate without any proven benefit to the mother or infant, ACOG also has no plans to call on American hospitals to stop the routine use of electronic monitoring during labor.


ACOG has no new guidelines to encourage women to have freedom of movement during labor, labor standing up or squatting, and to eat and drink at will. In fact, given the organization’s repeated negative stance on out-of-hospital births, it can be inferred that ACOG actively opposes freedom of movement during labor.


Cesarean can save lives. But doctors and consumers have to remember that this is major surgery that carries major risk. Some examples: 29-year-old Abbie Dorn, suffered severe hemorrhaging and brain damage after her uterus was nicked during a Cesarean section at Cedars-Sinai Medical Center (2006), 32-year-old Diane Rizk McCabe died following complications from a Caesarean section at Albany Medical Center Hospital (2007), and Karen Vasques, 27, died during a C-section at Beth Israel Deaconess Medical Center (2008).


Maternal mortality has risen every year in the United States for the past 25 years, while over the same period the rate of C-sections has gone up 33 percent.


The skyrocketing rate of C-section in America has had devastating consequences but ACOG, the most highly respected organization of obstetricians and gynecologists in the United States, refuses to lead the fight to stop it.


Many people took offense at the original satire that I wrote to highlight how serious the problem is.


I had no intention of duping or disappointing those who really are leading the fight to stop a systemic problem in our medical system that has spiraled out of control.


I know that OBs who do not rush to C-section breech births, twins, and women who have had prior cesareans are often under tremendous pressure from the hospitals where they work, and from their colleagues, to do more surgery. There are many wonderful OBs who do not overuse the C-section operation, and they, too, advocate returning to a healthier balance and letting a woman’s body do what it evolved to do.


My dear friend who is having a baby on Friday via C-section was told by her OB that he forbids trial of labor. She is young and healthy. She has big bones and wide hips. But since she had an unnecessary C-section in her twenties, her doctor will not allow her to go into labor naturally.


A new mom recently posted her birth experience on a baby message board. Unfortunately, the only atypical aspect of her experience is that the doctor pretended to allow her to try for a VBAC. Here’s part of her story:


“After switching doctors several times during the course of my pregnancy, at the time I delivered I was under the care of an OB & Midwives group. I was told that I was a good candidate for VBAC, was offered water birth if things went well, and believed that I was in the best possible circumstances to avoid surgery & any un-needed medical intervention.


I arrived at the hospital dialated to 4. An hour & a half later, my water had broken on its own and I was dialated to 6.


Since I was laboring on a birthing ball, the midwife wasn’t confident about the fetal heartrate monitor, it was showing decels, so I was asked to consent to an internal monitor (screws into the baby’s scalp during labor). I refused the first time I was asked, then consented the second time. I consented because I thought my husband was beginning to panic and hoped that it would ease his stress. When I consented to it, I looked at my husband & said “That is medical intervention #1.”


Before the monitor was even plugged in, we were told that we were going to be moved to the OR “just in case” while being monitored more closely. The midwife had called an OB to consult & we expected to meet him in the OR.


On the way to the OR, my husband was sent to a dressing area to change into scrubs & I was sent straight into the OR. My husband & I were separated.


As soon as I reached the OR, the staff began prepping me for surgery. I stated that I did NOT want a c-section. I demanded to see my husband and stated that IF I was to receive a c-section my DH & I would make that decision together. I was told that my husband was on his way. I was also told that my baby needed more oxygen & I was told to breathe deeply in a new mask because it had a better seal on my face (the oxygen I was breathing before was thru a smaller mask).


The new mask wasn’t oxygen, I was gassed against my will.


I am unaware of what was done to me from the time I was gassed up until I awoke in recovery. I am assuming that I only had a C-section. Any further details have not been shared with me.


When my husband exited the dressing area & went to go to the OR, he was told that he couldn’t go in because I was already being anesthetized for surgery. He was not asked to consent on my behalf. He was not told that I had refused consent. He was not told that I had requested his presence. He was not told WHY I was having surgery.


I found out that my son had been born, and that I had been operated on, when I woke up in recovery. No medical professional came to me and spoke to me about my surgery. I have never been told WHY I required a c-section. I only know the name of the delivering physician because it’s on my son’s birth certificate. I never met him. He never came to talk to me before or after surgery. I also never saw the midwife again after I was wheeled into the OR…


I’m having an extremely hard time coming to grips with having been lied to and operated on against my will. I love my son, but I did not give birth to him. I was not present at his birth. That moment in my life has been taken from me … I don’t know if I’ll ever again be capable of trusting a medical professional to respect me as a whole person, instead of just a slab of meat ready for their whim. I thought that it was required of medical professionals to obtain informed consent whenever possible prior to performing surgery.”


Can we agree that what’s really cruel are experiences like these, not my April Fools joke?




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Tags: ACOG, April Fools Day prank explained, C-section, forced C-sections, intervention during labor, press release, unnecessary intervention



 

Comments (11)

Thank you for an incredibly distasteful and poorly thought out April Fools Joke. Just lost a reader.
I just don't think there's an easy answer to this. ACOG has to walk some fine lines here. I'm no expert and thankfully, I never had to make a decision about a c-section since all of my kids were delivered vaginally, but I can understand how it's difficult for moms to really advocate for their wishes during labor and how doctors are in a tough spot worrying about the health of the mother, child and unfortunately potential lawsuits. Has any organization come out with a solution/proposals to this? Midwife organizations maybe?
I don't know why you can't limit your joking to nice, safe topics, Jennifer!?
I knew it was you! Good work.
Sorry, folks: this isn't Utopia, and ACOG didn't suddenly decide to solve their behavioral problems and let natural childbirth work. Part of what I think Jennifer was responding to was ACOG's actual press release against home birth from January of this year, in which they wrote, "The College believes that hospitals and birthing centers are the safest place for labor and delivery." This, despite their admission that "the absolute risk of planned home births is low," and that "A review of the data also found that planned home births among low risk women are associated with fewer medical interventions than planned hospital births." Interventions like major abdominal surgery when it is not medically necesary. If you go to the hospital, there is a very slippery slope toward intervention. Let's be clear, though: the small percentage of truly necessary C-sections were never questioned, but called lifesaving. Only the unnecessary interventions, the tee-time C-sections, the lifestyle C-sections of convenience, were called into question. To claim that a third of the time babies need to be cut out of the mother before they are ready is to deny Darwin's natural selection. No selective pressure is greater than the ability to reproduce successfully; so childbirth must succeed very close to 100% of the time. Genes for anything else never get passed on. More fools we, when we contravene it.
I am really grateful for this blog, which covers important issues that matter to me as a grandmother. If the only way to draw attention to this tendency of American doctors to choose C-sections is through an April Fool's joke, so be it. I believe this issue merits a closer look by the media, but instead we get celebrities and more celebrities, even on CNN. My son's French wife was obliged to have a C-Section for her second child. I doubt that would have happened had the couple lived in France. C-section for medical reasons is a no-brainer. The issue is C-section being pushed as the standard procedure for childbirth in the United States.
April Fool's Day can certainly be problematic with press releases or news reports that appear oh, so real but aren't. It probably wasn't the greatest idea for ACOG to even issue a prank press release. But thanks for commenting on your honest error here.
C-sections as a life-saving measure, yes. But c-sections to make it easier to "schedule" a birth, to save the mother the "trauma" and fear of a vaginal birth, I don't think so. That's why it is so very important for us to be as informed as possible so we can be participants in our own medical care.
Jennifer, I think you brought this incredibly important issue into light. And I love it that you're able to turn an April's Fool joke into something really significant and bring attention to an issue that NEEDS to be recognized. What ACOG, doctors, and the insurance companies are doing is way, way worse than this absolutely mild joke. And what's way better than being mad about this joke is-- that we can take action against this ridiculous rising (and dangerous) trend here in America. Start with education, awareness, and bring it out there. Thank you, Jennifer.
When my second child was breech at 37 weeks I had an external version so that I could try to avoid a C-section. I knew that there was still time for the baby to turn, and I know that breech babies can be delivered vaginally, but I didn't want to have to fight with the hospital. If only that baby would turn before I went into labor, I could take the worry of fighting with doctors and nurses off of my mind. How ridiculous is that? The baby did turn, but if she hadn't I would have waited and tried other things and fought with the doctors, but I'm not a very confrontational person and I know that it would have been hard for me to stick to my guns once in labor and once the professionals had given me their very "reasoned arguments" as to why I would need this or that intervention. So, and intervention to prevent an intervention (and the version itself could have lead to an emergency c-section). I don't feel %100 good about my choice, but my baby was delivered vaginally one day after her due date and I only had one awkward moment with the nurse when I refused an IV.
I am not a litigious person. I think medical malpractice suits are part of the reason so many c-sections are done. Nonetheless, I hope, hope, HOPE that the mother in the story you related sues her OB, midwife and the hospital out of business and that it is in every paper and on every website around the world. That type of behavior on the part of the medical "professionals" is not just atrocious, it's an unforgiveable crime.
Mothering › Pregnancy Articles › America's C-Section Rates Out of Control, but ACOG Refuses to Take Action