05 May Medical Intervention, Helpful or Not?
For the past 20 years, labor induction and the cesarean rate in the US has been on a steady incline. Currently, approximately 30% of women are giving birth via cesarean and more than 22% of women are being induced, according to ACOG (American College of Obstetricians and Gynecologists). The presumption is that with the increase in medical intervention, there will be a decrease in infant mortality rate and newborn health. This does not seem to be the case since the United States still ranks near the bottom of 32 other industrialized countries in terms of infant mortality rate (6.7 infant deaths per 1,000 live births), yet continues to be number one for cost per birth. Are these interventions helping or hindering?
A recent study published in the April issue of The Journal of Maternal-Fetal and Neonatal Medicine was highlighted in the New York Times earlier this week. The study, conducted over a 4 year period and involving over 25,000 low risk women in 10 different hospitals in Upstate New York, compared the outcome of medicalized births involving labor induction and cesarean section births to those without such interventions performed. The study concluded there was little difference on the health of the newborn.
“Whether a hospital had high or low labor induction rates or high or low C-section rates didn’t seem to make any difference to the baby,” says study researcher J. Christopher Glantz, MD, MPH, a professor of maternal-fetal medicine at University of Rochester School of Medicine. “If you don’t improve the health of the baby by doing these things, why not try for a lower rate?”
Dr. Glantz goes on to say, “I am not saying that no inductions or cesarean sections are beneficial, I’m certain some are,” he says. “Be clear what the reason is if your obstetrician is suggesting an induction or cesarean section,” he says. “If it is done for marginal reasons or convenience, I don’t think that is a good reason and women should not agree.”
It is encouraging that such studies are coming out and being publicized. Cesareans and inductions have become such commonplace in our society that it can be overlooked that cesarean sections are still major abdominal surgeries with chance of risk to both mother and baby. Hopefully, this will encourage women facing these options to dive deeper into the risks versus the benefits before undergoing procedures
For more information about labor induction please read “Understanding Labor Induction”
For more information about cesarean sections please read, Medical Indications for Cesarean Sections, Fact vs Myth and To Cesarean or Not To Cesarean, That is the Question!
SOURCES:Glantz, J.C. Journal of Maternal-Fetal and Neonatal Medicine, 2011; vol 24: pp 636-642.J. Christopher Glantz, MD, MPH, professor, maternal fetal medicine, University of Rochester School of Medicine, N.Y.John Weitzner, MD, obstetrician/gynecologist, Rush University Medical Center, Chicago.