ACOG Issues New Guidelines to Curb Overuse of C-Sections

Feb 27, 2014, 5:27 PM, Posted by

Tara Oakman Tara Oakman

While I knew that having children would turn my world upside down, I assumed that this transition would be more metaphorical than literal. Ha! Moments before I was discharged from a Maryland hospital a few days after my twins were delivered by c-section, the ground shook violently. My husband had just left the hospital room to get the car, so I was alone with two newborns and a painful surgical wound. All I could think was ... “This is an earthquake! I have two babies. And I can’t move!

One of the scariest parts of the experience was that I couldn’t respond to my maternal instinct to quickly pick up and protect my babies because I had just had major abdominal surgery. Granted, managing in an earthquake is not a common part of recovery from a C-section, but there can be many other dangerous complications that occur more frequently, such as infection, emergency hysterectomy or heavy blood loss. It can also lead to greater difficulty with breastfeeding. C-sections are also very costly, even if there are no major complications. They are much more expensive than vaginal delivery.

Despite the cost and risk, C-sections are the most frequently performed operation in U.S. hospitals and the rate has been increasing over time. Today, around 32 percent of deliveries are done by C-section—an 11 point increase since 1996.  Some of the explanations for the rise in C-section include an increase in rate of multiple gestation, maternal obesity, gestational diabetes, or hypertension. In many cases, however, delivery by C-section is not necessary, imposing excessive harm to mother and baby and needless additional cost on an already strained health care system, especially public insurance programs like Medicaid which pay for almost half of all births in this country.

This is why we applaud the American Congress on Obstetricians and Gynecologists (ACOG) for its release of new guidelines to prevent unnecessary C-sections. ACOG came out strongly against the overuse of C-sections by encouraging obstetricians to allow women to take more time to progress through a vaginal delivery without intervention, which research shows is healthier for both mother and baby. Obstetricians and gynecologists, as experts in childbirth, are in the best position to advocate for reducing unnecessary C-sections. They have taken a bold step in critically examining their practices and making evidence-based recommendations to improve women’s health and avoid unnecessary surgeries. C-sections can be life-saving under the right circumstances, but can threaten health when they are overused. ACOG’s new recommendations will help to keep more women safe from complications associated with unnecessary surgery.

As I learned taking care of my kids, it is important to minimize the aftershocks associated with childbirth whenever possible. A new baby is earth-shattering enough.

Tara Oakman

Tara Oakman, PhD, is a senior program officer at the Robert Wood Johnson Foundation focusing on strengthening vulnerable children and families and working to improve the value of national investments in health and health care. Read her full bio