July 25, 2014 — The Pittsburgh Post-Gazette looks at how new guidelines on caesarean sections might be affecting rates of vaginal births (Smydo, Pittsburgh Post-Gazette, 7/21).
C-sections account for one in three births in the U.S. Although the procedure can be lifesaving, it carries serious health risks and is sometimes performed for non-medical reasons, such as convenience or physicians' fear of lawsuits (Women's Health Policy Report, 2/20).
At Allegheny Health Network in Pennsylvania, the number of c-sections spiked last year, prompting obstetrical department leaders to issue guidelines on when they should be performed. The department also began monitoring doctors' individual c-section rates. Allan Klapper, chair of obstetrics and gynecology at Allegheny, said, "It really took just a month or two, and the rates plummeted down to where they'd been historically" (Pittsburgh Post-Gazette, 7/21).
In February, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine published guidelines in an effort to reduce c-sections. The recommendations suggest doctors should give healthy pregnant women more time to labor before considering a c-section (Women's Health Policy Report, 2/20).
The Post-Gazette reports that there is increased interest in services by midwives and doulas. Ann McCarthy -- clinical director of the Midwife Center for Birth and Women's Health -- said the clinic is "struggling to keep up with the demand," with the center's midwives delivering 423 infants in 2013 and having an 8.5% c-section rate (Pittsburgh Post-Gazette, 7/21).