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Can we Reduce the Rate of Cesarean Section Births?

 

Whether common knowledge or not, the Cesarean Section birth rate in the U.S. hovers around 31%. meaning that 1 of 3 babies in our country are born by Cesarean Section.  In the last 2 decades, the rate of Cesarean Section births has continued to rise, even for first-time mothers.  According to our national organization, ACOG, the most common reason for Cesarean Section birth among first-time mothers is abnormal progess in labor.  The rate of Cesarean Section birth among first-time mothers varies throughout the country, raising their concern for the re-evaluation and standardization of the definitions of 'normal labor progress' among practicing Obstetricians in our country.

 

Data from their more currently sited studies would suggest that labor may take longer than we were originally taught.  We know that the early phases of labor, from the start of contractions --to an active phase of dilation --can take may hours.  Once in the active phase of labor (previously thought to be >/= 4 cm dilated,) we've been taught that the dilation should then proceed at a more rapid rate.  Current studies would now suggest that the active phase of labor, where more rapid cervical dilation would occur, is >/= 6 cm, and that allowing more time to reach the active phase of labor, may more possibily achieve vaginal birth.  That being said, there are still established guidelines  by whch arrested labor is diagnosed, whereby Cesarean Section would then be recommended.

 

In my many years as a practicing Ob/Gyn, it's not been an uncommon scenario for a patient to be 'stalling out' in regards to labor progress, and to ask for more time in labor before a C-section is recommended.  It seems now that the research/science has finally caught up with her gut instincts!

 

 

Suzanne Hall, MD (@drsuzyyhall)

Eastside Gynecology Obstetrics, PC

Offices located in Macomb, Roseville, Rochester, Grosse Pointe, MI

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