Press Release - BirthNetwork National Applauds New Guidelines to Prevent Primary Cesarean – Calls on Doctors and Hospitals to Implement Them Quickly

20 Feb 2014 3:48 PM | Deleted user

Media Contact:  Michal Klau-Stevens, [email protected]
BirthNetwork National Applauds New Guidelines to Prevent Primary Cesarean – Calls on Doctors and Hospitals to Implement Them Quickly

February 20, 2014 – BirthNetwork National is praising new medical guidelines published by leading medical societies to prevent primary cesareans, and is calling for action from doctors and hospitals to quickly implement the recommendations into practice and hospital protocols.

The new guidelines are based on careful research of the best available scientific evidence relating to birth and focus on preventing primary cesarean surgery.  They call for longer time allowances for first stage of labor, longer pushing stage of labor, increased use of instrument delivery, changes in managing variations in fetal heart rate as read with electronic fetal monitors, abstaining from inducing labor before 41 weeks without maternal or fetal indications, not using ultrasound late in pregnancy to determine if a baby is large, increasing continuous labor support and the use of doulas to provide that support, and increasing access to vaginal birth for breech babies and twins  in certain circumstances.

“Much of this evidence has been available for years, and we are very pleased to see such a well-researched and comprehensive set of recommendations being offered as practice guidelines for obstetricians. The next step is incorporating these guidelines into hospital protocols and doctors’ practices so that women and babies can benefit from them,” states Cheryl Gates, President of BirthNetwork National.

BirthNetwork National is calling on hospitals to change protocols by extending time limits for first and second stage of labor, promoting intermittent auscultation for monitoring fetal heart rate, restricting non-medically indicated induction of labor before 41 weeks, promoting the use of doulas for continuous labor support for mothers, and increasing access to vaginal birth with informed consent to mothers of breech babies and twins.

BirthNetwork National is also calling on maternity care doctors to implement these evidence-based guidelines into their practice, including abandoning the use of ultrasound late in pregnancy as a diagnostic basis for requiring cesarean delivery for large babies.  BirthNetwork National encourages doctors to utilize all the non-surgical tools and skills at their disposal to encourage vaginal birth and utilize the option of cesarean surgery only in cases of clear medical need.

The new guidelines will be published by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) in a joint Obstetric Care Consensus statement: Safe Prevention of the Primary Cesarean Delivery, in the March 2014 journal Obstetrics and Gynecology.

The ACOG and SMFM are the leading organizations of maternity care doctors, but not all obstetricians and maternal-fetal medicine specialists are members, and doctors are not required to follow the guidelines.  For example, new guidelines for Vaginal Birth After Cesarean (VBAC) were issued in 2010 by ACOG, yet few women around the country who are eligible to attempt a VBAC according to the recommendations are given the opportunity by doctors or hospitals to do so.

BirthNetwork National chapters can provide neutral ground for hospital administrators, doctors, midwives, nurses, doulas, childbirth educators, and other birth-related service providers to come together with expectant parents and find ways to implement systemic change.  For example, the New Jersey BirthNetwork chapter is hosting its second symposium in March, Supporting New Jersey’s Birth Plan: Implementing Evidence-Based, Mother-Friendly Practices in New Jersey, to continue the work it began last year of developing a state-wide plan that engages hospitals, providers, and patients.

The United States has the highest infant and maternal death rates relating to childbirth than any other industrialized country in the world.  Part of the reason for this appears to be from overuse of cesarean surgery as a mode of birth.  One in three women give birth by cesarean in our country now.  Cesarean surgery can save lives in certain cases, but is also associated with higher rates of negative outcomes for mothers and babies in terms of physical, mental, and emotional health as compared with vaginal birth.  The surgeries are also very expensive, adding to our nation’s already bloated healthcare costs.

Fear of litigation is often stated as an underlying cause for the high rate of cesarean.  Current practice seems to seek to avoid litigation, but actually increases risk to the health of women and babies.

“We understand that incorporating these changes into practice can be challenging, and we offer our encouragement and support to make them happen for the women and babies in our communities,” says Michal Klau-Stevens, president emeritus of BirthNetwork National.  “Changing practice and culture requires investment in training and engagement at all levels of the maternity care system, and we hope to see that investment made because the way women give birth truly does affect lives.”

BirthNetwork National is a volunteer-run consumer organization with fifty chapters around the country with the mission of improving the awareness and availability of Mother-Friendly maternity care.

A full media kit is available at

Contact Details:

BirthNetwork National

Michal Klau-Stevens, President Emeritus and Administrator

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