ICAN Press Release

For Release June 25, 2003
Contact: Tonya Jamois, President
(760) 744-5260
ICAN Urges Ban on Unnecessary Cesareans

    Redondo Beach, CA – The International Cesarean Awareness Network (ICAN) today called for a ban on unnecessary cesarean sections in response to 2002 statistics released by the Centers for Disease Control that showed an increase in the number of U.S. women delivering babies via cesarean section for the sixth year in a row.
    The CDC said 26.1 percent of U.S. women delivered babies via cesarean in 2002, the highest ever reported in the United States. This marks a 7 percent increase from 2001. According to the World Health Organization (WHO), cesarean rates above 15 percent represent a danger to women and babies.
ICAN attributes the U.S. cesarean increase to the wide availability of elective cesareans and the elimination of vaginal birth after cesarean (VBAC) options at some hospitals due to changes in ACOG guidelines.
    “Women who endure unnecessary cesareans face increased health care costs and increased health risks, including maternal mortality,” said Tonya Jamois, ICAN President. “We urge physicians and hospitals across America to restore safe delivery protocols and bring U.S. cesarean rates down to the 15 percent or less goal recommended by the World Health Organization.”
    In July 1999, the American College of Obstetricians and Gynecologists (ACOG) issued an updated practice bulletin on VBAC, replacing their previous recommendations of October 1998. The previous bulletin called for a surgeon to be "readily available" when a woman with a prior cesarean was in labor. The 1999 guidelines changed this to recommend a "physician immediately available throughout active labor capable of monitoring labor and performing an immediate cesarean." The practice bulletin also states that a contraindication to VBAC would be "inability to perform emergency cesarean delivery because of unavailable surgeon, anesthesia, sufficient staff, or facility."
    This change has had a profound rippling effect in the obstetric community. Some hospitals and doctors are now refusing to allow VBACs at their institutions or in their practices because they are unable or unwilling to meet the guidelines, thus forcing women into repeat surgery. Failure to adhere to the ACOG guidelines could leave a physician or hospital open to malpractice in the unlikely event of a uterine rupture causing harm to mother or baby. In most cases, VBAC is safe for both mother and infant. Repeat cesareans are linked to a host of complications for baby including: low birth weight; prematurity; respiratory problems; and lacerations. The risks to mother include hemorrhage; infection; hysterectomy; surgical mistakes; re-hospitalization; dangerous placental abnormalities in future pregnancies; increased percentage of maternal death. ICAN believes a repeat cesarean should never be considered routine. It is major abdominal surgery with many risks.
    ICAN recognizes that when a cesarean is necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. With half the cesareans being performed deemed unnecessary by WHO, the risks these mothers and babies are exposed to are avoidable and costly.
    ICAN is a nonprofit organization working to reduce the rate of cesareans through education, provide support for cesarean recovery, and promote VBAC. For more information, visit our website at www.ICAN-online.org or call Tonya Jamois at (760) 744-5260 or the ICAN office at (800) 686-ICAN.

(SEE ATTACHED CESAREAN RATES, STATE BY STATE AS REPORTED BY THE CDC)

2002 CESAREAN RATES
STATE BY STATE (ALL RACES)

United States ............ 26.1
Alabama .................... 28.7
Alaska ....................... 19.4
Arizona ...................... 21.3
Arkansas ................... 29.1
California ................... 26.8
Colorado ................... 21.1
Connecticut ............... 26.1
Delaware ................... 27.3
District of Columbia ... 26.6
Florida ....................... 28.5
Georgia ..................... 25.9
Hawaii ....................... 21.4
Idaho ......................... 19.7
Illinois ........................ 23.9
Indiana ...................... 24.9
Iowa .......................... 24.8
Kansas ...................... 24.8
Kentucky ................... 27.8
Louisiana ................... 30.4
Maine ........................ 25.7
Maryland ................... 27.5
Massachusetts .......... 28.0
Michigan .................... 24.9
Minnesota ................. 22.2
Mississippi ................. 31.1
Missouri ..................... 25.7
Montana .................... 23.0
Nebraska ................... 26.7
Nevada ...................... 25.7
New Hampshire ........ 24.1
New Jersey ............... 30.9
New Mexico .............. 19.1
New York .................. 27.2
North Carolina ........... 26.3
North Dakota ............. 23.1
Ohio ........................... 23.4
Oklahoma .................. 28.1
Oregon ...................... 23.4
Pennsylvania ............. 24.9
Rhode Island ............. 26.0
South Carolina .......... 28.6
South Dakota ............ 24.6
Tennessee ................. 27.5
Texas ........................ 27.9
Utah .......................... 19.1
Vermont .................... 21.1
Virginia ...................... 26.8
Washington ............... 24.0
West Virginia ............. 29.3
Wisconsin .................. 20.6
Wyoming ................... 21.1
Puerto Rico ............... 44.7
Virgin Islands ............. 22.1
Guam ......................... 20.4

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Source: National Vital Statistics Reports Vol. 51, Number 11, Table 7