ICAN Responds to the Coalition for Childbirth Autonomy’s Statement on the Cesarean Rate

Statement Released 10/28/08b by the International Cesarean Awareness Network (ICAN)

The Coalition for Childbirth Autonomy (CCA) released a
statement today questioning the World Health Organization’s recommended cesarean rate of 10 – 15%.  CCA suggests that a woman should be able to request a cesarean without medical indication.  While ICAN supports both updated research on this topic and an increase in patient education and autonomy, we maintain that many women who are choosing a cesarean are making that decision without full informed consent.

Research shows that cesareans introduce additional risk in dozens of areas when compared to a vaginal birth.  For the mother, these increased risks include death, hysterectomy, bood clots, increased pain & recovery time, infection, and post-partum depression(1).  For the infant, additional risks include respiratory problems, breastfeeding problems, asthma in childhood(1), and type 1 diabetes(2).  In addition, there are increased risks in future pregnancies, such as infertility, ectopic pregnancy, placenta abnormality, uterine rupture, preterm birth, and stillbirth(1).

ICAN does not believe that cesarean should be the typical solution for fear of childbirth.  With appropriate counseling, most women who fear childbirth are comfortable attempting a vaginal birth (3, 4).  Most show long-term satisfaction with their decision to change modes of delivery (4), and with intensive therapy, labor times were shorter (3).

ICAN will continue to work to improve maternal-child health and to protect a woman’s right to ethical and evidence-based care during pregnancy and childbirth.

(1)  Maternity Center Association.  2004.  What Every Pregnant Woman Needs to Know about Cesarean Section.  New York:  MCA.  www.maternitywise.org.

(2)  Cardwell, CR et al.  Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia. 2008 May;51(5):726-35.

(3)  Saisto, T et al.  A randomized controlled trial of intervention in fear of childbirth. Obstet Gynecol. 2001 Nov;98(5 Pt 1):820-6.

(4)  Nerum, H et al.  Maternal request for cesarean section due to fear of birth: can it be changed through crisis-oriented counseling? Birth. 2006 Sep;33(3):221-8.

Fall Clarion Update

The Fall issue of the Clarion is wrapped up and nearly ready for bed.  I am excited about this issue for a number of reasons.  The submissions related to birth trauma have been outstanding – articles, birth stories, sketches, photos, and poetry.  Unfortunately too many women in our organization have looked birth trauma directly in the face, but by sharing these experiences we help others recognize signs, seek and find help, and know that they are not alone.

I am pleased to announce that we are working with a small publishing firm now, Lion Prints.  I met Rachell this summer at the golf club near my in-laws’ home in the Denver area.  She does publicity for Red Rocks Country Club and came highly recommended by my mother-in-law.  The moment I met Rachell, I liked her and knew we’d work well together.  She brings a fresh eye and enthusiasm to ICAN which will be clearly seen in the Fall Clarion.  She also designed the new header for the Clarion and for this blog!

Finally, I am grateful for Laura Possessky’s article on informed consent that she wrote for the Clarion.  For those of you who don’t know, Laura has a national practice in intellectual property, media, and entertainment law. For over a decade, she has counseled artists, nonprofits, associations and small businesses on intellectual property protection and on content transactions in publishing, television, film, media and the internet. Laura also advises clients on First Amendment issues relating to fair use of third-party content and intellectual property.  Additionally, she is General Counsel and an Alternate Workshop Host for Conscious Woman.  Click here to view her Conscious Woman Legal presentation information.

Can I get more copies?

It is a wonderful thing to be asked by Chapter Leaders for additional copies of the Clarion. Our CLs have good reasons for doing so! Each CL is given 4 extra copies of the Clarion each quarter to use at their discretion; the Clarion Editor does not receive extra copies for distribution. At this time it is not possible to purchase additional copies of the Clarion. An on-line version of the Clarion is in the works and may be the answer for giving new subscribers access to this quarterly benefit.

Coming Soon

It’s time for the ICAN Clarion to have a blog and a FAQ.  Check back soon for content!