American College Of Nurse-Midwives Calls For Accurate Reporting On New Nih Findings About Cesarean Delivery
The NIH conference report covers twenty-four outcomes for mothers and babies. In the case of twenty-one of those outcomes, the available evidence is labeled as weak-quality or absent. In the case of three of the outcomes, the evidence is labeled as moderate-quality. In the quality rating used by the panel, no evidence was deemed to be strong. The panel did make two important clinical recommendations: one is that cesarean delivery on maternal request is not recommended for women desiring several children, and the other is that the surgery should not be performed before 39 weeks, or without verification of lung maturity.
While ACNM believes it is appropriate for the panel to recognize that difficult surgical decisions must be individualized, new Listening to Mothers national survey data just released by Childbirth Connection reported that nearly 10 percent of survey respondents reported feeling pressure from health professionals to have a cesarean delivery. In the same survey, the majority indicated that it is necessary to know every possible complication before consenting to a cesarean section, yet the data also revealed that respondents were poorly informed about specific complications of cesarean section. The Listening to Mothers survey conducted by Harris Interactive is the only national survey to report mother's views and experiences with cesarean section. These results raise serious concerns about the adequacy of current informed consent processes for this major surgical procedure.
Health care professionals report that it is not unusual to find women who believe that cesarean delivery offers protection from problems with incontinence. The NIH report found only weak-quality evidence to support cesarean section as an appropriate approach to avoid urinary incontinence or other complications related to sexual function or bowel/bladder control.
"As long as we do not know if cesarean delivery on maternal request is the safest option, and we do know that a scarred uterus increases the risk of serious complications with subsequent pregnancies, it is not sound medical practice to do anything that encourages this option," said Deanne R. Williams, CNM, MS, ACNM executive director. "As health care professionals, who might be asked to help women consider these options, we must remember that women often change their minds about their plans for future pregnancies."
Better coverage - balanced reporting that offers a clear view of the NIH's findings - can be found in newspaper articles in USA Today, wire service reports such as from the Associated Press, and broadcast reports such as on National Public Radio. Health care professionals are likely to be deluged with calls from women who are reading or viewing misleading news reports, and ACNM encourages those professionals to direct women to more appropriate and informative sources of information.
Based on the NIH's findings yesterday, women need to seek out clear and understandable resources that can help them make an informed decision. Resources are available from organizations such as Childbirth Connection and Lamaze International, and ACNM encourages women, as well as media outlets working on this issue, to consider that information seriously.
With roots dating to 1929, the American College of Nurse-Midwives is the oldest women's health care association in the U.S. ACNM's mission is to promote the health and well-being of women and newborns within their families and communities through the development and support of the profession of midwifery as practiced by certified nurse-midwives and certified midwives. Midwives believe every individual has the right to safe, satisfying health care with respect for human dignity and cultural variations. More information about ACNM can be found at http://www.midwife.org.
American College of Nurse-Midwives
8403 Colesville Road, Suite 1550
Silver Spring, MD 20910-6374
ACNM 51st Annual Meeting & Exhibit
May 26 - June 1, 2006 - Salt Lake City, Utah
http://www.midwife.org
Colegiul American de sora-Moaºe solicitã exacte de raportare pe noi nih Constatãri Cesarean Despre livrare - American College Of Nurse-Midwives Calls For Accurate Reporting On New Nih Findings About Cesarean Delivery - articole medicale engleza - startsanatate