Raleigh, NC (PRWEB) March 16, 2010
In its recently publicized Sentinel Alert # 44, Preventing Maternal Deaths, the Joint Commission, a not-for-profit organization that accredits and certifies health care organizations in the United States, reported that maternal mortality is on the rise in the U.S. The report found that two of the four preventable pregnancy-related deaths were associated with cesarean section-the failure of hospital staff to pay attention to worsening vital signs after women have the operation, and the staff's inability to respond appropriately to hemorrhage resulting from a cesarean. The two others are uncontrolled high blood pressure and undiagnosed fluid build-up in the lungs of women with pre-eclampsia (pregnancy induced hypertension). Research conducted by the Coalition For Improving Maternity Services (CIMS) shows that by following the principles of the evidence-based Ten Steps of The Mother Friendly Childbirth Initiative (MFCI) and giving low-risk women access to midwifery care mothers' lives could be saved. The Initiative is an effective wellness model of maternity care that offers safe choices to overused and costly high-tech birth interventions that often lead to avoidable cesareans. According to the Centers for Disease Control there are 13.3 maternal deaths per 100,000 live births, about four times the target goal of 3.3 maternal deaths per 100,000 live births suggested by Healthy People 2010.
In its scientific publication, Evidence-Basis for the Ten Steps of Mother-Friendly Care, the CIMS Expert Work Group found that compared to maternity care provided by physicians to low-risk women, women cared for by professional midwives have a lower incidence of hypertension and pre-eclampsia, fewer hospital admissions for complications during pregnancy, fewer cesareans and more VBACs (vaginal birth after cesarean). The recent National Institutes for Health Consensus Conference, VBAC: New Insights confirmed that the risks of maternal mortality are increased with repeat cesarean section compared to vaginal birth after a prior cesarean.
CIMS supports a woman's right to choose where and with whom she wants to give birth. "By expanding access to and reimbursement for midwifery care, home birth, and birth centers for low-risk women," states Nicette Jukelevics, Chair of the CIMS Coalition Building Committee, "health outcomes for mothers and babies are improved and the risks associated with routine costly hospital interventions and cesarean section can be reduced."
In its Alert, the Joint Commission recommended a series of specific steps that hospitals and physicians could follow to prevent in-hospital maternal mortality. However, it made no recommendations to lower the overuse of high-tech birth interventions that can lead to avoidable cesarean sections. The US cesarean rate was 32% in 2007. Evidence shows that when cesarean rates rise above 15 percent health outcomes for mothers and babies worsen.
"Often we are concerned about the major health issues that cause maternal morbidity and mortality believing we can not affect change," states Jeanette Schwartz, RNC, President of the International Childbirth Education Association, an organization member of CIMS. "We forget about the simple changes that can make a big difference. We have control when it comes to changing routine birth practices used in hospitals today. If evidence-based care practices are adhered to, some of the identified issues in the Joint Commission Alert would decrease. There is evidence that hemorrhages are increasing secondary to unnecessary prolonged inductions of labor, which increase the risk for cesareans. Women who become pregnant after having a cesarean birth are more likely to have a placenta previa (one that attaches itself in the lower part of the uterus blocking the opening of the cervix) placenta accreta (a placenta whose blood vessels attach themselves beyond the uterine wall and to abdominal organs). Following The Ten Steps of the Mother Friendly Childbirth Initiative would be a simple start to help reduce the potential complications of pregnancy and childbirth. We need to stop and look at what we are doing and question if our birthing practices truly benefit mothers and their families."
To help increase awareness about the risks of cesareans, CIMS recently published The Risks of Cesarean Section: A CIMS Fact Sheet and About Cesarean Section, A Check List for Mothers To Read During Pregnancy, both available as a free download from http://www.motherfriendly.org .
About the Coalition for Improving Maternity Services: The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and well-being of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. This evidence-based mother-, baby-, and family-friendly model focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs. For more information, log on to http://www.motherfriendly.org/.
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