Although a Cesarean section can be a lifesaving technique for mother and infant, it is a major surgical procedure with substantial risk to both parties. Cesarean sections are now performed in nearly 25% of all deliveries in the United States - a dramatic increase from only 20 years ago.
Lack of progress in labor is a predominant reason for Cesarean delivery in the U.S., accounting for one third of the nearly one million Cesareans performed annually. Is this number too high? Yes, according to the American College of Obstetricians and Gynecologists’ (ACOG) published diagnostic criteria for abnormal labor patterns and guidelines for proceeding to Cesarean delivery. In a recent study, ACOG criteria were compared with actual clinical delivery practices involving 733 women in California and Iowa from 1993-1994.
A review of medical records and a postpartum telephone survey were used to gather data on proportion of unplanned Cesareans performed for lack of progress in labor; cervical dilation at time of Cesarean; length of second labor stage; and other variables. Results showed that lack of progress was a dominant reason for Cesarean delivery, even during the latent phase of labor or when labor was not prolonged (second stage).
The authors emphasize that “these practices do not conform to published diagnostic criteria for lack of progress.” In other words, too many Cesarean sections! Consult with your team of health care professionals during pregnancy to ensure a smooth, safe delivery.
Gifford DS, Morton SC, Fiske M, et al. Lack of progress in labor as a reason for cesarean. Obstetrics & Gynecology, April 2000: Vol. 95, No. 4, pp589-95.