I have been a huge fan of Dr. Eugene Declercq and his team over at Birth by the Numbers ever since I watched the original Birth by the Numbers bonus segment that was found on the Orgasmic Birth DVD I purchased back in 2008. I was on the board of REACHE when we brought Dr. Declercq to Seattle to speak at our regional childbirth conference in 2010 and since then have heard him present at various conferences around the country, including most recently at the 2014 Lamaze International/DONA International Confluence, where Dr. Declercq was a keynote speaker. I enjoy listening to him just as much now as I did back in 2008. You may also be familiar with Dr. Declercq's work as part of the Listening to Mothers research team that has brought us three very valuable studies.

Birth by the Numbers has grown into a valuable and up to date website for the birth professional and the consumer, filled to the brim with useful information, videos, slide presentations and blog posts. This past Tuesday, the newest video was released on the website: Birth By The Numbers: Part II - Myth and Reality Concerning US Cesareans and is embedded here for you to watch. We shared Part I in a blog post last fall.

Also available for public use is a slide presentation located in the the "Teaching Tools" section of the Birth by the Numbers website designed to provide additional information, maps, data and resources for this new Myths and Reality Concerning Cesareans video. Included in this slideshow are notes and updates to help you understand the slides and share with others. This material is freely given for your use.

© Birth by the Numbers

This video explores how cesareans impact maternity care systems in the USA. After watching the video and reviewing the slides, here are some of my top takeaways.

1. The common reasons given for the nearly 33% cesarean rate in the USA (bigger babies, older mothers, more mothers with obesity, diabetes and hypertension, more multiples and maternal request) just don't hold water when examined closer.
2. Many women feel pressure from their healthcare provider to have a cesarean, either prenatally or in labor.
3. The leading indicators for cesareans are labor arrest (34%) and nonreassuring fetal heart tracings (23%).
4. The rise in cesareans is not a result of a different indications. Dr. Declercq quotes a 20 year old article's title that could still grace the front pages today. "The Rise in Cesarean Section Rate: the same indications - but a lower threshold."
5. When examining the distribution of cesarean births by states over time, it is clear that those states with the highest cesarean birth rate decades ago, still remain in those spots today.
6. "We are talking about cultural phenomena when we are talking about cesareans, not just medical phenomena."
7. First time, low risk mothers who birthed at term and experienced labor had a 5% cesarean rate if they went into spontaneous labor and did not receive an epidural. If they were induced and received an epidural, the cesarean rate was 31%.
8. The United States has the lowest VBAC rate of any industrialized country in the world.

'© Birth by the Numbers

While the video is rich (and heavy) in data laden charts and diagrams, the message, though not new, is clear. The US maternity care system is in crisis. We have to right the ship, and get back on course for healthier and safer births for pregnant people and babies. Take a look at this new video, and think about what messages you can share with the families you work with and in the classes you teach, to help consumers make informed choices about the care they receive during the childbearing year.

Please watch the video, visit the website to view the slides and let me know here in the comments section what you are going to use from this information to improve birth.

Published: March 18, 2015

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