Amnesty International today pointed to new government figures showing the highest-ever rate of Caesarean sections as more evidence the United States needs to adopt guidelines for the use of obstetric procedures to begin reversing rising pregnancy complications and maternal deaths.
Amnesty International, in its recent report, Deadly Delivery: The Maternal Health Care Crisis in the USA, called on President Obama and Congress to create an Office of Maternal Care to deal with systemic failures in care that have placed the United States behind 40 other countries in terms of maternal deaths, including virtually all industrialized countries. The human rights organization says that nothing short of a comprehensive look at the catalogue of problems associated with maternal care will begin to bring down the number of deaths and serious complications.
The National Center for Health Statistics reported that the Caesarean rate reached 32 percent in 2007, the highest rate ever. C-sections have become the most common operation in American hospitals.
The Amnesty International report (available at: www.amnestyusa.org/deadlydelivery) finds that many women are not sufficiently informed about the risks of medical interventions and procedures like c-sections or given the opportunity to actively participate in care decisions.
"Too often, women are not sufficiently informed about the risks and benefits of the maternal care and procedures they face," said Rachel Ward, Amnesty International USA research and policy director and a co-author of the Deadly Delivery report. "The U.S. government must see to it that women are aware more fully of the risks of interventions. This is both an ethical obligation and a responsibility under international human rights standards."
The risk of death following c-sections is three times higher than for vaginal births, and c-sections also increase risks in future pregnancies.
In addition to outlining problems ranging from insufficient postpartum care and lower rates of prenatal care among racial and ethnic minorities, Amnesty International's report called for national evidence-based guidelines for medical procedures, noting that there is a significant variation from state to state and hospital to hospital. For example, state c-section rates range from 38 percent in New Jersey to 22 percent in Utah.
The report found, for example, that the use of compression stockings following c-sections is not consistently followed in the United States while in other countries, such as the U.K., their use lowers the rate of blood clots following c-sections. Blood clots are a leading cause of maternal deaths.
The United States government set a goal of reducing c-section rates to 15 percent for low-risk, first-time mothers under the Healthy Peoples 2010 objectives, established in 1998, but has failed to meet the goal.
"Too many unnecessary c-sections are being performed; that is clear," said Ward. "And the government's failure to meet its own goals after 12 years suggests a new approach is necessary -- one that tackles the range of maternal health care deficiencies in a comprehensive, consistent way."
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