Although a Cesarean section can be a lifesaving technique
for mother and infant, it is a major surgical procedure with
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.
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