HealthDay News — Primary cesarean delivery rates can be safely reduced by implementing various interventions, according to a consensus statement published online in the March issue of Obstetrics & Gynecology.
In 2011, one in three U.S. women gave birth via cesarean delivery, prompting Aaron B. Caughey, MD, PhD, and colleagues from the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine to call for distinct, cause-specific approaches to safely reduce primary cesarean delivery rates.
The most common indications for cesarean delivery include labor dystocia, abnormal or indeterminate fetal heart rate tracing, fetal malpresentation, multiple gestation and suspected fetal macrosomia.
Definitions of labor dystonia may need revising in light of recent data that suggest labor progresses at a substantially slower rate than previously thought, according to the researchers. Improved and standardized interpretation and management of fetal heart rate may also have an effect.
Cesarean birth rates may also be reduced by increasing access to nonmedical interventions during labor, such as continuous labor and delivery support. Other examples of interventions include external cephalic version for breech presentation, and a trial of labor for women with twin gestations when the first twin is in cephalic presentation.
“Individuals, organizations, and governing bodies should work to ensure that research is conducted to provide a better knowledge base to guide decisions regarding cesarean delivery and to encourage policy changes that safely lower the rate of primary cesarean delivery,” the researchers wrote.