Nursing Association Urges More Research into Elective Cesarean Sections and Health Impact on Mothers and Newborns

RELEASE DATE: April 3, 2006

STATEMENT OF KAREN TUCKER THOMAS, CAE, Executive Director, Association of Women's Health, Obstetric and Neonatal Nurses on the National Institutes of Health Consensus Conference Report on Cesarean Delivery on Maternal Request.

Cesarean deliveries (c-sections) on maternal request (CDMR), a subset of elective Cesareans, are a reality in the United States and one we need to take seriously and investigate thoroughly. The National Institutes of Health (NIH) State-of-the-Science conference has done a great service by focusing public attention on this important health care issue. Although c-sections are an important and necessary life-saving surgery when women experience complications during pregnancy or labor, women are increasingly requesting c-sections that are not medically necessary.

Consistent with the NIH State-of-the-Science expert panel's conclusions, the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) strongly supports dissuading women from having non-medically indicated c-sections prior to 39 weeks due to the risk for prematurity related to imprecise estimation of gestational age. Such c-sections contribute to the prevalence of near-term (most recently referred to as late preterm) birth and its associated serious health concerns including neonatal respiratory distress.

Earlier this year, AWHONN urged women considering non-medically indicated c-sections to thoroughly discuss this choice with their health care providers and ask about how the surgery might affect their babies. We continue to believe that educating women about both maternal and neonatal risks associated with cesarean birth is an important part of improving the health of women and newborns.

AWHONN agrees with the NIH State-of-the-Science expert panel's conclusion that CDMR is not recommended for women desiring several pregnancies. The evidence presented at this meeting demonstrates increased risk for complications related to the uterine scar, such as placenta previa. A placenta previa is an abnormal location of the placenta in the lower part of the uterus, near or over the cervix. This risk for complications related to the uterine scar increases with each subsequent c-section.

A key outcome of the NIH State-of-the-Science conference is identification of the need for additional research. AWHONN supports efforts to learn more about the frequency and health impact of CDMR. AWHONN also supports research that will help the health care community support and promote a women's choice of planned vaginal birth. Therefore, we urge the health care community to ensure that discussions and research are targeted toward further validation of the benefits of the variety of labor care practice and support options that can reduce trauma associated with vaginal birth and promote optimal outcomes for mother and baby.

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About AWHONN

A leader among the nation's nursing associations, the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) serves and represents more than 22,000 health care professionals in the US, Canada and abroad. AWHONN members are committed to delivering superior health care to women and newborns in hospitals, in home health and ambulatory care settings.

AWHONN members' rich diversity of skills and experience make AWHONN the voice for women's health and neonatal nursing. AWHONN received a 2005 Associations Advance America Award from the American Society of Association Executives for Promoting Health Among Hispanic Women through Toda Mujer, a Spanish language publication distributed free of charge to over 500,000 women through their nurses.

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