Contact: Kara Dress; 202-367-2434; marketing@lamaze.org    

WASHINGTON (October 23, 2006)—Although the great majority of pregnant women in the United States are healthy and have good reason to anticipate uncomplicated childbirth, Childbirth Connection’s new Listening to Mothers II survey shows that technology-intensive childbirth care is the norm. The survey was conducted by Harris Interactive for Childbirth Connection, in partnership with Lamaze International.

The national survey polled 1,573 women who gave birth in 2005, and found that most mothers experienced numerous labor and birth interventions with various degrees of risks that may benefit mothers with specific conditions, but are inappropriate as routine measures.

Listening to Mothers II identified many gaps between womens’ experiences, their desires and best medical practice. For example:

• Within this largely healthy population, four labors in ten were started artificially and one mother in three had a cesarean.
• Eighty-five percent felt that a woman who wants a VBAC (vaginal birth after cesarean) should be able to make that decision, but most women who were interested in a VBAC were denied this option by their caregiver (45%) or hospital (23%).
• Virtually all of the mothers asked felt that they should be informed about all (79%-81%) or most (17%-19%) of the complications related to labor induction and cesarean before deciding to have these interventions, yet the majority of mothers were poorly informed about several complications of labor induction and cesarean section and most had incorrect knowledge or were not sure.
• Among the vaginal birth mothers that experienced episiotomies (25%), only 18 percent stated that they had been given a choice about it.

In addition to overuse of interventions, the survey showed a striking under use of several care practices known to be safe and effective, and especially appropriate for healthy, low-risk women, including Lamaze International’s Six Care Practices that Support Normal Birth.

Only a small proportion of women experienced these beneficial practices, including use of highly rated drug-free methods of pain relief (e.g., immersion in a tub, shower, use of large "birth ball"), monitoring the baby with handheld devices instead of electronic fetal monitoring, drinking fluids or eating during labor, moving about during labor, giving birth in non-supine positions, and pushing guided only by their own reflexes rather than caregiver-directed pushing.

“These findings are of particular concern,” notes Judith A. Lothian, RN, PhD, LCCE, FACCE, of Lamaze International. “The care practices that promote, protect and support normal birth appear to be unavailable to the vast majority of childbearing women in the United States.”

Study director Eugene Declercq, PhD, explained, “The survey found scant evidence of maternal request cesareans. Rather, mothers indicated that the primary decision-maker concerning their cesarean was their care provider, either during or before labor. In contrast to an image of doctors pressured by mothers to perform a cesarean, 25 percent of those mothers who had a cesarean indicated that they felt pressure from a health professional to receive their cesarean. This hardly supports the theory that the rapidly rising cesarean rate is based on maternal request. Research is needed into the complex interplay between mothers and their doctors regarding cesarean decision-making to better understand why the U.S. cesarean rate has risen 41 percent in the past decade.”

For more information on the survey results and to download the executive summary or to purchase the full report, visit www.childbirthconnection.org.

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Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area affiliates, its members and volunteer leaders include childbirth educators, nurses, nurse midwives, physicians, students and consumers. For more information about Lamaze International and the Lamaze Institute for Normal Birth, visit www.lamaze.org.

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