Yesterday, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine issued a joint obstetric care consensus statement entitled, Safe Prevention of the Primary Cesarean Delivery. This groundbreaking statement has the potential to change how childbirth is managed in the United States- and prevent many unnecessary cesarean sections and other interventions.
Significantly, new recommendations include avoiding induction before 41 weeks (unless there is a medical indication); allowing for a longer latent stage and a longer second stage of labor; the use of amnioinfusion for variable fetal heart rate decelerations; and the use of instrument-assisted vaginal deliveries instead of cesareans when possible. The statement also notes that continuous labor support, including support provided by doulas, is one of the most effective ways to decrease the cesarean rate. In a nutshell, this ACOG and SMFM statement lends support to the midwifery model of care and the importance of allied birth workers and educators.
You can read the full statement here. A Science and Sensibility post by Judith Lothian, PhD, RN, LCCE, FACCE, summarizes many of the statement’s highlights in lay terms.