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Caesarean section delivery and women's choice.

An independent panel convened by the USA's Medical Research Agency, the National Institutes of Health (NIH), announced on March 29 that the available information comparing the risks and benefits of Caesarean section (CS) delivery on maternal request (CDMR) with planned vaginal birth does not provide the basis for a recommendation in either direction.

The panel defined CDMR as a CS delivery at the mother's request when she has no established medical indication for the procedure. Panel members did find evidence to suggest caution in certain situations, concluding that CDMR should be avoided for women desiring large families. The panel further stressed that CDMR should not be performed before the 39th week of pregnancy or without verification that the fetus's lungs have matured sufficiently to avoid newborn respiratory complications.

The American College of Nurse Midwives (ACNM), among other midwives' and women's organisations, responded with vigorous criticism of the statement and of the quality of evidence used, pointing out that, of the 24 outcomes considered, the evidence in 21 cases is weak or absent. They also asserted that the risks of CS delivery are substantially under-reported. The ACNM has launched a Campaign called REDUCE--Research and Education to Decrease Unnecessary Sections

The NIH statement is available at ACNM is at
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Title Annotation:Worldwide news
Publication:International Midwifery
Date:Jun 1, 2006
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