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OB/GYN groups issue new guidelines to lower c-section rates

According to HealthDay News on Thursday, two major medical groups representing America's obstetricians/gynecologists issued joint guidelines on Wednesday aimed at curbing the overuse of cesarean sections in first-time mothers.

The biggest change in the guidelines is extending the length of time a woman should be allowed to be in labor, to help lower the odds she will require a C-section.

Many doctors and hospitals have a policy in place that forbids a woman to have a vaginal birth after cesarean (or VBAC). However, multiple cesarean sections put women at higher risks for complications, such as abnormal placental adherence, bleeding and even hysterectomy.

According to an American College of Obstetricians and Gynecologists news release, about one-third of American women gave birth by C-section in 2011, a 60 percent rise since 1996. And the doctors' group said that women having their first child account for about 60 percent of all cesarean deliveries in the United States.

Among the other guidelines:

  • Active labor should be considered to begin at a cervical dilation of 6 centimeters, rather than the previous 4 centimeters.
  • Women should be allowed to push for at least two hours if they've given birth before, three hours if they are first-time mothers, and even longer in certain cases, such as when an epidural is used for pain relief.
  • Vaginal delivery is the preferred option whenever possible and doctors should use techniques -- forceps, for example -- to assist with natural birth.
  • Women should be advised to avoid excessive weight gain during pregnancy.

Safe Prevention of the Primary Cesarean Delivery is the first in a new Obstetric Care Consensus series from the College and SMFM; the series will provide high-quality, consistent, and concise clinical recommendations for practicing obstetricians and maternal-fetal medicine subspecialists.

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Emily Sutherlin is also the Pregnancy Examiner.

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