I woke up this morning to find this hair-raising headline in my Google Alerts from my nerdily beloved BBC:
Should There Be a Limit on Cesareans? The World Health Organization has dropped its recommendation that fewer births be carried out by Caesarean section, saying there was no evidence for a limit.
HOLY WTF, BATMAN! Courtroom Mama’s on the case!
I immediately wondered what they were citing, so using my trusty sidekick, Google, I discovered that the significant language (“there is no empirical evidence for an optimum percentage”) came, not from some new statement, but from the WHO’s 2009 handbook Monitoring Emergency Obstetric Care (pdf here).
Wait a second, that seems familiar…
Isn’t that the same report that says:
Pending further research, users of this handbook might want to continue to use a range of 5–15% or set their own standards… [t]here is no empirical evidence for an optimum percentage or range of percentages, despite a growing body of research that shows a negative effect of high rates. It should be noted that the proposed upper limit of 15% is not a target to be achieved but rather a threshold not to be exceeded.
And don’t forget
Many observers consider that we are experiencing a worldwide epidemic of overuse of caesarean section and that the rates will continue to rise, in view of practitioners’ and administrators’ fear of litigation, local hospital culture and practitioner style as well as increasing pressure from women in highly industrialized countries to undergo caesarean sections for non-medical reasons. At the same time, evidence for the negative consequences of caesarean section is increasing: recent studies in countries with high rates suggest that caesarean section carries increased risks for maternal and neonatal morbidity and mortality.
That’s a pretty far cry from Target to reduce caesareans scrapped as experts demolish ‘myth’ that they are more harmful.
Mystery solved. Does that mean I get to call it?
Shame on the press for putting this through the echo chamber. Jill at the Unnecesarean has a nifty angry letter you can send as a bit of Mother-Sized Activism.