Should "failure to progress" = caesarean?

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Pregnant women whose labor stalls while in the active phase of childbirth can reduce health risks to themselves and their infants by waiting out the delivery process for an extra two hours ...

By doing so, obstetricians could eliminate more than 130,000 cesarean deliveries – the more dangerous and expensive surgical approach – per year in the United States ...

The study examined the health outcomes of 1,014 pregnancies that involved active-phase arrest – two or more hours without cervical dilation during active labor – and found that one-third of the women achieved a normal delivery without harm to themselves or their child, with the rest proceeding with a cesarean delivery.

... it is routine practice in many clinical settings to proceed with a cesarean for "lack of progress"

"One third of all first-time cesareans are performed due to active-phase arrest during labor ... "In our study, we found that just by being patient, one third of those women could have avoided the more dangerous and costly surgical approach."

The cesarean delivery rate reached an all-time high in 2006 of 31.1 percent of all deliveries ... [failure to progress] has been previously shown to raise the risk of cesarean delivery between four- and six-fold.

"Cesarean delivery is associated with significantly increased risk of maternal hemorrhage, requiring a blood transfusion, and postpartum infection," ... "... women also have a higher risk in future pregnancies of experiencing abnormal placental location, surgical complications, and uterine rupture."

... The study found an increased risk of maternal health complications in the group that underwent cesarean deliveries, including postpartum hemorrhage, severe postpartum hemorrhage and infections such as chorioamnionitis and endomyometritis, but found no significant difference in the health outcomes of the infants.

It concluded that efforts to continue with a normal delivery can reduce the maternal risks associated with cesarean delivery, without a significant difference in the health risk to the infant.

"Given the extensive data on the risk of cesarean deliveries, both during the procedure and for later births, prevention of the first cesarean delivery should be given high priority," ...

Melissa Maimann, Essential Birth Consulting 0400 418 448