Wednesday, March 10, 2010

Dr. Hill Discusses C-Sections and the NIH Examines VBACs: A Progressive Moment for Birth in Sarasota

Dr. Washington Hill, director of Maternal-Fetal Medicine at Sarasota Memorial Hospital, appeared on HealthSmart today on WWSB with Heidi Godman. I would like to thank them both, so sincerely, for bringing maternal mortality, the rising c-section rates, and risks of elective c-sections to the local limelight.

I applaud Dr. Hill for calling out the rise in c-sections as a predominant factor in increased maternal mortality, and for discussing publicly some of the many risks of cesarean section.

The CDC currently reports maternal mortality at 13.1/100,000, and also acknowledges that due to reporting issues, the actual number is more like double to triple that rate. The numbers are high enough now for the Joint Commission to have recently issued a Sentinel Event Alert about the issue, which Dr. Hill mentioned.

While I agree that elective c-sections--both physician ordered and maternal request--are certainly part of the problem, I still have yet to see them among the list of top ten physician diagnoses for c-sections in Florida (which comprise over 75% of the surgeries). I have requested this information specific to c-sections at Sarasota Memorial Hospital.

I cannot thank Dr. Hill and Ms. Godman enough for bringing to public attention the importance of postpartum care. I would love to see Sarasota Memorial implement a permanent program for postpartum visitation.

This segment aired on the same evening that the National Institutes of Health has issued their Consensus Statement on Vaginal Birth After Cesarean (VBAC), following a three day conference on the issue. From the conclusion of the consensus:

"We recommend that hospitals, providers and policymakers collaborate on the development of integrated services that could mitigate or even eliminate barriers to trials of labor (TOL). We are concerned that medico-legal considerations exacerbate these barriers. We strongly recommend that policymakers and providers collaborate in the development and implementation of appropriate strategies to mitigate this problem."

I am so grateful and hopeful tonight.

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