Despite continued reports in the medical literature of harm caused by cesarean surgery, the U.S. cesarean section birth rate has increased to 31.1% for 2006, an historic high, according to a new report released by the Centers for Disease Control (CDC). Lamaze International is alarmed by this rate, which should be no higher than 15 percent, and encourages women to seek care providers and birth settings with low cesarean surgery rates in order to improve health outcomes for themselves and their babies.

Research indicates that where and with whom a woman gives birth are two of the most important factors affecting her likelihood of having cesarean surgery. Regardless of her health status and risk factors, a woman who chooses a provider or birth setting with a low cesarean rate is less likely to have a cesarean. Research also has shown that providers and facilities can lower their cesarean section rates without compromising health outcomes.

Expectant parents should interview care providers and carefully select one based on criteria that will optimize the chance of a safe and satisfying outcome, including the frequency with which that provider uses interventions that carry risks.

"When selecting a care provider, expectant parents should go to great lengths to find out the rate of cesareans for their providers and their hospitals, as well as other medical interventions," says Lamaze International President Allison J. Walsh, IBCLC, LCCE, FACCE.

Unfortunately, the rates of cesarean surgeries for many care providers and hospitals are not readily available. Most states do not require their maternity care providers or facilities publicly report intervention rates, such as cesareans. Expectant parents also often lack the ability to verify or compare rates voluntarily reported by providers and facilities.

Lamaze International supports community-based initiatives that promote transparency in maternity care. This year, Lamaze is giving priority funding, through Birth Network Mini-Grants, to projects that work toward improving public reporting and transparency in maternity care.

Lamaze International believes that when medically necessary, a cesarean surgery can be a lifesaving procedure for both mother and baby, and worth the risks involved. However, hospitals and providers have a responsibility to report their cesarean rates because of the significant public health impact caused by injudicious use of this intervention. Cesarean section is a major abdominal surgery, and carries both short-term risks, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications with future pregnancies. Cesarean surgery also increases harm to babies, including breathing problems, surgical injury and difficulties with breastfeeding. Without transparency, parents cannot make informed decisions about the care and safety of mother and child, and they may unknowingly increase their exposure to injury from unnecessary interventions.

For more information on finding a health care provider, transparency in maternity care, and Lamaze International, visit lamaze.

Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area networks, its members and volunteer leaders include childbirth educators, nurses, midwives, doulas, lactation consultants, physicians, students and consumers. For more information about Lamaze International and the Lamaze Institute for Normal Birth, visit lamaze.