New CDC Report
"Trends in the Attendant, Place, and Timing of Births, and the Use of Obstetric Interventions: United States, 1989-1997," Sally C. Curtin, Melissa M. Park.
In 1997:
- 99% of all births took place in hospitals
- 92% of all births were attended by physicians (4% with Osteopaths)
- 7% of all births were attended by midwives (of teh midwife-attended births, 95% were attended by CNMs)
- The state with the most midwife-attended births was New Mexico (20%)
- The states in the Northeast with the most midwife-attended births were New Hampshire (14%), Massachusetts (13%), and Rhode Island (12%)
From 1989 to 1997:
- Cesarean section rates decreased from 22.8% to 20.8%
- VBACs increased from 18.9% to 27.4% - still shameful, but it represents a 50% increase
- The use of electronic fetal monitoring increased 22% (to 83% in 1997)
- The use of at least one ultrasound during pregnancy increased 35% to (64% in 1997)
- STimulation of labor (oxytocic augmentation of labor after labbor has been established) increased 6% (to 17% in 1997)
- Induction of labor (initiating labor without oxytocin) increased to 18% in 1997
- Forceps deliveries fell 49% (from 5.5% to 2.8% of all births)
- Vacuum extraction increased 77% (from 3.5% to 6.2% of all births)
- CNMs became more likely to practice in hospitals than in out-of-hospital settings (their attendance at births in birthing centers and privated residences dropped between 1989 and 1997)
- "Other" midwives attendance at births in provate residences increased; in birthing centers dropped
- Among births in out-of-hospital settings, home births are on the rise and birthing center births are decreasing
The report concludes,"In general it appears from the data in this report that despite the increase in midwife-attended births, obstetric interventions are increasing. Although cesareans have generally delcined, induced vaginal births have doubled.
Note: The accuracy of CDC statistics on "other midwives" is questionable, since only a few states include this information on the birth certificates (Texas is one of the states that does), and in illegal states "other midwives" rarely sign birth certificates.
A copy of the full report can be found here.