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Birth, the American way

Rating

5 Star

Birth, the American way

Our Review Summary

Recent increases in the rate of Caesarean birth (or C-section) births have drawn attention to the phenomenon of women electing to choose the procedure over vaginal birth for convenience, appearance, concern about incontinence, sexual function or other reasons. However, studies have shown that elective C-section carries more risks than vaginal birth and should be reserved for only those indications that require it. This story reports on the recent publication in The British Medical Journal of a Latin American study showing an increase in mortality risk to the mothers with elective C-section.

This story does a great job of drawing attention to the problem of the potential overuse of elective C-section. The story is careful to point out that the the problem is with elective C-section, not conditions for which C-section is indicated.

The story adequately describes the design of the current study, however the story could have done more to discuss the limitations of the study and others like it. For example, it can be misleading to directly compare the risks of the two procedures because women who have C-section may have pre-existing conditions that place them at higher risk. And the story could have explored the extent to which the hospitals in South American are comparable to practices in the US.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story includes the note that "Caesarean can cost three times as much as normal birth."

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story provides information on the risks of C-section versus vaginal birth in absolute terms. [Because the story focuses on the harms of C-section, this criteria will be applied to the presentation of harms of the surgery, not the benefits.]

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story quantifies the risk of death in C-section versus vaginal birth. The story could have done more to describe other, more common risks, such as wound complications and infections.

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story adequately describes the design of the current study, however the story could have done more to discuss the limitations of the study and others like it. For example, it can be misleading to directly compare the risks of the two procedures because women who have C-section may have pre-existing conditions that place them at higher risk. And the story doesn’t explore the extent to which the hospitals in South America are comparable to practices in the US.

Does the story commit disease-mongering?

Satisfactory

The story is clear that there are clear indications for which Caesarean birth is appropriate but that the overuse of the elective procedure is concerning.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story quotes multiple sources, however only two of them are clinical experts, the others are authors of books or filmmakers.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story clearly mentions vaginal birth as the alternative to C-section.

Does the story establish the true novelty of the approach?

Satisfactory

Clearly C-sections are not new.

Does the story appear to rely solely or largely on a news release?

Satisfactory

Because the story quotes multiple sources, the reader can assume that the story did not rely on a press release as the sole source of information.

Total Score: 10 of 10 Satisfactory

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