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ICAN Responds: “Today Show” Spreads Misinformation

kaboom_heres_your_babyIn response to the Today’s Show “Live in the OR” segment that showed a scheduled cesarean in progress , ICAN is appalled by the lighthearted tone and lack of in-depth information regarding cesareans. Dr. Nancy Snyderman downplayed the risks of cesareans while adding to the myth that suspected fetal macrosomia and being postdates are true absolute indicators for a cesarean.

We believe this type of media coverage is negligent and clearly spreads misinformation. Many women, especially those undergoing a first cesarean tend to fare reasonably well in terms of physical healing. That said, cesarean should never be the primary goal without serious medical reason, due to higher risks and poorer short- and long-term outcomes  for both mother and baby compared to vaginal birth, even with a suspected larger baby and “post dates” pregnancy. We believe this segment strengthens the myth that a cesarean is easier and safer for mothers and babies in spite of clear scientific evidence to the contrary.  Most women are not counseled as to the long-term consequences of a cesarean, including the increased risks of injury and death to both the mother and baby in any future pregnancyICAN challenges The Today Show to take a more critical look at the deepening crisis in U.S. maternity care rather than producing frivolous “medical” pieces that misrepresent the seriousness of cesareans and ignore the role the skyrocketing cesarean rate plays in one of the poorest maternal and fetal mortality rates in the developed world.

51 Comments

  1. Sara says:

    Right on ICAN! I too thought it was misinformation!

  2. Karin says:

    It floors me when they talk about the uterine repair and that since it’s a horizontal incision she can VBAC in the future and the doctor says “absolutely”! Whatever…

  3. What we suffer in this country is “truth decay,” all for the sake of 5 minute sound bites!
    We know the truth and will risk all to tell the truth and live the truth.
    “It is always the right time to do the right thing.” Dr. Martin Luther King
    Don’t let mothers and their babies suffer needlessly. ICAN embodies the importance of speaking from the heart, but with a truck load of evidence behind us.
    Thank you, ICAN, for taking a stand, being a flower in the desert and telling the truth 24/7.
    Be BOLD
    Love and blessings,
    Barbara Harper

  4. I am glad ICAN is responding to this. The segment of the Today Show yesterday was beyond disgusting and provided nothing short of dangerous misinformation.

  5. Karianna says:

    Thank you, thank you, thank you for responding to such dribble!! I was appalled that “The Today Show” even aired such a biased, misinformed piece!!

  6. melane says:

    Thanks so much for putting together a formal response. I was livid at this piece all the mis-information they spouted and very ashamed at Dr Nancy Snyderman for not correcting this OB.

  7. Dr. Mitchell says:

    It seems mainstream media wants to put a light spin on many types of medical interventions. Why is the media in bed with big pharma, and political medicine? Pregnancy is not a disease, and a cesarian is not a cure.

  8. Social comments and analytics for this post…

    This post was mentioned on Twitter by KushielsMoon: RT @ICANtweets ICAN responds to” Today Show” Spreads Misinformation – http://bit.ly/dpD1ba…

  9. STEPHANIE says:

    I was appaule they were doing a c-section based on the fact she was “past due date” and both mother and fathers family has a history of big babies, like women couldn’t give birth to big babies. I’m 5ft, small framed, and gave birth at home under a CPM naturally to a 8 lb 2 oz 20 1/4 in baby. I measured 3wks big my whole pregnancy because I am smaller, but I had no problems. A friend of mine, 5ft2in small frame gave vaginally and natural to 3 babies over 10 pounds. It can be done and safely. I personally think Drs want all the control over a womans labor and not let things happen naturally. With my first I was strongly encouraged for induction by my OB b/c I was only a few days past due date and having BH, it was the worse labor and I’m so thankful I had my second at home with an OB

  10. Kristen says:

    Dr Mitchell- you just hit the nail on the head. What a wonderful statement about c sections.

    I am so glad that ican is putting this out there. When I watched that video the other day I was applauded.

  11. STEPHANIE says:

    correction… without an OB

  12. Angela says:

    I am glad that there are so many people out there who are becoming more and more aware of the dangers of c-sections. First this horrendously erroneous and misinformed piece about c-sections and then a movie in the works about “What to Expect When You’re Expecting”. Why all of this media attention? Because doctors and hospitals do not make tons of money off of natural births. They sure do off of c-sections. I hope that the majority of people who saw this piece took it with a grain of salt and go about researching more on c-sections to get more accurate and informative information. Yeah, you can do a VBAC…good luck trying to find a doctor who will actually agree to do it when the time comes. I have heard so many doctors state that they will do a VBAC only to back off and say “NO WAY” when the moment of truth comes. Very misleading and very sad.

  13. Did anyone notice at about 6:55 Merideth says that her first baby was a “section”. Does that mean Merideth Viera has had 2 VBACs?

  14. Dani Arnold says:

    I just wrote to The Today Show to express my disgust with the episode……ugh!

  15. Anna says:

    I gave birth to twins vaginally and without any drugs. I just don’t understand why women are not more proactive about their babies health and their own. I did not see the Today Show, I have already quit watching it because of the false truths they spread.

  16. Rebekah says:

    Absolutely. If they’re going to claim to provide fair coverage, they need to get all the facts straight and included in their story. Sloppy reporting, that.

  17. Kudos to Jill at The Unnecesarean for her ace reporting today. Beth Israel Deaconess Medical Center’s actual Cesarean rate in 2007 was a whopping 42%.

    http://www.theunnecesarean.com/blog/2010/2/3/transcript-of-the-today-shows-live-cesarean-section-episode.html

  18. Ami says:

    I’ve always been a fan of the Today Show but not when Dr. Snyderman appears. Every segment preaches a highly medical model…remember a few months ago when there was a doula segment and she said doulas are a “luxury?”
    Sadly, I am not surprised at all about this segment.
    They should have Gisele on or moms of large babies who were really “large” (like my 11 + pounder) who were born in water and/or at home.
    Ami Burns, CD(DONA), LCCE, FACCE

  19. Diane says:

    I just want to say what a wonderful experience it was to watch the C-section. I had one 10 years ago and to see it I am so amazed. Thank you and god bless the that family.

  20. Joelene says:

    This is not the first time Nancy Snyderman has stated her personal opinion as medical fact. When she stated that, because of a suspected big baby and post dates, c-section was actually “safer” than a vaginal delivery I wanted to reach through the TV and shake her. It’s unfortunate she’s free to spread her misinformation so widely and get paid for it.

  21. mom says:

    I had an emergency C-section for my 1st child and a scheduled one for my 2nd child. I wouldn’t have done it any other way. My doctor told me I needed to have the emergency one and I trusted my doctor to make the best decision for myself and my child. My child was having complications during my labor. The doctor could get him out quicker by c-section then letting him suffer during a difficult labor. Next child was scheduled c-section and it was easy. No complications and I hate it when people act like it makes a difference in bonding with a baby based on vaginal vs. c-section. No emotional trauma here, no bonding issues, and I picked doctors I trusted to help me make the decisions about my deliveries. I am not ignorant and I am in healthcare.

  22. Katharine says:

    Is it reasonable to see pitching and slotting a soft-pedal piece casting cesarean section in a positive light as an indirect response of sorts to news coming out of California re maternal mortality and cesarean section?

    Pregnancy-related death rate on the rise
    http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/02/03/MNER1BRFT4.DTL

  23. Sandy says:

    Dear Mom,

    I had an emergency c-section for my 1st and I would have done it completely different. I was so fearful of the pain of childbirth I had an epidural. Ironically I endured the pain of an ileus, infected incision, and 10 day hospital stay. I should have trusted my body the first time around, instead of my doctor.

    Next child was a scheduled VBAC with a midwife and there were no complications and I bonded with my son right away, whereas I was too weak and sick to hold my daughter when she was born. Since you are so enlightened and work in healthcare, please don’t be so dismissive of those who did experience trauma and have bonding issues. It does happen even it didn’t happen to you.

    Thanks
    Sandy

  24. Michelle says:

    Dear Mom,

    Might I suggest that since you have not had an uncomplicated vaginal birth where you were immediately able to hold your baby, imprint her smell (prior to being wiped off and sanitized) that your bonding experience might have had the possibility of even being deeper than you can imagine?

    I’ve had a number of vaginal births and then a c-section. My bonding experience is quite different with this baby – I think we’re biologically wired to hold a wet baby covered in birth fluid – it’s very primal and I miss not experiencing that with my last child.

    And, while my c-section was necessary – cord prolapse and uterine torsion, I did experience many complications including a 4 inch section of the incision opening back up that took 6 weeks to heal and pneumonia. I’ve had 30 days of prednisone and 4 different antibiotics. There are residual issues still lingering.

    I’m grateful that the skill exists to safely delivery a baby via a c-section, but they’re not always walks in the park.

  25. [...] birth journalism, showed a live cesarean on air earlier this week. The birth advocacy community has weighed in on the shoddy reporting and the circumstances of the cesarean, pointing out that the stated indications (”big babies run in the family” and [...]

  26. Numerous studies have demonstrated that when you compare planned cesarean delivery with planned vaginal delivery (emphasis on ‘planned’), mortality is lower for mothers and babies, and morbidity is less severe for babies and comparable for mothers.

    Some of the posts here seem to be talking about risks associated with emergency cesarean outcomes (which are actually – in the majority – an outcome of planned vaginal delivery) and comparing them with the risks associated with a spontaneous vaginal delivery (which is entirely unpredictable even in the healthiest pregnancy).

    More importantly, in relation to the mother whose birth was filmed, I don’t think it is right for ICAN to infer that suspected macrosomia as an indication for elective cesarean delivery is a ‘myth’. Numerous studies have demonstrated very poor health outcomes for both mothers and babies in cases of macrosomia, and it should be up to women to make an informed choice about their preferred delivery type and tolerance for risk. For some women, this will be a trial of labor while for others it will be scheduled surgery.

    As I always remind readers, if you read the thousands of stories posted on any birth trauma website, it is evident that complaints about a negative maternal request planned cesarean birth experience are extremely rare (and in some cases, do not exist). The overwhelming majority of traumatic posts are from women whose planned spontaneous vaginal delivery resulted in assisted delivery or emergency surgery. I would suggest that we need to focus more on supporting this latter group and concentrate less on criticizing the former.

  27. Kate Hansen says:

    Thanks for doing this, ICAN. I also didn’t appreciate that they said that “This was the RIGHT way to deliver this baby, by c-section” when they found that he was 10 pounds. Many large babies, (as you know,) are delivered naturally with great success. My mother delivered my brother, an 11 pound boy, in under 6 hours. I think this whole size issue has really gotten out of hand. Many times I’ve heard of women being induced, for fear that their babies will be “too big” by the time they are term. There is no consideration given for positioning, and many babies only begin positioning themselves correctly when they are fully term.
    Thanks again, Kate Hansen

  28. Lauren says:

    Pauline,

    I would suggest promoting practices that help avoid the need for emergency cesareans, instrumental deliveries, & a traumatizing vaginal birth. I know there’s no guarantee one way or the other, & that the kind of birth you plan is not always what you get. I have a hard time believing many studies because they’re not comparing one intervention to a normal birth; they’re comparing one intervention to other intervened births. I understand why some people plan cesareans that aren’t medically indicated- because they feel it’s the only way to protect themselves from the typically demeaning hospital routine. There are better, safer alternatives than planning an elective cesarean to avoid or minimize the chances of a traumatic vaginal birth. I’ve had a planned cesarean, & I’ve had an unplanned cesarean after the hospital crap- I can understand the appeal of a planned cesarean, but I chose not to believe that that was my only other option for #3. I’m thankful every day that I didn’t plan a repeat for #3 & instead had a safe, normal birth with a “big” baby.

  29. Dana says:

    Pauline,
    I’d love to know where you are getting your information. The 2007 Declercq study (”Maternal Outcomes Associated With Planned Primary Cesarean Births Compared With Planned Vaginal Births” published in Obstetrics and Gynecology) showed the following:

    - A woman with a planned primary c-section was 2.3x mor likely to be rehospitalized in the 1st month postpartum.

    - Hospitalizations for wound complications were 14 times higher in planned c-sections vs planned vaginal births

    - Postpartum infection are major cause of rehospitalization in both groups but 2x as high in planned c-section group vs planned vaginal group

    - Cost for planned c-section was 76% higher than initial costs for planned vaginal birth

    - Authors noted that planned primary cesareans increased rapidly between 1998 and 2003 and appeared to be medically elective but that does not necessarily “maternal request cesareans.”

    - Mothers who planned cesareans had a 77% longer hospital stay

    - The findings of this study do NOT support one of the rationales proposed for elective cesareans – greater maternal convenience since mothers who planned primary cesareans face outcomes they may not have anticipated including more than double the chance of being hospitalized in the first month for complications associated with the surgery.

    Other studies have shown that babies are more likely to die following elective c-sections (http://www.nytimes.com/2006/09/05/health/05birt.html?scp=11&sq=&st=nyt) and they are more likely to suffer from respiratory issues (http://www.usnews.com/health/family-health/womens-health/articles/2008/12/18/elective-early-deliveries-pose-risks-for-babies_print.html)

    - Mothers are 3.6 times more likely to die following a c-section vs a vaginal birth. Even if you want to argue “planned” vs “not planned,” you cannot take away the risk of anesthesia, infection and venous thromboembolism that comes from any surgery.

    - There isn’t evidence to support elective cesarean for suspected fetal macrosomia. One half of all cases of permanent brachial plexus injuries occur in infants weighing less than 4,500 g (9 lb, 15 oz) according to this study: http://www.aafp.org/afp/2001/0115/p302.pdf

    On a final note, it would be hard to argue with the cesarean rate if it were truly being done as an emergency option. However, cesareans are very often used for reason like “failure to progress” and “cephalopelvic disproportion” before the mom ever got to the pushing stage. An increasing number of cesareans are being electively scheduled for reasons like this c-section on the Today Show. Sadly, cesareans like this do NOT follow evidence-based medicine. Situations like this are what put women at risk for this birth and subsequent births.

  30. blog says:

    Pauline, I think you will also find that nowhere in ICAN’s response is there a criticism of this mother or any other woman who chooses a cesarean. Rather, this is a critique of the Today Show’s cavalier and misleading coverage. ICAN does just what you suggest: provide education so that women can be fully informed and support for any woman who wants it who is recovering from c-section or pursuing VBAC.

    As for macrosomia, our response clearly takes issue with the inaccurate implication that cesarean is a “true and absolute” indication for cesarean, not that it is never a valid consideration (though, as other commenters have noted, it is overused and often invalid as a medical justification).

  31. My son was 11.3 lbs, I had him on the floor of our playroom. It took 5 hours of labor and 6 minutes of pushing with minimal tearing. Big babies are not an indicator that a section is needed, period.

  32. Melody says:

    Pauline,

    It is also important to note that even ACOG’s practice bulletins do not recommend cesarean for suspected macrosomia:

    “Cesarean Delivery. The role of cesarean delivery in suspected fetal macrosomia remains controversial. While the risk of birth trauma with vaginal delivery is higher with increased birth weight, cesarean delivery reduces, but does not eliminate, this risk. In addition, randomized clinical trial results have not shown the clinical effectiveness of prophylactic cesarean delivery when any specific estimated fetal weight is unknown. Results from large cohort and case-control studies reveal that it is safe to allow a trial of labor for estimated fetal weight of more than 4,000 g. Nonetheless, the results of these reports, along with published cost-effectiveness data, do not support prophylactic cesarean delivery for suspected fetal macrosomia with estimated weights of less than 5,000 g (11 lb), although some authors agree that cesarean delivery in these situations should be considered.”

  33. Kristen says:

    Pauline, I would love to see the studies that you are talking about. I personally have never seen any to the effects of supporting Elective Cesareans as safer than Vaginal Births. On the contrary, I have seen much research backing the fact that a Cesarea (major surgery) has many risks associated with it. I personally do not feel that many elective cesarean sections are performed with TRUE informed consent. When I had my cesarean section with my daughter, my doctor never once told me anything about the risks to me or my baby. I was young and stupid and followed blindly in the the battle. If my obstetrician had TRULY told me what risks I faced, I may have taken a different route. I believe it is the woman’s right to choose, but only in the event that TRUE informed consent is given, which in most cases, is not. And, as Melody pointed out ACOG doesn’t even recommend cesarean deliveries for fetal macrosomia with weights less than 11 lbs, which this baby was. I also do not think that ICAN is criticizing this mother, but rather the reporting done by the Today show.

  34. MacroMama says:

    My vajayjay and sex have never been better after pushing out two “macrosomic” babies, after my first unnecessary cesarean for another “macrosomic” baby.

    I feel so sad for women who have traumatic vaginal births, and therefore assume that a cesarean is the answer, instead of STOPPING THE PRACTICE OF INTERVENTIVE, TRAUMATIC VAGINAL BIRTHS in our culture!!!! But no, we couldn’t possibly question THAT could we? Better to just lie down and slice open our bellies and put ourselves, our babies, and our future babies at risk.

  35. Pauline, I am not sure where you got those studies from, but I have never seen a study of that nature, also, all the studies I have seen about elective/planned cesareans vs VBAC always show better neonatal outcomes. I have links for that too if you care to view them.

    When it comes down to it, elective surgery for no medical reason is a dangerous option and I would challenge the funders, and motive of ANY study that gives out such dangerous information as those you posted about.

  36. [...] ICAN response Comments (0) [...]

  37. There were big problems with other segments in the Today Show series as well.

    See comments on my blog about the atrial fibrillation ablation segment.

    http://www.healthnewsreview.org/blog/2010/02/whats-wrong-with-nbc-today-show.html

    Your voices are important. The NBC execs should pay more attention to “the wisdom of the crowds.”

    Gary Schwitzer
    Publisher
    HealthNewsReview.org
    Associate Professor, Univ. of Minnesota School of Journalism

  38. Joy Szabo says:

    Pauline,

    Please direct me to the studies you refer to. Better yet, send me copies. Whenever I find a study concerning patient morbitity or mortality after cesarean surgery, planned or unplanned, I am usually required to subscribe to a OB/GYN professional organisation. Since I am not an OB/GYN, I have difficulty subscribing.
    With the limited information that the public is allowed to have freely, I find vaginal birth to result in improved outcomes in all studies I have researched.
    Even logic would assert that a baby coming through the birth canal would be preferrable to abdominal surgery. I required a three day hospital stay after my cesarean, and only a 24 hour stay for my four vaginal deliveries by hospital protocol. Why this difference, If cesareans result in lower morbidity? I felt like I was hit by a truck after my cesarean, where I was up and ready to care for my family within an hour of the vaginal deliveries.
    Please sent requested information to:

    Joy Szabo
    PO Box 2265
    Page, AZ 86040

    If you require more information or would like to have a disscusion, my number is listed.

  39. M Treadwell says:

    Pauline McDonagh Hull is absolutely right. Prelabour caesarean section has lower perinatal mortality and severe neonatal morbidity and for the mother lower risk of haemorrhage, less perineal trauma lower rates of faecal incontinence and less brachial plexus injury. Conversely, there is evidence of some respiratory distress and caesarean section is not a good idea for those planning a large family as risks such as uterine rupture increase with each caesarean section. If you google NIH Consensus Statement on Caesarean on Maternal Request you will find the references alternatively Pubmed is a good source.

    I think some of the confusion is arising because people are comparing the planned caesarean groups with planned vaginal groups. They are not comparable cohorts – the planned c/s group will contain many high risk women. Moreover, emergency caesarean on a contracting uterus is a much more traumatic procedure than pre labour caesarean.

    So the balance there are risks and benefits of both vaginal delivery and caesarean – what is important is that women respect other women’s choices and understand that we all assess risk differently.

  40. blog says:

    It is absolutely true that women assess risks differently, and should be free to do so. Which is why I’d like return to the point of ICAN’s critique of the Today Show segment: the show presented cesarean as if there are no risks whatsoever to consider. ICAN supports women making fully informed decisions in childbirth. The Today Show segment did not inform. In fact, it misinformed.

  41. VBA2C mama says:

    I had 2 unplanned C-sections. During the second one my bladder was severed and I had to have emergency surgery at 3am and did not hold my baby until 9am. I had to use a catheter for 10 days, which was painful and a huge challenge with a newborn and 2 year old at home.
    I recently had an amazing unmedicated VBA2C at the Medical College of VA after most other VA hospitals and doctors turned me down. There were NO complications and the recovery was so much easier.
    Why don’t we ever hear about the C-section complications?? I now live in FL where I want to get involved with ICAN and VBAC mamas and have found out that there are very few FL hospitals that allow VBACS. How upsetting!!! A mother should have the birth she wants.

  42. Thank you ICAN for this awesome response. I appreciate it very much!

  43. [...] « ICAN Responds: “Today Show” Spreads Misinformation [...]

  44. [...] « ICAN Responds: “Today Show” Spreads Misinformation Mother-sized Activism: Tell NBC What You Think! » [...]

  45. [...] I totally agree with what ICAN had to say! [...]

  46. [...] Say it with me: suspected macrosomia. Baby Boy W is projected to be a monster, so much so that they can’t even permit her to [...]