Élan McAllister's Remarks
Press Conference Called by Betsy Gotbaum
Public Advocate's Office
July 13, 2005
My name is Élan McAllister and I'm here representing the public interest group, Choices in Childbirth.
In 2003, 123,412 babies were born in New York City hospitals. Of those
births (as the Public Advocate has stated) 26.4% were delivered
surgically via cesarean section. This rate is the highest in New York
City's history. It is also an indication that New York City is in step
with a growing national trend. Increasingly the American health care
system is relying on medical interventions to deal with what is, in the
majority of cases, a normal and safe physiological process.
Choices in Childbirth is deeply concerned by this trend. We are
concerned that the rates of obstetrical interventions (including
c-sections, inductions, episiotomies, epidurals, and other routine
practices) continue to climb despite the release of multiple studies
indicating the need for moderation. We are concerned that women are not
being fully informed about all of the risks associated with these
commonly performed obstetrical interventions. And we are concerned that
hospitals are not releasing their rates of interventions despite the
fact that New York law requires them to do so.
Choices in Childbirth is dedicated to educating the public about
women's rights and options in childbirth. We believe that women have
the right to know all of the information available to them when
choosing where, how and with whom they will birth. The city-wide
non-compliance to the Maternity Information Act denies women access to
critical information that would allow them to make fully informed
maternity care decisions.
The Maternity Information Act provides women with a valuable tool. At
the very least, having a pamphlet listing her hospitals rates of
obstetrical interventions will encourage a woman to ask a few
questions: Why is the cesarean rate 37% at this hospital? What is your
cesarean rate, Doctor? When do you consider a cesarean to be justified?
Will you support my decision to avoid a cesarean section unless clearly
medically justified? Should I consider going to a different hospital
where cesarean sections are not so routinely practiced?
Women are pretty smart. Most of us, when given all of the facts, know
that we don't want unnecessary abdominal surgery. We know that we don't
want to be given drugs that are untested and could negatively impact
ourselves and our babies. We know that we don't want anyone going
anywhere near our perineum with a pair of scissors!
The problem is that most of us are not being given all of the facts.
Most of us do not have access to all of the information that would
allow us to make fully informed maternity care decisions. Give women
this information. Trust that we are intelligent enough to know what to
do with it.
Thank you for coming and thank you Public Advocate Gotbaum for
realizing the importance of this issue and for committing yourself to
improving maternity care for the women of New York City.
- In 2003 37.3% of births at New York Hospital, Cornell Weil, ended
in cesarean section. This is despite the fact that a cesarean section
is major abdominal surgery that poses many risks to both mother and
child. And despite the fact that the World Health Organization
recommends a safe c-section rate of no more then 15% for any hospital,
including those treating high risk populations. I'm quite certain that
women going to Cornell Weil, hoping for a vaginal birth, have no idea
that they have chosen a birthing environment that condones such an
appallingly high rate of surgical births. How would they know, the
pamphlet that would give them this information isn't made available to
- In 2003 61% of women who gave birth vaginally in Staten Island's
St. Vincent's Hospital were given an episiotomy, or a cut to the
perineum to broaden the vaginal opening. This despite the fact that
multiple studies over the years have proven that routine episiotomies
cause more harm then good and should be used in less then 15% of
births. Yet I'm sure that the thousands of women birthing at St.
Vincent's every year don't realize that they're choosing a birthing
environment that clearly condones the practice of routine episiotomies.
How would they know? This pamphlet isn't made available to them.
- In 2003 41% of women birthing at Brooklyn Hospital had their labors
artificially induced. This despite the fact that none of the drugs used
for elective induction has ever been approved by the FDA for such use.
And despite the fact that all of the drugs and procedures used for
elective induction can cause adverse effects, including a higher risk
of cesarean section. You can bet that women birthing at Brooklyn
Hospital don't realize that they run such a high risk for being
induced. How would they know? This pamphlet isn't made available to
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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
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