Lies, damned lies and the American College of Obstetricians and Gynecologists

ISSN 0256-5004 (Print)

AIMS Journal, 2012, Vol 24 No 1

The American College of Obstetricians and Gynecologists (now called the American Congress of Obstetricians and Gynecologists) is considered by some to be the authoritative body on matters maternity in the USA. One expects, therefore, that its statements are based on facts. The reality is somewhat different.

Last year AIMS was sent a press release from ACOG's President, Dr Richard N Waldman, which stated: 'Attempting a vaginal birth after cesarean (VBAC) at home is especially dangerous because if the uterus ruptures during labor, both the mother and baby face an emergency situation with potentially catastrophic consequences, including death. Unless a woman is in a hospital, an accredited freestanding birthing center, or a birthing center within a hospital complex, with physicians ready to intervene quickly if necessary, she puts herself and her baby's health and life at unnecessary risk.' Bearing in mind the paucity of American statistics, AIMS wrote to Dr Waldman and asked for the following statistics for 2005–2009 which, one presumes, would support his claims.

How many:

  • booked home births occurred?
  • unbooked births?
  • booked VBACs?
  • unbooked VBACs?
  • ruptured uteri occurred during a booked VBAC?
  • ruptured uteri occurred during an unbooked VBAC?

Of those ruptured uteri, how many:

  • resulted in the death of the woman?
  • of those deaths occurred at home?
  • of those deaths occurred following transfer to hospital?

In the fullness of time, AIMS received nine pages of statistics which revealed the total number of caesareans, VBACs, the bir th rates (but nothing about place of birth, other than freestanding birthing centres), induction, amniocentesis, EFM, ultrasound, episiotomy, lacerations, and more statistics that failed to answer any one of the questions posed. None of the statistics covered the period 2005-2009; instead they sent statistics from 1979-2006!

None of the questions AIMS asked was answered, despite two reminders. It is clear that Dr Waldman had no evidence whatsoever for his claim.

Beverley A Lawrence Beech

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