I realize that it is difficult to keep up with the obstetric literature, but I don’t think it is too much to ask that an organization that boasts about being evidence based should at least check to see that their recommendations are based on CURRENT evidence. There’s really no excuse for Lamaze International to promote an optimal C-section rate that has been withdrawn and discredited. That raises the question: is Lamaze promoting misinformation because they are so out of touch with what the scientific evidence shows, or are they promoting misinformation deliberately because they’d prefer misinformation that they like to accurate information that doesn’t serve their agenda?
I’m referring to the infographic promoted by Lamaze in today’s post on Science and Sensibility:
I used the magnifying glass to highlight the untrue claim:
“DOUBLE what UNICEF and the World Health Organization recommend.”
There’s just one teensy, weensy problem; actually it’s a very big problem. The World Health Organization (which UNICEF relied on) WITHDREW that recommendation 4 years ago, acknowledging that there was NEVER any data to support it.
In Monitoring emergency obstetric care; a handbook, published in 2009, the WHO admitted:
Earlier editions of this handbook set a minimum (5%) and a maximum (15%) acceptable level for caesarean section. Although WHO has recommended since 1985 that the rate not exceed 10–15%, there is no empirical evidence for an optimum percentage or range of percentages …
Where did that “optimal range” come from. It appears that Marsden Wagner, MD, a former WHO official, simply made it up. Wagner essentially admitted that there was no evidence when he published a paper in 2007 that claimed to be the first time anyone had attempted to correlate international C-section rates with outcomes.
The bottom line is that Lamaze International is aggressively promoting misinformation. The only question is whether Lamaze touts misinformation out of ignorance or as a deliberate attempt to mislead women.
In either case, it highlights that Lamaze International, far from recommending evidenced based practices, either doesn’t keep up with the evidence or chooses to misrepresent it. If you can’t belive Lamaze on a basic issue like this, how can you possibly believe anything else they have to say?