[Federal Register: February 1, 2006 (Volume 71, Number 21)]
[Notices]
[Page 5346-5347]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr01fe06-104]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
State-of-the-Science Conference: Cesarean Delivery on Maternal
Request; Notice
Notice is hereby given of the National Institutes of Health (NIH)
``State-of-the-Science Conference: Cesarean Delivery on Maternal
Request'' to be held March 27-29, 2006, in the NIH Natcher Conference
Center, 45 Center Drive, Bethesda, Maryland 20892. The conference will
begin at 8:30 a.m. on March 27 and 28, and at 9 a.m. on March 29, and
will be open to the public.
Despite the national goal of reducing rates of cesarean delivery to
15 percent of births established as part of Healthy People 2010,
cesarean delivery rates have continued to increase. In 2003, 1.1
million or 27.5 percent of births in the U.S. were by cesarean
delivery. An estimated 2.5 percent of births that year were cesarean
deliveries performed on request, in the absence of medical necessity,
and the rate of cesareans on request appears to be growing rapidly over
time.
The potential benefits of elective cesarean delivery as compared to
vaginal delivery are not fully understood but are thought to include
decreased risk of urinary incontinence, pelvic organ prolapse, anal
sphincter damage and fecal incontinence. Elective cesarean delivery
also has the benefit of flexible timing for mother and physician.
However, like any major surgical procedure, there are risks associated
with cesarean delivery. Risks that are known to be higher for cesarean
deliveries than for vaginal delivery include adverse reactions to
anesthesia, breathing problems, bleeding, infection, urinary tract
injury, and injury to the baby. In addition, recovery time following
cesarean delivery is typically longer than for vaginal delivery.
Given these risks, any decision to deliver by cesarean delivery
when vaginal delivery is also available should be informed by the best
possible information regarding potential health outcomes, good and bad,
for both mother and baby. Toward that end, the National Institute of
Child Health and Human Development and the Office of Medical
Applications of Research of the National Institutes of Health will
convene a State-of-the-Science Conference from March 27 to 29, 2006, to
assess the available scientific evidence relevant to the following
questions:
[[Page 5347]]
What is the trend and incidence of cesarean delivery over
time in the United States and in other countries?
What are the short-term (under one year) and long-term
benefits and harms to mother and baby associated with cesarean by
request versus attempted vaginal delivery?
What factors influence benefits and harms?
What future research directions need to be considered to
get evidence for making appropriate decisions regarding cesarean on
request or attempted vaginal delivery?
An impartial, independent panel will be charged with reviewing the
available published literature in advance of the conference, including
a systematic literature review commissioned through the Agency for
Healthcare Research and Quality. The first day and a half of the
conference will consist of presentations by expert researchers and
practitioners, and public discussions. On Wednesday, March 29, the
panel will present a statement of its collective assessment of the
evidence to answer each of the questions above. The panel will also
hold a press conference to address questions from the media. The draft
statement will be published online later that day, and the final
version will be released approximately six weeks later.
The primary sponsors of this meeting are the National Institute of
Child Health and Human Development and the NIH Office of Medical
Applications of Research.
Advance information about the conference and conference
registration materials may be obtained from American Institutes for
Research of Silver Spring, Maryland, by calling 888-644-2667, or by
sending e-mail to consensus@mail.nih.gov. American Institutes for
Research's mailing address is 10720 Columbia Pike, Silver Spring, MD
20901. Registration information is also available on the NIH Consensus
Development Program Web site at http://consensus.nih.gov.
Please Note: The NIH has recently instituted new security
measures to ensure the safety of NIH employees and property. All
visitors must be prepared to show a photo ID upon request. Visitors
may be required to pass through a metal detector and have bags,
backpacks, or purses inspected or x-rayed as they enter NIH
buildings. For more information about the new security measures at
NIH, please visit the Web site at http://www.nih.gov/about/visitorsecurity.htm
.
Dated: January 24, 2006.
Raynard S. Kington,
Deputy Director, National Institutes of Health.
[FR Doc. E6-1272 Filed 1-31-06; 8:45 am]
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