Whoops! Newscore, BBC News and Fox News Forgot to Fact-check
Wednesday, June 30, 2010 at 8:18AM
By Jill—Unnecesarean
Newscore.com has allowed some sloppy journalism to slip through without any fact checking. The story was picked up by the BBC News, where health reporter Philippa Roxby wrote the article, “Should there be a limit on Caesareans?” FoxNews.com also ran the Newscore item titled, “Pressure Off to Reduce Number of Cesarean Births.”
Neither web site is accepting comments on articles, but this is my feedback.
How about some fact checking?
Page 5 of the WHO’s Monitoring emergency obstetric care: a handbook to which you refer clearly states: “The estimated proportion of births by caesarean section in the population is not less than 5% or more than 15%.”
The discussion on this, which you have partially cited, elaborates:
Although WHO has recommended since 1985 that the rate not exceed 10–15% (125), thereis no empirical evidence for an optimum percentage or range of percentages, despite a growing body of research that shows a negative effect of high rates (126-128). It should be noted that the proposed upper limit of 15% is not a target to be achieved but rather a threshold not to be exceeded. Nevertheless, the rates in most developed countries and in many urban areas of lesser-developed countries are above that threshold. Ultimately, what matters most is that all women who need caesarean sections actually receive them.
So the WHO still recommends, in their words, that “the proposed upper limit of 15% is not a target to be achieved but rather a threshold not to be exceeded.”
This was discussed in detail last year on the Science and Sensibility blog by Henci Goer.
If those quoted disagree with the WHO’s recommendation or take issue with their research, they should consider addressing it through proper channels instead of fabricating things in press releases. Please consider publishing a retraction or correction.
If any readers of The Unnecesarean are up for sending this to Newscore, the BBC News and FoxNews.com, please feel free. Newscore.com’s banner displays the following logos, so the story will probably pop up elsewhere.
Reader Comments (28)
That's infuriating! How irresponsible to release misinformation that can potentially damage women's health.
Webform to submit a complaint to the BBC site:
http://news.bbc.co.uk/newswatch/ifs/hi/newsid_4000000/newsid_4000500/4000545.stm
For fun, you can call Fox News at 1-888-369-4762
or email them at yourcomments@foxnews.com
It's not that hard to get through to a voicebox to leave a message for FOX.
Thank you - this is exactly what I said when I saw people reposting the article. That handbook specifically says "a threshold not to be exceeded." That does NOT mean "Yay! Elective cesareans for every woman are totally fine!" as that article would have us believe.
Hey, Jill - The data on page five has a footnote asking you to go to page 25 of the publication for further explanation. The FOX news piece used HALF of one sentence, leaving out what is probably the more important half! ALL THE WORDS COUNT! What I sent is below:
************
Hello!
I just left a voicemail on your watcher/listener/reader hotline but wanted to follow up with an email.
There is information in your piece entitled "Pressure off to Reduce Number of Cesarean Births"
located here: http://www.foxnews.com/story/0,2933,595468,00.html dated June 29th 2010
that is inaccurate and dangerous.
The article included a half of a sentence found on page 25 of the WHO document referenced.
The entire sentence reads as follows:
"Although WHO has recommended since 1985 that the rate not exceed 10–15% (125), there is no empirical evidence for an optimum percentage or range of percentages, despite a growing body of
research that shows a negative effect of high rates (126-128)."
It goes on to say: It should be noted that the proposed upper limit of 15% is not a target to be achieved but rather a threshold not to be exceeded. Nevertheless, the rates in most developed countries and in many urban areas of lesser-developed countries are above that thresh- old. Ultimately, what matters most is that all women who need caesarean sections actually receive them."
With many regions of the United States hovering around the 30% range of c-sections from all births - some even touching 40% and above - it is dangerous to publish material such as this that indicates that what is actually major surgery is not more than a routine procedure.
Additionally, evidence shows that cesarean delivery (along with early inductions) could be a contributor in newborn and maternal complications and even death, along with a major factor in the difficulty of establishing and maintaining breastfeeding relationships.
As a childbirth educator, breastfeeding counselor, and mother of four children - three of whom are girls, I ask that you publish a retraction immediately. There is so much out there that can be written in favor of the promotion of healthy birth practices that benefit both mom and baby, without putting anyone at unnecessary risk.
Thanks for your time,
Foxy.Kate
****************
Can you tell my mom took the baby and the older kids are at camp? Look at me with all this time on my hands!! Wheeeeee!
Terrific, foxy.kate!!
Nice, foxy.kate! Way to use your actual free time today.
If people take issue with the research or don't think it's realistic, there are legitimate ways to critique it that don't involve being disingenous. I think a lot of people would be interested in reading some real criticism. There seems to be a gap in logic in the argument that lowering the cesarean rate will result in forcing women to give birth vaginally against their will and denying them necessary cesareans. How about working on swinging the pendulum back by reducing unnecessary and unwanted cesareans? That was part of the WHO's handbook: "Ultimately, what matters most is that all women who need caesarean sections actually receive them."
Anyone have any thoughts about the electivecaesarean.com site featured in the BBC article?
I'm new to all of this. Could someone summarize for me which are the necessary C-Sections and which are the unnecessary ones. Thanks.
@Rita Cord prolapse, placenta previa or one of the major placental issues that are virtually unheard of except in women who've had cesareans already, placental abruption unless the baby is practically born. Severe pelvic deformation. Extreme declels of the baby's heart that don't return to normal. Transverse lie. I think those are the only "real" reasons for a cesarean, although I may have missed one or two.
^^ I would disagree on the placenta previa being virtually unheard of in any women but those with prior cesareans. I know the risk increases, but it does happen to other women (and often for reasons involving scarring of other types, as in previous surgical procedures, including D&C). There are other risk factors as well. Most cases resolve by the end of pregnancy, so only a very small percentage end up affecting labor, but it does occur to women without prior cesareans. (I had one up until week 34 with my daughter, my first and only birth so far. I know that's an anecdote, but the number back me up.)
Since my website has been mentioned here, and I am one of the authors of the original October 2009 press release on this subject, I just wanted to post the rebuttal I'd written to Henci Goer's post since you also mention that here.
Unfortunately, time constraints mean that I cannot enter into further debate here today, but I believe that my comments in the above blog post are sufficient to answer most of the questions you may have.
Incidentally, your elaboration of the WHO's statement, above, is still not the full citation, as you will read in my blog post:
http://cesareandebate.blogspot.com/2009/11/my-response-to-who-press-release.html
I'm sorry, but did I miss something? Is someone really arguing that a planned cesarean delivery (ie. major abdominal surgery) is better for the mother and baby than the baby coming out the way it was meant to?!
sorry....I just can't believe that, and research doesn't back it up...so I just can't fathom setting up a whole website to convince women that cutting their babies out of their bodies at 39 weeks is a-okay.
rant over.
@ Pauline (and Pauline's blog), you feel that data actual do not support the fact that Cesareans cause potential harm? What about the evidence used by the NIH in formulating their statement on VBACs? Cesareans were associated with increased maternal death, future placental problems (even with one previous Cesarean), etc. How about the actual monetary cost, which is spread around to everyone who pays into a public or private insurance plan. I don't get it. Why dispute that very high Cesarean rates are a negative thing overall for women?
http://consensus.nih.gov/2010/vbacstatement.htm
http://www.ahrq.gov/clinic/tp/vbacuptp.htm
Pauline wrote: "Incidentally, your elaboration of the WHO's statement, above, is still not the full citation..."
I pulled the paragraph in question from the handbook, which is available to the public online. Since the entire handbook is linked and readily accessible, I encourage everyone skeptical about the recent series of articles the simply read the handbook itself.
It looks like Pauline, the creator of the electivecesarean.com site has a "debate" blog, so I'm assuming she wants people to go debate her. cesareandebate.blogspot.com. I don't know much about it, so you could probably take it up there. This particular post about fact-checking has nothing to do with the benefits of 39 week wanted cesareans performed without medical indication.
The issue of the Newscore, Fox, BBC, etc. articles that popped up in late June regarding the WHO handbook is resolved simply by reading the handbook in question, a step that none of the new outlets appears to have taken the time to do.
Hi Rita,
One good place to start for information on the current climate of cesarean overuse in the U.S. is Childbirth Connection.
A quote from a personal anecdote on the Cesarean Debate blog:
"Joanna: admitted that she’d asked for caesarean just so that she could have a Virgo baby rather than a Libra. Her doctor did nothing to dissuade her, she said. “I’d heard that Virgo boys are easier going than Libra boys and so I asked to be booked in for a c-section on September 20. My due date was September 22 which was too close to the cusp and I didn’t want to risk it.”
*head explodes* Is this site a joke?
Another good one:
Katerina: “I was terrified of natural childbirth. I just couldn’t take the thought of the pain. I then thought that it would be more convenient to know the specific date so that I could have everything ready. I discussed it with my doctor and he agreed to perform a c-section... I don’t regret it for a minute. It was painless and harmless. They say the recovery time takes longer but a friend of mine who gave birth naturally developed an infection after they had to cut her during labour and took even longer to recuperate. I don’t think I could have handled being cut. I just couldn’t bear thinking about it."
Um, Katerina? You do realise that a cesarean section requires being cut, right? Across the abdomen and uterus and through several layers of fat, muscle and tissue?