[Federal Register Volume 71, Number 21 (Wednesday, February 1, 2006)]
[Notices]
[Pages 5346-5347]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-1272]


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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 [email protected]. 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]
BILLING CODE 4140-01-P