As some families gather Monday to mark the last holiday of the summer, other families will rally in Fort Myers to raise awareness about the state of maternity care in the United States.
About 100 people are expected to gather outside of Gulf Coast Medical Center as part of a movement called the National Rally for Change. The aim is to raise awareness about what the group maintains is the lack of evidence-based maternity care.
Rallies will be hosted in more than 100 major cities across America.
Angela Bailey, a co-leader with the Southwest Florida Birth Network who helped organize the Fort Myers rally, explained that supporters want to see a cut in elective induced labor and medically unjustified Caesarean sections.
"Many mothers are unaware of the risks, and they think these things are normal," she said, adding that many later find out their procedure was unnecessary.
"It's more for women to have an informed choice," Bailey said.
She reported that electing to induce labor increases a woman's risk of requiring a Caesarean section, or C-section, by about 50 percent.
"It's major abdominal surgery," Bailey added, emphasizing one risk.
"And the recovery time is harder than with a vaginal birth," she said.
Improving Birth, a non-profit organization founded with the mission of encouraging hospitals to review their birth-specific policies and procedures, is spearheading the massive, nationwide movement set for Labor Day.
"This is not a protest," founder Dawn Thompson reported. "It is a public awareness campaign to bring attention to the outdated practices that have been proven time and again to not be what is best for mothers and babies."
The United States reportedly outspends every country in the world for maternity care, yet America still ranks 49th for maternal mortality rates.
"Although we spend and spend and add more technology, the (maternal mortality) rate has gotten worse," Bailey said.
Constant electronic fetal monitoring and the restriction of food and water during labor are some of the routine practices with which the group takes issue.
"Research does not show them to be beneficial," she said. "There's no scientific evidence that shows that that needs to be done."
Last year, Lee Memorial Health System applied for and was accepted as a participant in a statewide collaborative put together by the March of Dimes. The aim of the effort is eliminating elective deliveries before 39 weeks.
A baby is considered "full term" at about 39 or 40 weeks old.
"Lee Memorial Health System supports evidence-based practices and obstetrics," Nancy Travis, the director of Women's Care Birth Suites at the Cape Coral Hospital, said. "We have been working very hard since 2011."
As part of the collaborative, LMHS set policy that prevents all elective deliveries - induced labor and C-sections - unless medically warranted.
"It has to be part of their medical record, and it has to be sent to us," Kathy Bridge-Liles, the vice president of Women's and Children's Services, said.
In an effort to ease into the change, LMHS held an educational seminar for about 100 providers and OB-GYNs to cover the reasons behind the policy.
"Had we not done that, we would have had a lot of pushback," she said.
Bridge-Liles explained that prior to the policy being set, a physician or mother-to-be could ask for a delivery on a specific date for any reason.
"There really wasn't a process in place to prevent that," she said.
As a result, babies were being delivered before reaching full development.
"We had been seeing that babies were being born a little bit earlier," Travis said, adding that elective deliveries were occurring at 37 and 38 weeks.
According to the Southwest Florida Birth Network, the World Health Organization suggests a C-section birth rate of 15 percent or less when dealing with primary Caesareans - women having their first C-section.
"It should not be any higher than 15 percent," Bailey said.
From 2008-2010, Lee County had a C-section birth rate of 35.9 percent, ranking 23rd in Florida. Charlotte County took 20th at 36.6 percent, while Collier County ranked seventh with 39 percent, according to the network.
Florida's C-section rate during the same period was 37.8 percent.
"Cape Coral (Hospital) has the highest C-section rate right now between Collier, Lee and Charlotte," Bailey said.
Gulf Coast Medical Center reportedly has the lowest induction rate. She attributed it to a higher number of midwives than OB-GYNs on staff.
According to Bridge-Liles, the higher number of C-sections at the Cape hospital is due to the types of scenarios that the medical staff see.
"C-sections are not called unless there's a danger to the mom and baby," she said.
As for the countywide rate, Bridge-Liles pointed to the collaborative.
"I think that when you are looking at an initiative this large that impacts everyone's perceptions," she said. "I think that it's an evolution."
"Over time it's going to reduce the C-section rate," Bridge-Liles said.
Travis added that LMHS offers tools to help mothers have a natural birth, including hydrotherapy and squat bars, along with childbirth education.
"There's other things we do to help women in our facilities have the birth that they want," she said.
As for constant fetal monitoring, any woman requiring medicine during the birth or having induced labor must be monitored for her and the baby's sake. Women not at risk can request intermittent monitoring, as can her doctor.
"We, as an organization, really believe in supporting women and their families," Travis said. "As long as it's safe for that mother and that baby."
The public is welcome to attend Monday's National Rally for Change at Gulf Coast Medical Center. The event will take place from 10 a.m. to noon. Those planning to attend can talk about the issues - information will be available.
Raffle prizes and goodie bags will be given away as part of the rally.
For more details, call 849-5019 or e-mail SWFLBirthNetwork@gmail.com.
Gulf Coast Medical Center is at 13681 Doctor's Way, in Fort Myers.