Archive for pregnancy

Why has the C-section rate increased?

The Caesarian Section (C-section) Rate: Why has it doubled in the past 25 years even as this form of delivery increases the risks for mothers and their babies?

In the 1980s, the C-section rate in Greater Cincinnati was 17 percent and Managed Care Organizations such as ChoiceCare and Anthem considered this far too high. At that time, Managed Care considered a 12 percent C-sections rate to be optimally consistent with best medical practices. The current World Health Organization guidelines indicate that C-sections are warranted in only about 10 to 15 percent of deliveries.

The C-section rate across the United States is now higher than a third of all deliveries. With C-sections come higher complications and recovery time from major open surgery as well as risks to the baby including neonatal respiratory problems and possibly medical problems later in life such as asthma, diabetes and allergies. Certainly, emergency C-section in cases of preeclampsia, obstructed labors, fetal distress and abnormal placentas are an absolute necessity to save the life of both the mother and child.

Then why is elective or planned C-section that can complicate future pregnancies so popular? There are many incentives for physicians and their patients to choose elective C-section.

  1. Convenience of elective delivery for both mother and doctor.
  2. Avoidance of painful labor and changes to pelvic support structures
  3. Higher reimbursements for C-section than vaginal deliveries
  4. Threat of malpractice due to fetal trauma with vaginal deliveries

 

As a general rule, I think most physicians believe that there should be a medical indication to justify the performance of a C-section. A lower C-section rate would be cost and life saving.

-Richard Wendel MD, MBA