Why Are There So Many C-Sections?
By Tine Reese
August 17, 2009You probably know a few women who have had c-section births and may wonder “Will I have to have one too?” The answer may lie in the type of prenatal care provider you choose and how much personal responsibility you take for the birth of your child. Recent studies put the c-section rate in the U.S. at over 30% and show it trending upward still. Because health care typically pays doctors and hospitals more for a quick c-section than it does for long, drawn-out vaginal births, there is more incentive to perform surgery and get patients in and out quickly. It’s safe to say that the health care system is providing incentives for c-sections and if you put your birth in the hands of a doctor or hospital who is paid by the insurance providers you likely have a 30% chance of having a c-section yourself—unless, of course, you have carefully selected a provider with a low c-section rate, educated yourself about the birth process and are willing to advocate for what’s in the best interest of your health and that of your unborn baby.
It’s a shame that we have come to accept c-sections (and the medical procedures that often lead to them) as the norm for birth in America when studies clearly show that letting the birth process happen naturally is usually better for both mom and baby. I definitely believe that we’re lucky to have the technology and medical experts there to save lives when it’s necessary, but I think that birth isn’t a medical emergency until it’s a medical emergency. When pregnant women and their families start receiving truthful information from doctors, media sources and our health care system about the risks of epidurals, interventions and c-sections, only then will we see a wide-spread shift away from medical intervention in birth. Until then, we are each responsible to spread the word about the benefits of natural birth and give other women the courage and inspiration they need to make it happen for them—even amidst the obstacles posed by hospitals and health insurance.
That said, I came across a great article on this topic last week and want to share it with Bloom readers. “Take Away the Incentives for Too Many C-Sections” is an article that appears on Crosscut.com (a Seattle news organization). It discusses the fact that 11,000 unneeded c-sections are performed in Washington state each year—partly due to insurance incentives—and that a measure passed by that state could help bring the rate down. In fact, childbirth is the most common reason for hospitalization in America and the most common surgical procedure is C-section.
The author states, “C-section rates have been rising rapidly for several decades, a major contributor to the spiraling cost of childbirth in the U.S. Yet maternal and baby outcomes have been stagnating or worsening. The U.S. ranks dead last among industrialized nations for maternal mortality and second to last for infant mortality.” Why isn’t this fact making headlines now when our health care system is in crisis and childbirth is the largest drain on the system? The article points out that Obama’s health care reform should start by reigning in childbirth costs while providing better care to patients.
She also says, “Currently, the rate of C-sections in Washington is just under 30 percent. Nationwide, the rate is almost 32 percent, more than double what both the World Health Organization and the Centers for Disease Control say it should be. In many cases, C-sections save mothers’ and babies’ lives. But, like any surgical procedure, C-section causes harm as well as benefit. When the rate at which they’re performed rises above 10 to 15 percent, the WHO and CDC have found, the harm outweighs the benefits to mothers and babies.” If the health of mothers and babies isn’t the main driver for so many c-sections, then the profit motive is the most obvious answer—doctors and hospital have too much financial incentive for performing unnecessary surgery and none for providing better care.
I hope that the new Washington state legislation mentioned in this article helps to lower the number of c-sections being performed in our state and can serve as a model for the federal government and the health care industry to take similar action. Please pass this information along to other women you know and encourage them to spread the word too. When we understand what’s truly best for ourselves, our babies and our families, we can take action that will effect positive change in our own birth experiences and the broken health care system that most of us rely on.
Comments
My first wife had both my daughters by c-section and probably would not have survived if she had not. She was perfectly built for child birth, according to her physicians, but she never could. The babies just would come down, even after her fluid would erupt. So I guess I have to advocate birth by c-section.
I read this article a couple of weeks ago, too, but I wasn’t able to find any other evidence of the legislation. Have you heard about it elsewhere?
Annie, thanks for your comment. I have found the following online about the new WA State legislation. Hope this is helpful!
Progressive States Network
This article provides a link where you can download a PDF containing details of the hospital cost controls enacted by the state.
Perfect, thanks! I’m surprised more people aren’t talking about this!
I am interested in how inducing labor increases a woman’s chance of needing a c-section. I know 8 women (including me) who were induced and only one of them did not have a c-section. The other 7 of us had long labors that stalled.
Thanks for your comment Erin. The risk of inducing labor is that it often leads to further medical interventions—known as the “cascade effect”—often ending with a c-section. This is especially true for first-time moms. There are definitely times when an emergency medical situation warrants induction, but a lot of times doctors allow, or even recommend, elective inductions without informing parents of the potential risks involved. I know a couple of good articles that speak to your questions about induction and c-sections. Hope you find these helpful!
http://www.hencigoer.com/articles/elective_induction/
http://www.babyzone.com/pregnancy/labor_birth/article/inducing-labor-pitocin-pg2
http://www.pregnancylounge.com/laborinductionrisks.php
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