Forty years ago, only 4.5% of all births took place by Cesarean section. Today, that number has jumped to 31%. Has this dramatic increase led to a decline in the quality of U.S. maternity care?
Lisa Girion of the Los Angeles Times explores the connection between rising cesarean rates and the flailing U.S. healthcare system, which has become burdened, according to Dr. Elliott Main of Sutter Health, by a push for unnecessary cesarean sections, which he suspects are given more for hospital profit than for the overall safety of the mother and child. "Cesarean birth ends up being a profit center in hospitals, so there's not a lot of incentive to reduce them," Main says.
Girion points out that cesareans are incredibly expensive when compared to routine vaginal births: "Because spending on the average uncomplicated cesarean for all patients runs about $4,500, nearly twice as much as a comparable vaginal birth, cesareans account for a disproportionate amount (45%) of delivery costs. (Among privately insured patients, uncomplicated cesareans run about $13,000.)" While some women absolutely need cesarean sections, due to medical complications, it's a bit troubling to think that doctors are steering women towards a risky procedure that leaves women open to risk of "infection, blood clots and other serious problems," including an increase in "premature births and the need for intensive care for newborns."
Disturbingly enough, Girion notes that the rise in cesareans may not be fully driven by a need for hospital profit, but also by celebrity magazines that celebrate famous mothers who delivered via C-section. "Physicians, too, have been blamed for failing to make women fully aware of the consequences of cesareans, and for promoting them for convenience."
I have never had children, but I have seen my sister recovery from a cesarean section—hers was necessary, as she was having twins and they were positioned in a manner that made vaginal birth quite risky—and her recovery process was slow and quite painful (all this while nursing two boys). It's troubling to me that C-sections are paraded around as quick, easy modes of delivering a child, and bothers me even more that women are being led toward C-sections without being fully prepared for the risks and the complications that may occur afterward.
However, as Girion notes, it appears that some doctors are trying to change the pattern, and cutting back on unnecessary procedures. "Change is underway. The Institute for Healthcare Improvement's Strategic Partners program trains hospitals to implement a set of guidelines, such as the careful use of oxytocin, and a ban on elective deliveries before 39 weeks. In four years, 60 hospitals have signed on." One hopes that these changes will ensure safer conditions for both mothers and babies.
Childbirth: Can The US Improve? [LATimes]