C-Section Rates Reach All Time High, Says New Study

More American women are having Cesarian section deliveries than ever before.

According to a new report released today by HealthGrades, titled Obstetrics and Gynecology in American Hospitals, between 2002 and 2009, C-section rates in the U.S. rose from 27 percent of all single birth deliveries to 34 percent, which is an all time high.

The study also found that Florida, New Jersey and Texas had the highest rates, while Utah, Wisconsin and Colorado had the lowest.

In a press release, the report's author Dr. Divya Cantor said:

Women today have a wide array options when it comes to reproductive health and choosing a health care provider who aligns with their personal preferences. From pregnancy and childbirth to more serious interventions such as hysterectomy, surgeries to treat incontinence, ovarian and other cancers of the reproductive organs, women can optimize their chances for receiving the highest possible quality of care by researching and comparing the clinical outcomes of hospitals and doctors in their area.

But the study's findings don't sit well with everyone. Jacqueline Wolf, a researcher at Ohio University told MSNBC that a 34 percent C-section rate is far too high. "Medical reasons alone cannot possibly explain why more than one in three American women need major abdominal surgery in order to safely give birth," she said.

C-section deliveries have been typically performed when unexpected complications arise during birth, but electing the procedure instead of a vaginal birth is a big issue, and one that is going to be under a lot of scrutiny in the coming year, Dr. Elliot Main, chairman of the Department of Obstetrics and Gynecology at California Pacific Medical Center in San Francisco, told California Watch.

According to Main, while risk factors like obesity, diabetes and multiple births are common reasons for electing the procedure, they only account for a small portion of the increase. "It's more an attitudinal issue of doctors and patients not wanting to spend extra time in labor or not wanting to take any perceived extra risk," he said.

If 34 percent seems like a large number, it's because it is. Groups including the World Health Organization have suggested that the C-section rate should be only 15 percent, while the Joint Commission, a non-profit that accredits and certifies health care organizations, has noted, "there are no data that higher rates improve any outcomes, yet the C‐section rates continue to rise," reports MSNBC.

Comments

[mrsL]

09:10 PM on 08/17/2011

I am sad for what my daughters and daughters-in-law will face in the future.

[DoberDaneGirl]

06:08 PM on 08/10/2011

I watched an INCREDIBLE documentary with Ricki Lake, called, "The Business of Being Born", and I watched another called, "Pregnant in America". Both very well done. I had a c-section 12 yrs. ago for a medically necessary reason (toxemia that was quickly getting worse). I am 37 wks. pregnant now, have had my birth plan in place for quite some time, but I find it absolutely amazing how many times doctors have tried to dissuade me from going natural. (And the reason I have stuck closest to the one doctor that has been on my side for a VBAC). So, I have called on my mom and my SO to be my backbone and my mouth during the labor and delivery process. (Because I know "they" will try to get me when I'm most vulnerable).

To doctors, it's about time and money. Some women opt for the elective c-section for convenience. No thanks! That is probably the worst pain and longest recovery time I have ever experienced. You also miss out on crucial bonding time and the entire birthing process!

I am NOT looking forward to laboring, but should my birth go as planned, I will deliver vaginally, will have done it without an epidural or pitocin (the "needle in the back" is enough motivation for me to go natural). AND, for as advanced as we are, we sure have a high incident of infant death and maternal death. Europe and Asia have the lowest!

[mrsL]

09:12 PM on 08/17/2011

Good luck to you DoberDaneGirl! Just take one contraction at a time and relax! get out of your own way and you should have a great birth!

[DoberDaneGirl]

10:51 PM on 08/17/2011

Thanks so much, mrsL. That is very kind! I will take your advice. ;o) I suppose there have been MANY MANY MANY women who have done this many times before me, so if they can do it....I can at least attempt to. lol....Thanks again!

[Raven1970]

03:53 PM on 07/25/2011

Now they should check the rate of C-Sections on the uninsured vs. the well insured....I think they will find that C-Sections are far more prevalant in the "well insured" group. When I had my first baby we had no insurance, they left me in labor for 42 hours before performing an emergency C-Section, with my second child 5 years later I was insured and wanted to try to have a V-Back, they were insistent on scheduling a C-Section even though there was really no reason why I would have been at risk.

[mrsL]

09:12 PM on 08/17/2011

I have suspected that for many years Raven! Good observation

[crtlvmm]

08:50 AM on 07/22/2011

Interesting comments. My first baby was a vag birth. I was in labor for 12 hours but delivered safely. Some usual tearig and such. Labor sucked. I dont care how many people say it is "easy and beautiful." The recovery was tough as well the first two days as you are so sore you cant walk. My second baby I had different inssurance and therefore a different dr. He in no way encouraged me to have a c-sec. but when i asked for one he said he let the women decide for themselves. my c-sec was awesome and no less emotional during delivery. the recovery was no worse except for pain in a different area. For people who want home births, vag, births, whatever.....i say let people do what they want to do with their own body and labor.

[JennyHatch]

12:17 PM on 07/21/2011

FREEBIRTH: A MESSAGE TO OBSTETRICIANS FROM JENNY HATCH, “PHYSICIAN HEAL THYSELF!!” http://jennyhatch.com/2009/11/20/freebirth-a-message-to-obstetricians-from-jenny-hatch-physician-heal-thyself-2/

[Bee]

05:34 PM on 07/20/2011

Not everyone gets the c-section they want. My cousin's wife wanted one during her long labor with a big baby. Well, baby died, and they sued and they settled with 100k; not a fortune.

[C Karen Stopford]

04:10 PM on 07/20/2011

In a culture that treats pregnancy (and, more recently, childhood) as a pathology, I find this is no surprise. After all, vaginal delivery is so horribly inconvenient for the parents, and not nearly as lucrative for the medical establishment. Pretty soon they will have baby farms where you can grow your young ex utero, and avoid the messy birthing process altogether.

[mzrecycle]

03:54 PM on 07/20/2011

When I had my first baby in '75, the rate was 33%. It really hasn't changed much. I'm astounded it ever got down to 27%.

I never had any of my 3 babies in a hosp. I had heard all sorts of other women's stories and just decided to find good care from a physician who would deliver out of the hosp. All 3 were vag. deliveries with no problems. Another benefit: the first cost us $350 (no insurance), the next 2 were $600. Compare that to what families are paying AFTER the insurance covers what it will.

[Laura Fields]

06:12 PM on 07/23/2011

I'm about 99% sure the c-section rate in the mid-70s was under 10% in the US. It rose with the routine use of the external fetal monitor starting in the 70s, IIRC.

[rrob568115]

03:44 PM on 07/20/2011

I know the answer to this one. It is called practicing "defensive medicine". Doctors are automatically doing C sections to prevent law suites from birth complications. The poor woman often has no choice because the doctor simply tells her it MUST be done at delivery time. Its all about law suite protection and greed. Sickening really. She has a big ugly scar for life, and he goes home to his family unaffected. The feds need to step in and STOP this nonsense! But the AMA sends too much lobby money to our elected officials for anything to change. The feds give doctors a rubber stamp to do what they want.

[MommyMD]

04:46 AM on 07/22/2011

Answer correct. It is often defensive medicine. But if a poor baby is born with any problem, the doctor will be sued. Her career will be over (whether she acted properly of improperly). We do protect ourselves because we like taking care of patients....you know that's why we lost our 20's, have 300K in debt etc. And of course, as most know, the doc gets 0-50 dollars more for a c-section. Not sure I get the greed. Maybe talk the lawyers, politicians, and insurance companies...they'll recognize the word a lot better. We will be adrift in this mess until for-profit health care bankrupts this nation.

[rrob568115]

10:28 AM on 07/22/2011

The doctor only gets 0-50.00 more for a C section delivery? LOL! You REALLY think we believe that? And how much more does the hospital get for the time and drugs and equipment? We all know that hospitals force you doctors to use their facilities as much as possbile. If you do, you might soon loose your privilages to practice there. Like the local teaching hospital here tells their own employees "bring in the money!" You are correct that the for profit medical system here is totally corrupted with greed. Sadly, YOU are part of it.

[cinemaven]

03:36 PM on 07/20/2011

My ob-gyn, 23 years ago told me that my son was in breech position and asked if I would like to schedule a c-section. I laughed and then was stunned to find he was serious. I was only 7 months pregnant and I explained to him that my son would turn and roll for at least 2 more months so NO.. He was aggravated because he was going on vacation and tried to have all his pending cases (yeah, that's what he called us) resolved. As it happened, my son was a 10 month baby so he would have been over 2 months early had I listened to the doctor.

I know a few women who had voluntary c-sections and it boggled my mind that any doctor would go along with it. I also know a few who were talked into an unnecessary section by their doctor but most of the women I know who had sections had them after a long and difficult natural birth attempt.

The medicalization of a totally natural process is damaging women and babies. The rate should never be higher than about 3 - 5% and birth should be in the hands of midwives and doula's in most cases.

[MommyMD]

04:28 AM on 07/22/2011

Totally understand your post. But.....C-sections are scheduled incredibly early as OR time is often impossible to obtain unless their is an emergency. A booked OR at 28 weeks is perfectly reasonable (and now days too late in many hospitals!). I think your doc wanted his schedule set up for the coming months. Since a baby has a small chance of survival at 24 weeks today, 28 weeks (7 months) would have 23 years ago left you and your OB with a tragedy. Unless he is a charlatan, he had NO intention at delivering you at that time.

Midwives and doulas are amazing (in my experience) unless they are not attached to a hospital in case of emergency. For my own two daughters, the emergencies were quite unexpected and delivered by crash C-section within minutes. A midwife simply cannot get a woman to hospital if G-d forbid the unexpected happens.
Birthing areas in hospitals should be more mom and baby friendly, while maintaining their safety net capacity.

[cinemaven]

09:19 AM on 07/22/2011

He wanted to schedule my section for Jan 28th and my original due date was Feb 14th (a Saturday) but he was going to be away for over a month. Looking at the dates, it could seem reasonable (unless you remember that his excuse for my section was that my son was breech at 7 months which is medically ludicrous) EXCEPT my son was born on March 10th. (we were under the care of a fertility doctor and doing basel readings so his conception date was known to the day but many people are less sure of their true dates)

There were no complications related to my pregnancy. My son was 9lbs 8ozs and healthy as a horse. My labor was horrible because unfortunately the ob-gyn was back and his nurse wouldn't believe I was pushing. She laughed and told me I'd go another 6 hours and needed an epidural. She told me to pant and they gave me 1/4 strength epidural and I gave birth 12 minutes later, still panting with the nurse telling me not to push. Needless to say, I was ripped when my son came zipping out and the nurse angrily told the doctor (who was still washing up) that she'd told me not to push but I wouldn't listen.

He WAS a charlatan, as later evidenced by the loss of his license for having scheduled a higher than 50% rate of sections with many of them yielding dangerously under-developed babies.

[nokaoi]

01:19 PM on 07/20/2011

i think pregnant women when looking for an ob-gyn, should call and ask the staff for the doctor's c-section rate.

[MommyMD]

04:30 AM on 07/22/2011

The question is too simple, unfortunately. You may just find out how many high-risk patients the doc takes on....leading you away from a highly skilled doc. A low c-section doc may be unskilled, and only take healthy moms with previous normal pregnancies.....just saying.

[Kira Young]

09:31 AM on 07/20/2011

I had a c-section and really wanted a natural birth but because I had had a myomectomy (surgical removal of a fibroid) the scar left behind was too dangerous to go into labor. I risked rupture at that point. I also had another fibroid during the pregnancy, further complicating the pregnancy and birth. It is true though that many doctors and some nurses just want to go home so they don't have to take the time it required for some women who have long labors. I know several women who were bullied into c-sections because their labor was long. Some held their own and others were too exhausted to fight off the bullying. There are valid medical reasons for a c-section but not for 34% of pregnant (to term) American women. That is just the medical community yanking our chains all the way to the bank...

[cinemaven]

03:53 PM on 07/20/2011

I know a number of women who've had necessary sections but I also know several who had them electively and others who were bullied.

The ob-gyn who delivered my first son was brought up on charges for scheduling births far too early. He tried to talk me into a section at 8 months, 1 week along by telling me my son was breech. My son was a 10 month baby so he would have been barely cooked at that point but the dr. was going to India for a month and wanted everyone out before he left. His practice had an almost 50% c-section rate when the charges were brought.

After my first son was born, we moved to a small city with a large Mennonite population and amazing midwives. There's just a different vibe about childbirth here. I had my second son in hospital but the nurses and my doctor were amazing and supportive. So different from my first experience.

I think a lot of sections are for the convenience of the doctor and to prevent lawsuits.

[rrob568115]

03:56 PM on 07/20/2011

Same thing with the pap smears. Its a HUGE money maker! Biggest HOAX ever put off on women. Google uneccessary pap smears and read the blog.

[Victoria Carson]

08:08 PM on 07/20/2011

I will admit I haven't read the blog, but I am a strong believer in yearly paps. I had an abnormal pap once, and ended up with dysplasia. I would rather have early paps then cervical cancer. I am finally back to the yearly paps, having had paps every 3 months, then 6 months. Nice to have normal paps and no cancer.

[Victoria Carson]

08:18 PM on 07/20/2011

okay, I read the blog. Pap smears are the scraping of cells from the cervix to test for abnormal cell growth which usually indicates pre-cancerous cells. If a woman does not have a cervix, she does not need paps. Paps are not a hoax, but it is unnecessary in women without a cervix or who are not sexually active and have not been exposed to HPV.

[kae521]

09:01 AM on 07/20/2011

I was actually discussing this very thing with someone awhile ago. Personally, I think doctors tend to jump to C-sections awful fast nowadays. Now, if it's a medical emergency and the baby needs to come out then that's one thing. However, just because a woman is in labor for 18 hours with her first child, it doesn't mean there is anything medically wrong. Also, I know different hospitals do/don't do VBACs, but from what I know about them, babies are safely delivered through VBACs all of the time. Vaginal deliveries are a much better option to C-sections and there is much less recovery time, but it seems like hospitals want to get patients in and out while making more money rather than look at what's best for the patient.

[kkpeter1831]

06:20 AM on 07/20/2011

DO ANY OF YOU OPPONANTS OF C-SECTIONS CARE HOW MANY LIVES THEY SAVE? IN THE 1980'S DOCTORS WERE BEING FORCED TO CUT THE MUMBER OF C-SECTIONS THEY DID. AT THAT TIME MY DR. LEFT ME IN LABOR 3 DAYS BEFORE FINALLY OPERATING. I HAVE NEVER RECOVERED AND MY CHILD WILL FOREVER BE UNDER MY CARE. NO ONE WHO HAS NOT HAD A C-SECTION SHOULD TELL SOME ONE ELSE NOT TO HAVE ONE. THE OPPONANTS ARE LOOKING AT THE $$$$ NOT AT WHAT IS BEST FOR MOTHER AND CHILD! YOU CAN READ ALL THE ARTICLES AND WATCH ALL THE DOCUMENTARIES YOU WANT, BUT UNTIL YOU HAVE BEEN THERE YOURSELF - SHUT UP!

[Aaron Frost]

08:39 AM on 07/20/2011

Why are you yelling?

[dreamer1]

11:43 AM on 07/20/2011

This is not true about C-sections being cut in the 80s. For one C-Sections started to spike around the mid 70s-early 80s, and have continued to spike since then. Your case looks like it was negligence on the Dr's part and it is unfortunate what happened to you and your child, but please do you research on the entire topic before responding. Dr's, hospitals, and the healthcare industry as a whole make tons of more money off of doing C-Sections as opposed to delivering vaginal births. There's more staff involved, medication, and follow-up when a woman has a section. Also, there are negative side affects to the child not being able to come through the birth canal and get that last gulp of amniotic fluid to build its immune system and prepare it to live outside the womb.

This is why research is important to do before we respond. Also, there's no reason to type in Caps...there's plenty of room for everyone's opinion, objective or not.

[matilda81]

12:07 AM on 07/20/2011

This is disturbing but not surprising. Doctors are comfortable with surgery because it is easier on them. There is a reason that c-section rates are higher between the hours of 5 and 10:00 at night. The Drs. want to go home! So, women are pressured to induce. They are given pitocin in order to speed up their labor, but the pitocin has the side effect of causing much more painful intense contractions which can put the baby at risk. Then, the woman ends up having to get a c-section, which was caused by the pitocin. (The documentary, The Business of Being Born talks about this) Doctors are familiar with surgery, but most of them have never witnessed a natural childbirth, which on average last much longer than a hospital birth. C-sections save them time and end up costing the patient more money. Healthcare isn't about what is best for the patient anymore. The c-section rates are only going to increase.