Too Many C-Sections?

From the June 10, 2009 issue of the Los Angeles Times comes an article with the title, "Childbirth: Can the U.S. improve?", by Lisa Girion. This article argues the point that there are too many C-sections performed in the United States. The article noted that cesarean is most common operation in the U.S.. In 1965 only 4.5% of all births were by cesarean. The rate has grown substantially with currently 31% of all births in the US by cesarean.

The article quotes Dr. Roger A. Rosenblatt, a University of Washington professor of family medicine who has written in the past that the increase in interventions such as cesarean is linked to declining outcomes. Dr. Rosenblatt said, "We're going in the wrong direction, (maternity care) "is a microcosm of the entire medical enterprise."

The article notes that childbirth is the number one reason for hospital admissions costing $79 billion per year and representing a large part of the $2.4 trillion dollars spent on medical care each year in the US. In 2008 a New York think tank group, Childbirth Connection, issued a report that said, "The financial toll of maternity care on private [insurers]/employers and Medicaid/taxpayers is especially large. Maternity care thus plays a considerable role in escalating healthcare costs, which increasingly threaten the financial stability of families, employers, and federal and state budgets."

The LA Times article also noted that in the U.S. the cesarean rate is higher than in most all other developed nations. They also note that even though the government has set goals to reducing such deliveries, the number of cesareans performed has set a new record every year for more than a decade.

In spite of the high level of medical intervention in the birth process, the U.S. ranks behind other developed nations on key performance indicators including infant mortality and birth weight. A typical American newborn is delivered at 39 weeks, instead of the full 40 weeks. Additionally, the article reports that starting in 2002 the death rate for mothers in childbirth began to rise.

Perhaps the most telling comment as to why there is no major effort to reverse this issue came from Dr. Elliot Main, chief of obstetrics for Sutter Health hospital in Northern California, "Cesarean birth ends up being a profit center in hospitals, so there's not a lot of incentive to reduce them."

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