Unnecessary Cesarean Section Risk Mothers' and Babies' Health

The percentage of women who undergo a cesarean section at the end of their pregnancy has skyrocketed to nearly a third of all births within the nation. C-sections are thought to reduce the number of babies born with cerebral palsy (CP) and other birth injuries, yet a decrease in these disorders has not been observed in conjunction with the country's rising cesarean section birth rate. Women and children are far more likely to experience complications after a cesarean birth when compared to those who experience a vaginal birth. Numerous experts acknowledge the existence of strong financial incentives which serve as motivators to increase the number of interventions performed during labor and delivery. Interestingly, in hospitals where physicians are paid a flat salary, c-section rates are significantly lower and serve as additional evidence that many c-sections are medically unwarranted.

Cesarean Sections on Rise with Little Benefit for Patients

Health care providers generally state that cesarean sections are performed in order to reduce the risk of harm to the mother and/or child in specific situations. Although certain rare medical conditions, such as placenta previa (where the placenta blocks the cervical opening at the bottom of the uterus) do warrant a c-section to save the life of the unborn child, the overall number of birth related injuries (including CP) have not declined in proportion to the number of cesareans performed in the U.S. The National Institutes of Health (NIH) claims as many as 75 percent of all c-sections are medically unnecessary; some experts believe that 90 percent or more could be avoided. Dr. Mayer Eisenstein, founder of Homefirst Health Services in Chicago, states that her organization's c-section rate has been a mere four percent over the course of serving more than 20,000 women.

C-Sections are Not Safe when Unwarranted

Women who undergo a cesarean section are far more likely to experience subsequent cesareans after the completion of future pregnancies; these additional surgeries result in an increased risk of placenta related issues which can be life threatening for both mother and child. Maternal hemorrhage is far more common after a c-section, as are infections and blood clots. Newborns delivered via c-section are more likely to require CPR and life support; they are also more prone to develop hypoglycemia and sepsis as well as brain, lung, or liver disorders. Sadly, the U.S. ranks 30th in the world in regards to maternal and neonatal well being, despite having a larger health care budget than any other nation .

Financial Incentives to Perform Cesarean Sections

In the majority of American hospitals, physicians are paid based on services rendered. As a result, there are significant financial incentives for health care providers to increase the number of interventions performed during labor and delivery. Although women are led to believe that the high tech monitoring devices utilized in nearly every hospital lead to an improved outcome for the baby, scientific evidence supporting this claim is lacking. Conversely, data shows that intervention of any kind, particularly the induction of labor, is linked to an increased likelihood of undergoing a cesarean section. Intermountain Healthcare claims that the average cost of a cesarean birth is greater than $16,000 as opposed to just over $9000 for a vaginal delivery. These figures do not even take into account any additional care mothers and children require once the delivery phase is complete; hospitals themselves are said to financially benefit from interventions through longer hospital stays and the requirement of additional medical services.

Salaried Physicians Have Lower Cesarean Birth Rates

An interesting piece of evidence is revealed when the cesarean rate of salaried physicians is compared to those who receive payment based on services rendered. In some hospitals, medical care providers work shifts and are paid a flat salary. In these situations, the rate of c-sections have been shown to be as low as 15 percent, with no adverse effects on maternal or neonatal wellbeing. When financial incentives to raise patient bills are eliminated, doctors seem to focus more directly on the needs of the patient instead of thinking in terms of how they are able to increase their bottom line.

Myth of Litigation Fears and Cesarean Sections

Some state that the nation's high cesarean birth rate is the result of fear of litigation, however, a study published in Med Care reveals that the effect is much smaller than once believed. While a small correlation between increased insurance premiums, tort reform and c-section rates have been observed, the influence is shown to be slight and far less significant than financial incentives. Women are advised to educate themselves before consenting to a cesarean section; they can also ask about the average cesarean rate of any health care provider they are considering working with. Additionally, parents to be should determine which local hospitals have the lowest c-section rates as a whole, as hospital choice is a significant factor which impacts the likelihood of undergoing a cesarean section.