Unnecessary C-sections more common at for-profit hospitals

Critics who long suspected that unnecessary C-sections were performed to pad bottom lines now have ammunition. For-profit hospitals are more likely to perform cesarean sections for nonmedical reasons than nonprofit hospitals, according to a California Watch analysis of rates at 253 California hospitals that were reported to the state between 2005 and 2007.

When California Watch, an independent investigative reporting group, examined births least likely to need a C-section--those in which mothers without earlier C-sections carry a single fetus positioned head down at full term--researchers found that the average weighted C-section rate for nonprofit hospitals was 16 percent, while it was 19 percent for for-profit hospitals.

The overall range of C-section rates was wide. At the nonprofit Kaiser Permanente Redwood City Medical Center, new mothers had a 9 percent chance of giving birth by C-section. But at the for-profit Los Angeles Community Hospital, new mothers faced a 47 percent chance of getting a C-section.

Among the 15 hospitals with the highest rates of C-sections, 10 were for-profit facilities. Among the 15 hospitals with the lowest rates, zero were for-profit.

Rick Black, a representative for the for-profit Tenet Healthcare told California Watch that assuming hospitals are pushing C-sections for the money is a mistake. The hospital has no direct influence on the decision, which is made by the doctor and patient, he said.

Dr. Guillermo Valenzuela, vice chairman of obstetrics at Riverside County Regional, told California Watch that his hospital's low rate of 9 percent can be linked to shift work doctors, who have no financial incentive to hurry a delivery along. They get paid the same, regardless of whether they deliver the baby or simply are involved in the early stages of labor.

To learn more:
- read the California Watch article
- check out this bar chart that compares hospital in California by C-section rate
- here's the searchable database of C-section rates at California hospitals

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