Hospitals perform too many C-sections

Cesarean sections rates vary dramatically even between neighborhood hospitals, according to a Consumer Reports investigation, which determined that hospitals perform too many of the surgeries, driving up costs and increasing risks for mothers and newborns.

The publication reviewed C-section rates for mothers who anticipate low-risk deliveries at 1,500 hospitals in 22 states. Although some of the surgeries are necessary for the health of the mother or baby, Elliot Main, M.D., director of the California Maternal Quality Care Collaboration, told Consumer Reports that the high C-section rates at the low-scoring hospitals are "unsupportable by professional guidelines and studies of birth outcomes."

Despite the known risks of mortality and complications, and the fact that C-section rates declined since the 1970s, C-sections are the second most commonly performed surgical procedure in the country, according to the publication. Doctors and hospitals perform them for various reasons, including scheduling ease, and patient and doctor convenience. For example, the publication found  fewer babies in the U.S.  are born on holidays such as the Fourth of July or Thanksgiving and Christmas--an indicator that physicians and mothers may not want deliveries to interrupt holiday plans.

The investigation found that 55 percent of pregnant women who expected low-risk deliveries at Los Angeles Community Hospital underwent a C-section. But at nearby California Hospital Medical Center, the rate is 15 percent, and 28 miles away at Western Medical Center Anaheim, the rate drops to 11 percent. The same scenario replayed itself throughout communities across the country, Consumer Reports found.

"We think it's time those hidden numbers are brought to light," said John Santa, M.D., medical director of Consumer Reports Health. "How you deliver your baby should be determined by the safest delivery method, not which hospital you choose."

But some hospitals claim the frequency of C-sections cited by the publication may be misleading because Consumer Reports doesn't take all factors involved in a decision to perform the surgeries, according to KOMONews.

For example, the University of Washington Medical Center in Seattle submitted a statement to KOMONews, indicating that Consumer Reports didn't take into consideration the severity of illness present in the mother or baby before or during the pregnancy. "Thus the population of patients it describes corrects for some high risk factors (for example prematurity, twins, breech presentation) it does not correct for hypertension, diabetes, obesity or fetal growth problems," the statement read.

The medical center says its population of patients has the highest severity of illness of any hospital in the state of Washington, and the fifth highest for any hospital in the United States. "We would therefore expect our cesarean section rates to be higher than most hospitals in Washington State," the statement said.

To learn more:
- here's Consumer Reports' findings
- read the KOMONews article
- check out statistics from the Centers for Disease Control and Prevention  (.pdf)

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