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Tuesday
Oct062009

Flashback to 1986: Researchers say cesarean rate can drop without risk

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This article by Howard Wolinsky appeared on July 28, 1986 in the Chicago Sun-Times.

 

Researchers say cesarean rate can drop without risk 

The cesarean-section rate in the United States could be cut in half easily without harming the women or babies, while saving more than $1 billion in hospital costs, Chicago researchers report.

Dr. Stephen Myers, director of maternal/fetal medicine at Mount Sinai Medical Center, said that if physicians could change their attitudes toward birth, C-section rates could be reduced “overnight” from 23 percent of births nationally to 10 percent.

Figures show the C-section rate in Chicago is about 20 percent.

At a seminar on C-sections in his hospital, Myers said physicians tend to justify C-sections because they believe the surgery will produce a healthier child. But he noted that research doesn’t support this argument, citing a Colorado study showing a hospital’s clinic group, with a 5.7 percent C-section rate, and a private-pay group with a 17 percent rate had a similar number of birth complications.

To lower the rate nationally, he said, doctors must be more willing to have women who previously had C-sections try vaginal deliveries and to have more patience toward the birthing process.

Myers reported last week that his analysis showed doctors too often tell women who previously had C-sections: “Once a C-section always a C-section.”

As a result, he said, only about 4 percent of women who previously had the operation deliver vaginally on subsequent births while at least two-thirds of these women could have vaginal deliveries. Myers said this approach has not been shown to harm mothers or babies.

Dr. Norbert Gleicher, obstetrics chairman in Mount Sinai and a fellow researcher with Myers, predicted a drop in the number of C-sections will occur as it “dawns” on insurance companies that they are paying for unnecessary surgery.

Myers said C-sections increase society’s medical bill tremendously, with each C-section birth adding between $2,600 and $3,500 a patient to the cost of a vaginal birth. Nationally, if the C-section rate were brought down to 10 percent of deliveries, it would save $1 billion to $1.3 billion annually, he said.

 

 

NB: Mount Sinai Medical Center’s 2007 cesarean rate was 32.7 percent. [PDF]

 

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Reader Comments (7)

Some of these things read like fairytales, looking back......once upon a time there was a Dr. who wanted to cut c-section rates....

October 6, 2009 | Unregistered CommenterDesalie Lowe

Ha ha!!

October 7, 2009 | Registered CommenterJill

What's really sad is that I look at Mt. Sinai's CURRENT cesarean rate and I am jealous, being in South Florida.

I have got to go to residency somewhere else. my perspective is whacked.

October 7, 2009 | Unregistered CommenterMomTFH

This makes me want to cry. Seriously. We are like voices crying in the wilderness.

October 7, 2009 | Unregistered CommenterMegan

It's the old story of "it's fine to have the theory but who will walk the talk?" Every dr hopes the other drs will lower the c-section rate. Every midwife hopes the other midwives will catch the breech babies. Meanwhile the rhetoric goes on, nobody has the courage to face the court system and women's bellies pour out blood.

The women are waking up to the game.

October 7, 2009 | Unregistered CommenterGloria Lemay

As someone who's has her finger on the pulse of birth and the politics and big business surrounding it for years, I was hoping you'd respond, Gloria. Thanks.

By the way, MomTFH, I know the feeling. When I read cesarean rates by hospital, I sometimes think, "Wow! Only a 24 percent rate! What's their secret?" We're ALL skewed at this point.

October 8, 2009 | Registered CommenterJill

Apparently they didn't just talk the talk. They walked it too... with great success:

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-466KK06-5W&_user=10&_coverDate=11/30/1993&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1235980459&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=c1671b99502e9887870275fb78a2c02d

Too bad the momentum died.

March 6, 2010 | Unregistered CommenterBuscando la Luz
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