The St. Barnabas Medical Center Web site explains cesarean surgery and when it is considered necessary. It also defines VBAC and the term “c-section rate.”
Text: There are two types of c-section rates that measure how frequently c-sections are performed––total c-section rates and primary c-section rates. The total c-section rate is determined by dividing the number of cesarean sections by the total number of deliveries for a specific period. This is the rate typically published in newspaper and consumer reports.
The primary c-section rate is considered more accurate because it looks at first-time c-sections, thereby ruling out patient preference. The primary c-section rate is determined by dividing the number of women having a c-section for the first time by the total number of deliveries by women who have never had a c-section. Women who have had repeat c-sections or VBACs are not included in primary c-section rates.
St. Barnabas took the time to define what “c-section rate” means, but omitted their c-section rate.
Total c-section rate (2008): 49.3 percent
Primary c-section rate (2008):29.2 percent
St. Barnabas Medical Center is the hospital at which staff called for a psychiatric consult of a woman in labor who was refusing an unnecessary cesarean, then called for yet another consult when the woman was found to be anxious, yet competent. In the middle of her second psychiatric consult, she gave birth vaginally with no incident to a healthy baby. The appellate court findings do not show whether the woman was given the chance to seek a second opinion for the recommendation of an unnecessary cesarean for misdiagnosed nonreassuring fetal heart tones, but the staff at St. Barnabas exercised the right to seek a second opinion regarding the laboring woman’s psychiatric state because they did not agree with the first doctor’s decision.
The St. Barnabas Medical Center Web site states that patients should ask the doctor or midwife about whether or not to seek a second opinion about their cesarean recommendation:
Who determines if a C-Section is necessary?
Your physician or midwife; but you should be part of the decision too. You should take an active role by talking with your physician or midwife and asking specific questions such as when a c-section would be recommended; what steps would be taken prior to performing a c-section; whether to seek a second opinion; and whether vaginal delivery is encouraged after a previous c-section. It is important that you feel comfortable with the views of your physician or midwife on c-section deliveries.
Refusal of Unnecesarean Leads to Loss of Custody: V’s Story (July 21, 2009)
New Jersey Cesarean Refusal Case: The “System” is Schizophrenic (July 23, 2009)
Anonymous Comments about New Jersey Cesarean Refusal Case (July 30, 2009)