C-sections on the rise: One in three mothers opting for procedure

By Dr. Ananya Mandal, MDJul 24 2011

According to the latest study reports, one in three births in the U.S. are now delivered by Caesarean section, which is an all time high and an increasd of 25 percent over seven years.

The report comes from the data from 19 U.S. states that show that C-section deliveries shot up from 27 percent of all births when independent health care ratings company HealthGrades began the study in 2002 compared to 34 percent in 2009. Experts attributed the reasons to convenience, risk factors, fertility treatment increase and general attitudes.

The study, entitled “HealthGrades 2011 Obstetrics and Gynecology in American Hospitals,” noted that the states with the highest rates were Texas, New Jersey and Florida while Utah, Colorado and Wisconsin as the lowest.

According to Divya Cantor, HealthGrades Senior Physician Consultant, “C-sections are rising, and there needs to be a little bit more scrutiny from the person who is having the C-section as well as doctors and hospitals.” Experts say many complications can arise from a C-section delivery including blood clots, excessive bleeding, infection, longer recovery time and injury to the bladder, uterus or bowel. The most common in hospital complications stemming from C-section deliveries were hemorrhages, postpartum infections and wounds and complications related to anesthesia. Cantor added, “Doctors need to better understand when a C-section is called for.” She also noted that patients need more awareness regarding the risks of C-sections.

Some causes of this trend were common labor practices that can increase the likelihood of needing a C-section, such as induction of labor or having an epidural early in labor. Most mothers chose C-section due to convenience in delivery timing. Increasing maternal age and other maternal risk factors, such as obesity and diabetes, multiple births (e.g., twins, triplets) are some other reasons. Most mothers do not understand the complications well enough write experts.

The Joint Commission and the Agency for Healthcare Research and Quality noted that no data is evident that points to higher outcome rates involving C-section births, though the rate continues to rise exponentially since the rate was first measured in 1965 at 4.5 percent, or about 1 in 20 births.

While the rates of C-Section births increase, the amount of hysterectomies performed since 2002 has declined by 31 percent, or nearly one third. Hysterectomies, or the surgical removal of the uterus to treat diseases or disorders, were the most common gynecological procedure in 2009 accounting for 79 percent of all inpatient surgeries.

Health Grades, an independent health care ratings organization, also rated the obstetrical and gynecological quality in the hospitals of the 19 states studied using a five star scale, taking into account neonatal mortality rates, complications and overall performance Doylestown Hospital's maternity care services recently received the highest score — 5-stars — for its outcomes with mothers and babies, in the most recent HealthGrades report. The HealthGrades' report found that women who give birth at 5-star-rated hospitals experience 32 percent fewer complications.