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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