Study: Medical Conditions Have Little To Do With Nationwide C-Section Rates
MINNEAPOLIS (WCCO) -- Pregnant women are faced with many decisions and often have lots of questions. Now, it appears there's something new they may want to ask their doctors: the cesarean rate at the hospital where the baby will be born.
On Tuesday, researchers at the University of Minnesota and Harvard University released the findings of a study that looked at how often C-sections are performed at hospitals nationwide. It found that it varies widely and the reason has little to do with the medical condition of the pregnant women.
The lead author of the study, Dr. Katy Kozhimannil, says the rates have more to do with hospital policies.
Between 2009 and 2010, researchers at the School of Public Health at the U of M and Harvard looked at childbirths at 1,300 hospitals in 46 states. On average, the likelihood of a cesarean delivery varied between 19 percent and 48 percent. And the reason it varied so much had more to do with the hospital itself, than the medical condition of the pregnant mom.
The study found that pregnant women could end up with very different deliveries, depending on the hospital they chose.
Kozhimannil gave an example of a healthy woman with gestational diabetes having her first baby.
"If she goes to one hospital, the chances of having a cesarean may be 11 percent. We found in our study that she could walk into another hospital with exactly the same medical history, exactly the same conditions and her chances of having a cesarean would be 36 percent. That's a big difference for one woman," she said.
Kozhimannil says in a previous study she found the C-section rate at hospitals varied 10-fold, from a low of 7 percent to a high of 70 percent of deliveries.
That got her and her colleagues digging deeper and finding a difference from other nations.
"Women's medical conditions and health did not account for the variability at all in cesarean delivery rates at all across hospitals. We are doing something differently here. Which brings us to the point of why might this be?" She said.
She says while women may be very familiar with their doctors, they may not know much about the policies of the hospitals where those doctors deliver babies. Those policies play a role in the decisions that are made during childbirth.
That means moms-to-be need to ask some questions beforehand.
"From the administrative perspective, how is the labor and delivery unit run, what are the rules in terms of when someone is admitted, when a procedure is scheduled or not and how do those rules affect patterns of patient care," she said.
So what do we do with this information?
Ask questions. If you are pregnant, look at where you are planning to have your baby and ask what the
Cesarean rate is at that hospital and then compare it with another hospital in your area.
Minnesota is one of the states in the study and the rate is different from one place to the next here, as well.
There's also big difference in the recovery time after a C-section and the expense of one. Cesareans are more expensive than natural births and more is paid by health insurance companies for them.
The length of stay in the hospital is longer, too. Mothers are expected to stay about five days after a C-section compared to two days in the hospital after a vaginal delivery.