Under The Knife Too Often: Study Finds Local Hospitals Perform Many Unnecessary C-Sections
By Ian Bush
PHILADELPHIA (CBS) - Are too many moms-to-be subjected to C-sections when they could have a normal birth? That's the concern raised in a new study of hospitals in South Jersey, Southeastern Pennsylvania, and across the country.
Caesarean sections are one of the most common surgical procedures and generally are very safe.
"But they still have a slightly higher risk of complications for the mom and some complications for the baby," says Doris Peter, associate director of Consumer Reports Health. "Adding to recovery time and driving up healthcare costs are other issues."
One in three moms now has the procedure, compared to one in 20 back in 1970.
"But at the same time," Peter notes, "the outcomes for moms and babies haven't gotten better."
Some C-sections, of course, are medically necessary -- such as for multiple births or a breach or other abnormal presentation. But for low-risk births, no hospital in Greater Philadelphia ranked by Consumer Reports (using data from 2010-2011) earned better than an 'average' rating for potential C-section overuse.
Virtua Hospitals in Mount Holly and Voorhees report lowering the rate of primary C-sections -- surgical deliveries by first-time moms -- by nearly seven percent over four years.
"By being patient with our patients, we are finding that our outcomes for our vaginal delivery have increased," explains Kelly Nierstedt, assistant vice president of Women's and Children's Services at Virtua. "That may mean that we allow a patient to labor longer, to push for a longer amount of time, and to allow patients to take more time through the natural process."
Nierstedt says they've also developed strategies to lower the number of induced births.
"A lot of work has been done nationally to reduce inductions before 39 weeks completed gestation. But we still have a large population of women being induced after 39 completed weeks for no medical indication. Several factors that impact that -- women are making that choice, there are convenience issues, a woman is very uncomfortable toward the later part of her pregnancy. But we know that when you induce a patient whose body may not be physiologically ready for that delivery, you increase the risk of a C-section."
Those who deliver a first child by C-section are said to be 90 percent more likely to have to do the same for kid #2.
To lower odds of having to turn to a surgical delivery, Consumer Reports suggests checking a hospital's C-section rates; staying fit, since obesity leads to a higher risk of C-section; and getting support during labor, such as from a trained birth assistant.
"If you need a C-section," advises Peter, "ask for antibiotics. Ask for the uterus to be closed with two layers of stitches. And ask for measures to prevent blood clots after surgery, such as inflatable devices on your legs or a prescription blood thinner.
Virtua is adding things squatting bars, birthing balls, and -- in its Vorhees location -- birthing tubs to help women try to relax through labor.
