C-Section Rate Reductions Panned

John Commins, for HealthLeaders Media , July 1, 2013

"The bad news is we are seeing an increase in cesareans for longer gestational ages, for full term. That is very disturbing. It's part of an overall trend of increased use of cesarean sections for normal births and that trend has obviously been rising significantly since the 1990s from 20% back in 1996 to the current 31%. It is a very steep increase."

The CDC report does not suggest what an acceptable rate of cesarean section births should be, but Binder says the World Health Organization has stated that cesarean section rate should be about 15%.

"It is extremely disturbing to see increases in the rates of cesarean after 39 weeks. It is masked by the overall numbers of cesareans because there has been this successful effort to reduce them at the early stages. They ought to be reduced at all stages," Binder said.  

"One-in-three women do not need major abdominal surgery to have a baby. That is not how it works. It doesn't make sense. None of the literature supports it and it suggests that when a pregnant woman walks through the hospital door someone is holding a knife. Women's bodies are built for child birth and we can do a lot better than this."

The CDC study found that:

  • After 12 years of consecutive increases, the preliminary cesarean delivery rate among singleton births was unchanged from 2009 to 2011 (31.3%).
  • Cesarean delivery rates decreased more than 5% among births at 38 weeks of gestation, but increased 4% among births at 39 weeks.
  • Decreases in cesarean delivery rates for births at 38 weeks occurred for non-Hispanic white, non-Hispanic black, and Hispanic women, as well as for all maternal age groups.
  • Increases in cesarean delivery rates for births at 39 weeks occurred among non-Hispanic white, non-Hispanic black, and Hispanic women, as well as for all maternal age groups.
  • The cesarean delivery rate at 38 weeks decreased in 30 states; the cesarean delivery rate at 39 weeks increased in 23 states.
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