INDIANAPOLIS, Ind.-- According to the Centers for Disease Control and Prevention (CDC), the total U.S. cesarean delivery rate reached a high of 32.9 percent of all births in 2009, rising 60 percent from the recent low of 20.7 percent in 1996.
The American College of Obstetricians and Gynecologists (ACOG)developed clinical guidelines for reducing the occurrence of non-medically indicated cesarean delivery and labor induction before 39 weeks.
ACOG advises improvements in perinatal care: changes in hospital policy to disallow elective delivery before 39 weeks and education of the public.
CBS4 spoke with Dr. Mary Abernathy, of St. Vincent Womens Hospital, about some of the many drivers of C-sections.
“Weight can be an issue,” according to Dr. Abernathy, “because the more a mom weighs, the more the likelihood that she might have labor dystocia- her labor either stalls out or we can’t get her into a good labor pattern. Larger women tend to have larger babies, so that can contribute to that as well. When a patient stalls out, it’s probably different, and we need to be a little bit more patient. So we’re now being given more time before we call or say she needs to be delivered by C-section.”
Epidurals can lead to C-sections as well.
“We have come to realize, by having an epidural, we probably need to increase the time that we allow her to have a normal labor and delivery.”
Certainly, the cost of C-sections is higher than vaginal deliveries. On average, C-sections cost around $15,800 . Natural childbirth is around $9,600
One study by Dr. Erika Cheng of the IU Medical Center found a number of women get bad information regarding the size of their baby. In fact, Dr. Cheng found 30 percent are told their babies are getting quite large, when in fact they may be normal size.
“We also found, among these women, there are higher rates of labor induction, use of pain medications during labor and delivery and more requests for C-section delivery," said Dr. Cheng.
Continual monitoring of fetal heart rate can lead to increased C-sections, according to Dr. Abernathy.
Convenience for doctors is a factor as well.
“A lot of physicians and patients want to be there for their patient, and so we’re trying to induce patients either a little bit earlier than we should have and/or induce them when it’s convenient for the physician and the mom. And what we’re finding is that when you induce, actually you increase the C-section rate,” said Dr. Abernathy. "Convenience can be a driver. It certainly can be.”
Expectant mothers may point to increased safety for the baby when delivered by C-section, but the data doesn’t necessarily bear that out.
“I would say all things considered, if you’ve never had a C-section, your chances of having a healthy baby should be equal with a vaginal delivery vs a C-section,” said Dr. Abernathy.
The key is to reduce C-sections in first time mothers, and to be a little more patient during labor.
“We know now, some of our research may indicate that we need to wait. Be a little more patient before we actually call for a C-section,” said Dr. Abernathy.
For more information on C-section rates, click here.