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Cesareans should not be performed for the convenience of a woman or her doctor, expert says
TUESDAY, July 19 (HealthDay News) -- Between 2002 and 2009, the number of cesarean deliveries rose significantly, from 27 percent of births to 34 percent, finds a new report based on information from 19 U.S. states.
"C-sections are rising, and there needs to be a little bit more scrutiny from the person who is having the C-section as well as doctors and hospitals," said report author Dr. Divya Cantor, the senior physician consultant for HealthGrades, the organization that put together the report.
HealthGrades is a source for physician information and hospital quality outcomes.
The jump in C-sections is a national trend, according to Cantor. "Doctors need to better understand when a C-section is called for," she said. "Patients need to have a better understanding of C-sections and not go into it blindly."
Commenting on the report, Dr. Alan Fleischman, medical director of the March of Dimes, said that the findings in the report are "not surprising, but they are quite dramatic."
"We at the March of Dimes have great concerns not just about the rate, but about what's driving it," he said.
According to the report, some of the reasons the number of cesarean deliveries are on the rise include:
"Many women and many babies have benefited from a cesarean when the fetus is sick," Fleischman said. "But in fact, there is very little an obstetrician can do after 34 weeks of gestation other than deliver a baby," he said.
Fleischman thinks too many babies are delivered early to minimize risk, in part because the outcomes of infants delivered after 34 weeks are good. "But not as good as [a full-term birth]," he said.
"Cesarean section should be done at the right time and for the right reason," he insisted. "Some cesarean sections are being done too early and not for the right reason. Convenience for the woman or her doctor isn't the right reason."
Cesarean delivery can be dangerous for the mother, Fleischman added. Complications can include blood clots, excessive bleeding, infection, longer recovery time and injury to the bladder, uterus or bowel, according to the report. The risk of complications is even higher in obese women, where a cesarean is a major operation, Fleischman noted.
In addition, infants born before term can also experience problems, Fleischman said, warning that there is an increased risk of complications such as breathing difficulties and even death.
Women need to understand how important it is for a delivery to go to term, Fleischman pointed out. "Fetuses are not just getting fatter in the last month," he said. "They are actually growing and developing. Their lungs and brains and kidneys are developing," he stated.
The findings are published in a report titled HealthGrades 2011 Obstetrics & Gynecology in American Hospitals.
Other highlights in the report include:
For more information on cesarean section delivery, visit the U.S. National Library of Medicine.
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