Healthcare News & Insights

Too many C-sections in hospitals

The rates of hospital C-sections are higher than ever. This suggests many new mothers don’t actually need the procedure. One patient-safety group is bringing attention to this fact and calling on hospitals to make better judgments. 

ThinkstockPhotos-140403244New data from the Leapfrog Group shows the number of C-section births at hospitals in 48 states and Washington DC.

According to a press release, this is the first time C-section data by hospital has been gathered and compared.

Using federal data on quality measures, plus recommendations from the Healthy People 2020 initiative, the Leapfrog Group created a benchmark for hospital C-sections: Per hospital, only 23.9% of births should be C-sections.

However, over half of reporting hospitals failed to meet this target.

Rural hospitals fared better than urban hospitals. Nearly 50% of rural hospitals that reported birth data had C-section rates of 23.9% or lower, while only 36.8% of urban hospitals fell within this range. In fact, one hospital in the Northeast metropolitan area performed C-sections on new mothers over 40% of the time.

Hospitals in Utah and Idaho had some of the lowest C-section rates, with averages of less than 20%. On the other hand, hospitals in Kentucky and Florida had the highest rates of over 32%.

Medical significance

While C-sections are necessary in certain cases to save lives, they’re performed too quickly in others. And it’s often for the sake of convenience – for the future parents or even the doctors.

C-sections are major surgeries and come with many risks and a significant recovery time. The cost is also higher than a traditional birth, which draws more payor scrutiny.

With that in mind, the procedure should only be performed if it’s medically necessary. And in hospitals that have high C-section rates, that’s not likely the case.

Preventing overuse

C-sections are performed more often than necessary on first-time mothers who’ve reached 37 weeks and are carrying one fetus in the head-down position.

According to data from the Leapfrog Group, a C-section isn’t appropriate for first-time mothers before the “pushing” phase of labor begins even if labor is slow but progressing and lasts several hours.

During the pushing phase, there’s no upper limit time frame for labor. Until a first-time mother has pushed for at least three hours (or an experienced mother has pushed for at least two hours), a C-section shouldn’t even be considered

As long as the birth is progressing, the time may be extended depending on the baby’s position or whether the mother is using an epidural.

In addition, C-sections shouldn’t be the “go-to” choice for large babies, mothers expecting twins (as long as the first twin is positioned head-first) or babies in the breech position a few weeks before the due date.

Hospitals may need to do more to educate providers on these facts and encourage them to promote traditional birth over C-sections unless specific circumstances dictate otherwise.

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