Thursday, December 06, 2007


According to an article at today, that was the rate of cesarean section delivery in the United States in 2005-2006. When I was a second year med student, they told us it was around 25%, and that was still too high.

Interestingly, this number was squeezed in at the end of an article about the teen birth rate rising 3% those same years. While I oppose abstinence-only sex education, I am not too keen to jump on these numbers and say "of course, that's what I expected." After all, the teen birth rate had been dropping every year prior to that one. It will be interesting to see what happens in the next year's data analysis of teen motherhood, as well as what political fodder this will make with the Iowa caucus approaching quickly.

As far as the c-section number, that's 31% of delivering mothers who are exposed to increased risks of bleeding, DVT/PE, wound infection, endometritis, hysterectomy, uterine rupture/placenta accreta in future pregnancies, etc. Of course some of those women required c-section, but many of them did not. How many women would continue to choose c-section if we in the medical community did a better job taking the fear away from labor and delivery? Or if we did a better job of pointing out that the recovery from a c-section takes weeks to months longer than from a vaginal? Or if the lawyers wouldn't ask for millions for a family with a sad outcome by accusing the physician of not doing a cesarean? Even though medical science cannot say when CP happens, even though the rising rate of c-section has not dropped the rate of CP, we continue to do more as we fear the lawsuit. It's a terrible thing.


Gauderio said...

Wow. This post is like a throw back to when the S stood for surgeon and not shrink.

The hospital my mom works in has a c section rate >60%. They even have use the abreviation "WIL" on the chart. "Walk-In Labor".

It just means you really have to pick and choose your OB - and when you get there ask the C/S rate of them and their group.

Tiny Shrink said...

My interests are many and varied, and I like to keep people on their toes. ;)

Agreed, that you should choose your OB AND your delivering hospital carefully. Part of my concern here, though, is that I don't think many women know about the risks of c-section compared to SVD. Of course, should your lovely pregnant lady require a c-section, we'll all take good care of her, but I'm glad you have chosen wisely with your OB to *try* to avoid such a thing.

Tami of BrooksGroth said...

Kudos to you for helping to bring attention to the rising c/s rate. Help us continue to bring attention to this -- and HELP us to change it!!! -- visit and share the link and info with others.

(I found your blog entry on my google alerts on this issue.)

Midwife with a Knife said...

I know OBs who say, "You will never get sued for doing a c-section". :P It's really society that has driven us to this point.

Now with patients requesting (and getting!) c-sections on demand... ARGH!!!

On the bright side, schedualed c-sections disrupt my schedule much less than those pesky night-time deliveries.

frectis said...

Word, TS.

Tiny Shrink said...

I knew frectis would appreciate that commentary!

And I know that many c-sections are driven by fear of litigation; I just wonder why lawyers haven't jumped on the bandwagon of suing after the c-section for DVT/PE, wound infection requiring re-hospitalization, uterine rupture, etc. (I'm not suggesting that these things SHOULD be sued for!) I just wonder why not doing a c-section has become such a cash cow for the litigation community, and the c-section is seen as such a safe, benign surgery. It can be a great surgery when needed, but it certainly isn't benign.