Doctor preferences may explain high C-section rates

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NEW YORK | Mon May 24, 2010 5:30pm EDT

NEW YORK (Reuters Health) - The number of Cesarean sections performed at hospitals across British Columbia is highly variable, Canadian researchers have found.

Even when accounting for differences in women's preferences and conditions that could complicate vaginal delivery, C-section rates varied from less than 15 percent to more than 27 percent of all births.

"Thus, our results illustrate what we believe to be 'unwarranted variation,'" the researchers write in the latest issue of the journal Obstetrics and Gynecology, noting that mothers requested C-sections in only 2 percent of the cases.

According to the new report, earlier studies have found marked variation in the United States as well. Both Canadian and US experts agree that the current Cesarean rate -- in the US, one-third of all births -- is too high.

It is not entirely clear why the rates vary so drastically, but the Canadian researchers, from the University of British Columbia in Vancouver, suggest that limited resources at smaller hospitals may lower the bar for C-sections to avoid emergency surgeries.

Among the more than 100,000 deliveries that they analyzed, the most common reason for C-section was difficult labor, which accounted for one-third of the surgeries, and was also highly variable between different areas.

As a result, the researchers write, "we suggest that revising the current guidelines regarding the management of (difficult labor) may be a good starting point on the road to decreasing unwarranted variation in cesarean delivery and assisted vaginal delivery rates."

SOURCE: www.ajog.org

Obstetrics and Gynecology, June 2010.
Health
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Comments (2)
Alan_McCrindle wrote:
Natural childbirth is unpredictable and can happen at any time of the day and any day of the week. C -sections on the other hand can be scheduled during the day and on weekdays. This is much more convenient for doctors who might want to live a life according the the schedule of most the rest of us.

Being a doctor used to be a self sacrificial job – you had to be prepared to be available all all sorts of hours to deal with medical issues as they emerged.

We now live in a far more individualistic – less self sacrificial world – It should be no surprise that doctors are acting more in their own self interest with regard to recommending c-sections that they can schedule at times that suit them over natural births that create lifestyle restrictions.

May 24, 2010 7:23pm EDT  --  Report as abuse
elizabette wrote:
Doctor’s are compensated at a higher rates for less time, often during predictable hours, when they do a C-Section.

But also, being surgeons, they tend to see little disadvantage to performing surgery. To them it is routine.

May 25, 2010 11:49am EDT  --  Report as abuse
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