Overuse of c-sections: bad for women, babies, and the bottom line

Last month, Childbirth Connection issued Cesarean or Vaginal Birth: What Is At Stake for Mothers and Babies, a best evidence review cataloging dozens of adverse outcomes made more common by cesarean surgery. Maternal infections, prolonged pain, life-threatening complications, and childhood chronic illnesses – evidence demonstrates cesarean increases the likelihood of each of these. These risks are appropriate tradeoffs in some circumstances when cesarean offers a clear benefit. But a growing chorus of obstetric leaders and maternity care reformers are warning that the c-section rate is too high. For the benefit of public health – for the 4 million women who give birth every year and their 4 million babies – we must work to safely rein in the overuse of c-sections.

Today, we learn the extent to which c-section overuse is driving up health care costs, too. Together with Catalyst for Payment Reform and the Center for Healthcare Quality and Payment Reform, we have issued The Cost of Having a Baby in the United States, prepared by Truven Health Analytics.

What is at stake for payers? Not only do unwarranted c-sections create greater health risks for women and babies, this study shows that they also dramatically increase costs for employers and, through Medicaid programs, state and federal budgets. Medicaid programs paid nearly $4,000 more for c-sections than vaginal births, while for commercial insurers the difference topped $9,500. The World Health Organization recommends a c-section rate of 15% or less for any country. If the U.S. c-section rate was reduced from 33% to 15%, national spending on maternity care would decline by more than $5 billion each year.

This was just one of the important findings in The Cost of Having a Baby in the United States. Download the report to view more. These data provide needed groundwork for improvement programs to align maternity care payment and quality.  As governments and businesses work to balance budgets, and zero in on the costly maternity care segment, we must target the areas where we can reduce cost while simultaneously improving health and safety. High-quality, high-value care is within reach. We must rapidly spread innovation and best practices to improve the health of women, babies, and families. We can’t afford not to.

Filed in Blog, Costs - Charges - Value, New Reports and Resources on Mon., Jan 7, 2013

3 Responses to “Overuse of c-sections: bad for women, babies, and the bottom line”

  1. Angie says:

    The complications listed above apply to those of us who have uterine scars other than low transverse as well, yet everyone tends to brush those of us who have them aside. That’s part of the overuse of cesarean issue but no one says anything about that. That’s not right and deserves to be addressed! We deserve the same right to avoid these complications just like everyone else. We deserve choices and more of a say in our care too. Not forced into repeat c-sections because care providers are more concerned about getting sued than providing quality care. Please consider that the next time your website puts these articles out about lowering the c-section rate.

  2. Rosie says:

    Angie, you are absolutely right. I vbac’d with a J scar this past year in April and it was an uphill battle almost all the way. Woman like us need options and evidence based information not fear mongering and scare tactics due to lack of knowledge and fear of litigation! If you are looking for support there is a site called http://www.specialscars.org (hugs!!)

  3. Leigh says:

    The WHO admitted nearly two years ago that there is no optimum rate for CS, they have removed their statement about 15% and updated their recommendations to this effect too.

    Women need balanced, unbiased information. Caesareans are not an easy option but nor are vaginal births. We hear a lot about the risks and morbidity associated with caesareans because these are an ‘intervention’ but women are often totally unprepared for the morbidity and risks associated with vaginal birth.

    Women need access to balanced information and there is a book available on Amazon that offers not only a great deal of information on caesarean burth but it also details the benefits and risks of BOTH modes of birth. Supported by well known UK obstetricians and midwives “Caesarean Birth: A positive approach to preparation and recovery” puts women in a strong position to make informed decisions for themselves.