From the TMC blog: Will Obstetricians Heed a Leader’s Warning to “Stop the Relentless Rise in Cesarean Deliveries?”
Kudos to Dr. John Queenan for his candid editorial “How to Stop the Relentless Rise in Cesarean Deliveries,” published in the August issue of Obstetrics and Gynecology. We applaud his candor as an obstetric leader willing to confront the serious problems associated with the steadily rising cesarean section rate now approaching 34%.
Dr. Queenan predicts that the significant increase in primary cesareans coupled with the sharp decrease in the VBAC rate will soon result in a 50% cesarean section rate in the U.S.
There’s no doubt that the relentless rise has been a source of anxiety for maternity care stakeholders for at least a decade as the rate has increased year after year. Women feel pressure to accept interventions including major surgery they’re not sure they’ll benefit from, driving a small but rapidly growing group of women to opt for home birth instead. Medicaid programs face severe financial constraints and are set to accept millions of new enrollees in 2014. Given the price tag, Medicaid simply can’t afford a 50% cesarean rate, nor even to sustain the current rate. Obstetricians are now seeing more and more patients with sometimes life-threatening consequences of too many c-sections at unprecedented rates. As Dr. Queenan warns, “the rising cesarean rate is a threat to the profession and there’s no time for complacency.” His editorial ends with a clarion call for concerted action by his profession to confront the problem and commit to action before policy-makers and payers step in and force change.