TUESDAY, July 19 (HealthDay News) -- Between 2002 and 2009, the
number of cesarean deliveries rose significantly, from 27 percent
of births to 34 percent, finds a new report based on information
from 19 U.S. states.
"C-sections are rising, and there needs to be a little bit more scrutiny from the person who is having the C-section as well as doctors and hospitals," said report author Dr. Divya Cantor, the senior physician consultant for HealthGrades, the organization that put together the report.
HealthGrades is a source for physician information and hospital
The jump in C-sections is a national trend, according to Cantor.
"Doctors need to better understand when a C-section is called for,"
she said. "Patients need to have a better understanding of
C-sections and not go into it blindly."
Commenting on the report, Dr. Alan Fleischman, medical director
of the March of Dimes, said that the findings in the report are
"not surprising, but they are quite dramatic."
"We at the March of Dimes have great concerns not just about the rate, but about what's driving it," he said.
According to the report, some of the reasons the number of
cesarean deliveries are on the rise include:
- Convenience in delivery timing for the doctor or the
- Women giving birth later in life, which raises the risk of
complications during pregnancy and delivery.
- An increase in maternal risk factors, such as obesity and
- Increase in multiple births, sometimes due to the increase in
- Increased willingness of doctors to perform C-sections.
- Pregnant women's lack of understanding of the potentially
serious complications of C-sections.
- Pregnant women requesting C-sections.
- Fear of malpractice for not doing a C-section.
- Common labor practices, such as inducing labor or using
"Many women and many babies have benefited from a cesarean when the fetus is sick," Fleischman said. "But in fact, there is very little an obstetrician can do after 34 weeks of gestation other than deliver a baby," he said.
Fleischman thinks too many babies are delivered early to
minimize risk, in part because the outcomes of infants delivered
after 34 weeks are good. "But not as good as [a full-term birth],"
"Cesarean section should be done at the right time and for the right reason," he insisted. "Some cesarean sections are being done too early and not for the right reason. Convenience for the woman or her doctor isn't the right reason."
Cesarean delivery can be dangerous for the mother, Fleischman
added. Complications can include blood clots, excessive bleeding,
infection, longer recovery time and injury to the bladder, uterus
or bowel, according to the report. The risk of complications is
even higher in obese women, where a cesarean is a major operation,
In addition, infants born before term can also experience
problems, Fleischman said, warning that there is an increased risk
of complications such as breathing difficulties and even death.
Women need to understand how important it is for a delivery to
go to term, Fleischman pointed out. "Fetuses are not just getting
fatter in the last month," he said. "They are actually growing and
developing. Their lungs and brains and kidneys are developing," he
The findings are published in a report titled
HealthGrades 2011 Obstetrics & Gynecology in American
Other highlights in the report include:
- 7 percent of women having babies in hospitals had a
complication. If all hospitals performed at the level of the
best-rated hospitals, 32 percent of these complications (141,869)
might have been avoided.
- 9 percent of women undergoing gynecologic surgery had a
complication. If all hospitals performed at the level of the best
hospitals, 35 percent of these complications (30,675) might have
- Although hysterectomies are the most common gynecological
procedure performed, representing 79 percent of procedures, the
number has decreased since 2002, by 31 percent.
- Of the 19 states included in the report, the highest rates of
C-section deliveries were in Florida (38.6 percent) and New Jersey
(38 percent). The lowest rate was in Utah (22.4 percent).
For more information on cesarean section delivery, visit the
U.S. National Library of Medicine.