Excessive? Hospitals Might Be Giving Too Many Risky C-Sections, Report Finds

There are many benefits for both the mother and baby when it comes to a traditional, vaginal delivery, but a new report found that the number of Cesarean sections being performed is up, to the point where it might be excessive.

The American College of Obstetricians and Gynecologists recommends vaginal deliveries over elective C-sections, which it says comes with risks and longer hospital stays. Risks include bladder and bowel injuries and complications with future pregnancies. While vaginal births usually have a quicker recovery periods and babies are at a lower risk for respiratory problems.

An investigation by Consumer Reports of 1,500 hospitals in 22 states found hospitals might be performing C-sections when they are not necessary. Of these hospitals, it found that the rate for C-sections in deliveries considered low-risk was about 18 percent, which is above the national average of 12.6 percent reported in 2000.

A look at some of the hospitals with the higher C-section rates that were reviewed in the investigation. (Image source: Consumer Reports)

What's more, Consumer Reports said 66 percent of the hospitals it rated were within its two lowest scoring options. Twelve percent received its top score.

Dr. Elliot Main, the director of the California Maternal Quality Care Collaborative, reviewed Consumer Reports' data and said that the reasons some doctors are citing for C-sections are "completely bogus."

“[The mothers] must be older, fatter, sicker or they must be requesting C-sections, but that’s completely bogus," Main told Consumer Reports. "As a doctor, I can convince almost any woman in labor to have a C-section.”

It cited a survey of mothers that found two-thirds had C-sections at the recommendation of their doctor and one-quarter felt pressured into this form of delivery.

Here's one woman's experience with such a situation:

Melek Speros of Austin, Texas, says her doctor warned her late in her first pregnancy that her pelvis might be too small to allow for a vaginal delivery. "I was really surprised because I'm 5'8" tall with a large frame," Speros said. Reluctantly, her doctor agreed to allow her to “try” a vaginal birth by inducing labor eight days before her due date at St. David’s South Austin Medical Center (which earned low marks in our Ratings.) When the induction didn’t quickly work, he recommended a C-section. "He said that a vaginal birth would be unsafe, that my baby could get stuck and suffer serious harm," Speros said.

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Speros’ experience—feeling pressured into a C-section without being informed about her birthing options—prompted her to change career plans, switching from lawyer to childbirth educator. And indeed getting reliable information about how hospitals approach childbirth can be  difficult. For example, while hospitals often target expectant mothers with ads featuring cherubic infants and cozy birthing rooms, they seldom publicize their rates for surgical deliveries.

Aside from a high-risk delivery that could not be done safely vaginally, some reasons for a C-section include convenience on the part of the patient or doctor. For example, Consumer Reports noted that some doctors might take this stance when they think a labor is going to slowly. Plus, health insurance and Medicaid pay more for C-sections than vaginal deliveries.

Watch Consumer Report's video about its findings:

As for why some hospitals had higher rates of C-sections than others, Consumer Reports said it "found no simple answers" to this question.

“What it boils down to is culture,” Main said. “Culture of the hospital, the nursing staff, even the patients.”

Check out Consumer Reports full investigation for more information, including its tips to help women avoid unwanted C-sections.

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Front page image via Shutterstock.