Cesareans more likely for women at for-profit hospitals, study finds

[mike r]

http://www.mercurynews.com/health/ci_16045358

Cesareans more likely for women at for-profit hospitals, study finds
By Nathanael Johnson

For-profit hospitals across the state are performing cesarean sections at higher rates than nonprofit hospitals, a California Watch analysis has found.

A database compiled from state birthing records revealed that women were at least 17 percent more likely to have a cesarean section at a for-profit hospital than at a nonprofit or public hospital from 2005 to 2007. A surgical birth can bring in twice the revenue of a vaginal delivery.

In addition, some hospitals appear to be performing more C-sections for nonmedical reasons -- including an individual doctor's level of patience and the staffing schedules in maternity wards, according to interviews with health professionals... The numbers provide ammunition to those who have long suspected that unnecessary C-sections are performed to help pad the bottom line.

This was the first independent analysis of C-section rates at the 253 hospitals reporting birth statistics to state health authorities. The data focuses on low-risk pregnancies where cesareans are more likely to be unnecessary -- excluding deliveries by older mothers, women with certain medical conditions and women with previous C-sections...

[valerief]

1. Quelle surprise! Not. nt

[Odin2005]

2. BREAKING NEWS: Water is Wet!

[Renew Deal]

3. Shocking!

Well, not really.

[Pooka Fey]

4. Well, SurPRISE, surprise.

[CTyankee]

5. Why would any woman in her right mind want to have a C section if she didn't need one?

I don't get it. A surgical procedure is much more dangerous than vaginal delivery. Recovery is longer.

My daughter wound up having a C section because she developed a serious form of pre-eclamsia and was forced to have her baby delivered earlier than expected. He was fine and so was she but it was a tough go for a while for her. But my other daughter has had 3 noncomplicated pregnancies and deliveries. She had the last one induced because she barely made it to the hospital with the second and didn't want a repeat of THAT.

Trying to figure out why a woman would want a C section...

[knitter4democracy]

6. Many seem to think it's easier.

I have no idea why, but I've run into that attitude more than once.

[CTyankee]

8. If it's the pain of labor, you can get great pain relief...but you have to be very clear

with your OB...they sometimes DO tend to say "wait a little longer" and then when the going gets tough they say "too late!"

But having a C section to ease pain is just overkill. You suffer more on the other end of the process. And it's more dangerous. What do people you meet say when you tell them it is more dangerous?

[knitter4democracy]

11. I don't play up how it's more dangerous, just that it's more pain.

I see this in some of the teens I teach, and when I explain that major muscles they'll use to bend over and pick up the baby will need to be sliced and then sewn back together, they seem to get it.

There's a meme out there that C-sections are easier because you just go in, they slice you open, get the baby out, sew you back up, and you're on your way. No labor, no pain. The problem is, those muscles don't like to be sliced, and they can take a long time to heal up. I always tell people that I had mine vaginally with no pain control and that I was just fine. If I can do it, most women can (barring any unforeseen issues or health problems).

[uncommon]

7. Because in the moment it is the easier option. They fail to consider the post-op

recovery however.

[CTyankee]

9. But doesn't the process of cutting open your abdomen make them squeamish?

It would to me...

[AtomicKitten]

10. It also covers their collective ass legally.

I transcribe for Sutter Maternity and Surgery Center. Midwives are directly connected to acute care hospitals for a reason. Much can go wrong during the labor and delivery process. Obstetricians and midwives operate under the "better safe than sorry" theory.

[CTyankee]

12. I don't blame the health care professionals...but I do wonder about the women who

seem so eager for this form of surgery when they don't need it...

[AtomicKitten]

13. Some women are terrified of labor, but it is very infrequent when

that alone is the indication for a C-section. Most often it is done for fetal distress, other times for failure to descend, inadequate labor, unstable lie, cephalopelvic disproportion, etc.

[CTyankee]

14. Well, under those conditions, yes, I think it is entirely appropriate for a C section.

I think having a discussion ahead of time about labor and delivery with one's OB is a good idea. There may be problems developing that a pregnant woman shouldbe informed about. If they develop in labor, or a week or so prior to the due date, then the woman is more prepared. In my dtr's case, her OB's staff obviously missed her high blood pressure reading at her last office visit. She went to the hospital with pain that could not be accurately described as labor...and discovered that her liver was threatened and she was not making blood platelets. She hadn't begun dilating so she was taken in the OR for a section. Everything was fine, but it turns out her form of pre eclamsia was called HELLP Syndrome. Thankfully, my grandson was far enough along to be just fine and she was fine, too. It was just very tense for a while there...