C-sections gone wild

Sometimes it is impossible to avoid delivering a baby by cesarean section, but the high rate of operating room deliveries in America has many doctors worried.An upcoming study in the American Journal of Obstetrics & Gynecology published online found that 30.5 percent of births in America are now by c-section, including nearly one in three deliveries to first-time mothers.

In 2008, 45,822 babies were delivered  via c-section births in Pennsylvania; This represents 30.9 percent of the 148,464 births. New Jersey’s rate of c-section deliveries was an even higher 39.4 percent (43,019 or 109,257 births). An Inquirer analysis of data from the two states found that the eight county Philadelphia region’s rate was 34.3 percent – 23, 077 of the 67,336 births, compared with 21 percent a decade earlier.

Therates varied widely among local hospitals with some high volume hospitals such as the Hospital of the University of Pennsylvania (28 percent of 4,326 births by c-section in ’08) to nearly 42 percent (929 or 2,220 deliveries) at Main Line Health’s Lankenau hospital in Wynnewood.

Researchers from the National Institute of Child Health and Human Development examined date on 228,668 births at 19 hospitals, including from the Christiana Care Health System in Delaware to understand the factors behind the 50-percent increase in c-section rates over the last decade.

The most common reason was a previous c-section delivery that left a uterine scar. Another big risk factor was having labor induced by drugs. Women whose labor was induced had twice the cesarean rate as those with spontaneous labor. Older women also had high rates.

The researchers concluded that greater effort was needed to reduce the number of first time deliveries by c-section. Moreover, they wrote, “increasing [the] vaginal birth after previous cesarean is urgently needed.”

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