The rate of delivery by U.S. women via cesarean section fell ever so slightly for the first time in nearly 15 years according to recently published federal data. The current rate for c-section delivery of 32.8% ticked down .1% from 2009 to 2010. Physicians have long expressed concerns about rising c-sections rates because the surgical procedure is more risky and expensive than vaginal delivery. The recovery time is also much greater.
The threat of medical malpractice lawsuits has been raised as one of the factors spurring the steady rise in c-section procedures. Some have suggested that physicians were too quick to pull the trigger on a c-section where there was really no emergent medical need for the procedure. Certainly, a circumspect and cautious approach is warranted in all areas of medicine, including obstetrics, but utilizing an otherwise unnecessary procedure solely out of concern for litigation itself borders on malpractice.
There is no clear emperical evidence to suggest why c-sections have been on the rise for so long. Anecdotally, in addition to the fear of malpractice lawsuits, other reasons have been offered for the past rate increases. They include the notions that increased complications are resulting from more women having babies later in life, that better medical technology is providing physicians with the ability to diagnose problems which warrant a c-section earlier, that there is reluctance to try a vaginal delivery in women who have delivered by c-section in the past, and that more women are taking advantage of the convenience of c-section delivery as a scheduled method of delivery. Whatever the reason, some analysits suggest that c-sections performed without a medical reason cost the U.S. health care system over $1 billion each year.
Some satistics, however, appear to suggest no relationship between increasing rates for c-section and malpractice lawsuits. Data from the National Practitioner Databank, a repository of information related to malpractice by health care providers, shows variable rates in obstetric malpractice cases over the past 20 years, while the rate of c-sections steadily rose. If malpractice were driving c-section deliveries, one would expect a stronger correlation with the rate of litigation. The question of whether malpractice lawsuits drive c-section rates may never be definitively answered without more research. The reduced rate would appear to be welcome news to the medical community which generally views vaginal delivery as the safest, easiest and most economical way to give birth.
