C-Section Rates Not Best Quality Gauge

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When cesarean section rates are lower than expected, adverse maternal or neonatal outcomes are higher ... But the converse isn't true -- higher-than-expected C-section rates aren't associated with a protective effect ...

The finding comes from an attempt to see if the risk-adjusted C-section rate can be used as a marker for the quality of obstetric care ...

The measure has been proposed previously, but has been criticized for including all deliveries -- including those where it is medically necessary -- and because the overall rate of C-sections had been rising.

... hospitals that perform fewer than expected cesarean sections are likely to have poorer outcomes for mothers and children.

... 59.8% of ... hospitals with lower-than-expected risk-adjusted C-section rates had a higher-than-expected rate of at least one of the six adverse outcomes. * Only 19.6% of ... hospitals with higher-than-expected risk-adjusted C-section rates had a higher-than-expected rate of any of the six adverse outcomes.

... On the other hand, performing too many C-sections wasn't associated with improved outcomes, they noted, adding that the finding "should not suggest" that the practice is desirable.

Instead, they said, "it likely reflects an overuse of medical care and the performance of unnecessary procedures."...

Melissa Maimann, Essential Birth Consulting 0400 418 448