Cutting C-sections cuts costs, medical risks: article

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Health-care service providers and politicians looking to cut health-care costs might want to consider taking a scalpel to the number of caesarean sections performed each year without medical reason ...

... a first-time C-section costs about $2,265 more than a vaginal delivery.

"Canada's health-care system could save close to $25 million if the rate of first-time C-sections, let alone repeat C-sections, could be reduced to the 15 per cent recommended by the World Health Organization," ...

Canada's caesarean section rate is at about 27 per cent ...

A greater incidence of maternal obesity in Canada, as well as older mothers in general, mean riskier pregnancies and more caesarians than in other countries, ... but the current rate is still too high.

"No one agrees on what the rate should be," says Bourgeault, noting that the WHO guideline of 15 per cent could be too low, "but pretty much everyone agrees that anything higher than 30 or even in the high 20s is too high."

... The hospital has developed a three-pronged approach to reducing caesarian rates: doing a better job of informing expectant mothers of their choices, keeping track of which doctors are performing the surgical procedures, and changing their policies around inductions.

Interestingly, they have ignored the number one intervention that has been shown to reduce caesarean rates: exclusive one-to-one midwifery care in labour for all women.

"There's a higher risk of caesarean section if your labour is induced so they give it a little extra time for the woman to go into labour, and it's much more likely that women will give birth vaginally and avoid a caesarean section," ...

... "Compared to vaginal delivery, C-sections pose greater risk of cardiac arrest, hysterectomy, infection, fever, pneumonia, blood-vessel clotting and hemorrhaging, as well as risks for the baby," ...

The myth that the article wants to bust is the common belief expectant mothers are the ones driving the increase in the number of C-sections. Instead ... it's doctors, not pregnant women, pushing the scalpel option.

... only eight per cent of mothers asked for C-sections, and of that number most had already given birth that way. In a similar study in the U.S., fewer than one per cent of respondents indicated a preference for surgical delivery.

"Interestingly, most of the mothers who had a C-section indicated that it was their health care provider who made the decision," ...