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C-Sections on the Rise: New Insight
Reported March 11, 2010
(Ivanhoe Newswire) -- "Once a C-section, always a C-section" seems to be
taking hold as a mantra at medical facilities across the United States. Fear
over complications associated with attempting vaginal birth after a cesarean
section has lead to an increase in repeat C-sections since 1996.
A new study shows across the United States, the rate of C-sections is going
up and the rate of Vaginal Birth After Cesarean, or VBAC, is plummeting.
While rates of VBAC hit a peak in 1996 at 28.3 percent, since then, the rate
has dropped to as low as 8.5 percent.
Experts say the plummeting numbers of VBAC cases and the related rise in
C-sections can be in part attributed to a study published in 1996
emphasizing the risk of complications -- including uterine rupture,
hysterectomy, transfusion, "major operative injury," and maternal or newborn
death -- that can be associated with VBAC. Also contributing to the
declining number of VBAC cases, experts note, was a recommendation by the
American Congress of Obstetricians and Gynecologists (ACOG) in 1999 that
women should be "offered" VBAC only if a physician is available to
immediately perform a C-section, rather than "encouraged" to choose it.
Data from a national sample of inpatients shows between 2000 and 2005, the
rate of elective repeat C-sections increased from 59 percent to 83 percent,
while the overall rate of VBAC declined -- across all age groups and all
racial/ethnic groups.
Surveys of hospital administrators found about 30 percent of hospitals have
stopped allowing VBAC services altogether, and of hospitals that allow VBAC,
more than half were forced to change their policies to be compliant with the
revised ACOG guidelines.
Source: Presented at the NIH Consensus Development Conference, March
8-10, 2010; Bethesda, Md. |
