Wednesday, July 5, 2017

The Most Common Surgery in America

Plastic surgery?

Gastric bypass?

Heart surgery?

Nope. The most common surgery in America is Cesarean section (C-section) with approximately 1.3 million babies delivered each year via this surgery.

About 1 in 3 babies are born via C-section in America -- the highest rate among developed nations.

Why the uptick?

Many people blame women having children later in life ("advanced maternal age") and obesity rates on the rise. Although these factors can contribute, a woman's number one risk factor is simply the hospital where she delivers.

One hospital may have a Cesarean section rate of less than 10% while another hospital has a rate as high as 64% (almost two out of every three births and nearly twice the national average!). Are the women who go to that second hospital always more high risk than the women who go to the first hospital? Could the discrepancy in patients be that vast?

The national target for C-sections is 23%. Why are some hospitals missing the mark so dramatically?

There are many possible reasons. Doctors have more control when the birth is a surgical one. It is also typically faster and more convenient for scheduling to have a C-section. It also costs about 30% more than a vaginal delivery so the hospital makes more money.

There is certainly a time and place for C-sections, but when the national average is far above the target, something is broken with the system, not the women.

Vaginal deliveries for low-risk mothers is better for the mom and the baby. 20,000 major surgical complications arise each year as a result of C-section surgeries. These complications include sepsis, hemorrhage, and organ injury. For low risk mothers have their first C-section, their risk of dying as a complication of childbirth or suffering from a serious complication such as blood clot, heart attack, or major infection increases three times compared to a mom delivering vaginally. Babies born vaginally are less likely to have breathing issues and more likely to breastfeed. There is no doubt that delivering vaginally for low-risk moms is the safer choice for everyone involved.

If more mothers would start researching their hospital's Cesarean rate and choose a hospital with a lower rate, the hospitals that need to improve their practice would be forced to change their ways. There are situations where C-sections save lives, but when overused they can do just the opposite. If you are expecting or know someone who is, I recommend reading the Consumer Report on C-sections. Know your local hospitals and choose one with a C-section rate at or under 23% if possible. This is not always easy due to vast differences in medical care across the country. But the first step to reducing the risk of an unnecessary Cesarean is finding a hospital with a low C-section rate.

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