Pitiful statistic

Yes. And Hackensack is rated the "#1 Hospital in NJ." Until hospitals or individual providers are taken to task for their practice, nothing will change.

Yes, there are many hospitals that have abysmal C/S rates. I'm proud to work for an organization that has a true collaborative model between the physicians and the midwives, and we have one of the lowest C/S rates in the country.

Ever consider maybe that the patients are asking for a section?

If we're talking about primary C/S, as the OP did when she referred to Hackensack Medical Center, studies have shown that elective primary C/S account for a very small portion of C/S rates overall, and can't be considered a major reason C/S rates are rising. Other factors are at play.

Repeat C/S certainly account for a sizable portion of total C/S rates, which is also a reason to both try to reduce the primary rates, and increase rates of VBAC where possible.

Ever consider maybe that the patients are asking for a section?

Sure. But not 40% of them. And a woman can ASK all she wants, but without any indication, it would be malpractice to perform it, simply because that's what she is requesting.

These c/s statistics are first time pregnancy, low risk mothers. These aren't including high risk or repeat c/s. Other facilities are >50% for first time low risk mothers!

Brittany Spears aside who volunteers for major abdominal surgery that is not low risk when having a normal, low risk, no comorbid factor pregnancy?

These c/s statistics are first time pregnancy, low risk mothers. These aren't including high risk or repeat c/s. Other facilities are >50% for first time low risk mothers!

Brittany Spears aside who volunteers for major abdominal surgery that is not low risk when having a normal, low risk, no comorbid factor pregnancy?

Who does that? Women that want to avoid pelvic relaxation corrective surgery in the future, that's who. And it's far more common, apparently, than folks realize.

And it's far more common, apparently, than folks realize.

Enlighten us with some stats, then.

Enlighten us with some stats, then.

Some 'stats'? Do you mean some literature that discusses the increased rates of pelvic floor dysfunction after lady partsl delivery vs c-section?

I suppose if someone were truly interested, Google is easy enough.

Some stats that support your hypothesis that the main reason for the ever-increasing primary cesarean rate is maternal request.

Who does that? Women that want to avoid pelvic relaxation corrective surgery in the future, that's who. And it's far more common, apparently, than folks realize.

While pelvic floor relaxation corrective surgery might be more common, people choosing a section to prevent this, having one major abdominal surgery to avoid the *possibility* of another, is simply NOT a major influence in the rising c section rates across the country. It doesn't account for why facilities rates are double and above the 15% rate recommended WHO rate.

Without knowing the reasons for the C-Sections, its hard to say if a 42% rate is excessive or not. Low-risk pregnancy does not mean low-risk delivery, and most "unnecessary" C-sections are only found to be unnecessary after the fact.

The WHO admitted last year that there's no such thing as an "ideal" C-section rate.

Since 1985, the international healthcare community has considered the ideal rate for caesarean sections to be between 10-15%. Since then, caesarean sections have become increasingly common in both developed and developing countries. The WHO statement published today says that when caesarean section rates rise towards 10% across a population, the number of maternal and newborn deaths decreases. When the rate goes above 10% there is no evidence that mortality rates improve. Across a population, the effects of caesarean section rates on maternal and newborn outcomes such as stillbirths or morbidities like birth asphyxia are still unknown and more research on the impact of caesarean section on women's psychological and social well-being is needed.

Dr Marleen Temmerman, Director of WHO Department of Reproductive Health and Research including HRP states, These conclusions highlight the value of caesarean section in saving the lives of mothers and newborns. They also illustrate how important it is to ensure caesarean sections are provided to the women in need - and to not just focus on achieving any specific rate.” (emphasis added)

A meta-analysis in Reproductive Health came to the same conclusion.

In unadjusted analyses, authors found a strong inverse relationship between CS rates and the mortality outcomes so that maternal, neonatal and infant mortality decrease as CS rates increase up to a certain threshold. In the eight studies included in this review, this threshold was at CS rates between 9 and 16%. However, in the two studies that adjusted for socio-economic factors, this relationship was either weakened or disappeared after controlling for these confounders. CS rates above the threshold of 9-16% were not associated with decreases in mortality outcomes regardless of adjustments. Our findings could be interpreted to mean that at CS rates below this threshold, socio-economic development may be driving the ecologic association between CS rates and mortality. On the other hand, at rates higher than this threshold, there is no association between CS and mortality outcomes regardless of adjustment. The ecological association between CS rates and relevant morbidity outcomes needs to be evaluated before drawing more definite conclusions at population level.