Pitiful statistic

[JustBeachyNurse]

Your Biggest C-Section Risk May Be Your Hospital - Consumer Reports

NJ Hospital Hackensack UMC 42% c/s rate for low risk, first time mothers. I don't work OB but many of my pediatric patients have life altering issues as a result of birth trauma/complications. I know parents who had such a traumatic first birth they are afraid to even try again.

Is this reality?

[Not_A_Hat_Person, RN]

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.