NYC C-Section Rates on the Rise

A recent study was published showing that New York City based hospitals ceaseran section rates are on the rise. The local Park Slope Parents community discussion board was buzzing with questions and concerns about the report. Rebecca Benghiat, Executive Director of New Space for Women's Health answered cleared the air in her reponse post which she gave me permission to reprint.

I wanted to reprint it because I have met too many women who assume that thier doctor or hospital are familiar with natural births and that they support natural birth. Unfortunetly, this is a misconception proven by the skyrocketing c-section rates in our local hospitals. There are links to the full report at the end of the letter.

There are times when c-sections are medically necessary. After three days of labor without progressing past 4 cm of dialation, mine was. But I find it hard to believe that the numbers of women reflected in the report really needed this major surgery.

Hi Everyone,

I just wanted to respond, since we (New Space for Women's Health) were the non-profit that jointly released the 2006 NYC c-section data along with Choices in Childbirth. Choices in Childbirth worked tirelessly to obtain the hospital by hospital data from NY State - it was not easy to get, and they have done a huge service to our community by adding to the pool of information available to women and families.

Hospital rates are relevant for a few reasons. First, absolutely - your choice of provider is crucial in your care, but all hospital based providers have to work within hospital dictated protocols. These protocols vary in their support of vaginal birth (for instance, the option for intermittent monitoring, offering other pain relief other than epidural, etc). The doctors, midwives, and nurses must follow hospital protocols, and the hospital-wide rates are a sort of "temperature read" of how they compare to the WHO recommended rate of 10-15%. That rate, by the way, was calculated by determining the nexus of best outcomes for moms and babies. Fewer c-sections, or more, and infant and maternal mortality rates increase. The hospital with the lowest rates in NYC (~17%) is North Central Bronx, a public hospital with a midwifery run floor and a number of protocols in place that have been shown to reduce c-sections.

The rates also help us see trends in our area's maternity care and to begin a discussion with hospitals about what they are doing to address the changes in rates. For example, a number of hospitals in Westchester, where rates are 50+%, are increasing their number of recovery and postpartum rooms to handle the longer stays required. We should ask: how should hospitals address their care trends? Should they increase beds or act preventatively to adjust protocols, etc.

A final note on the NYC data - the increases were across the board - the numbers were not driven by the mother's age, socioeconomic status, ethnicity, or other demographic - another reason to look at the institutions providing maternity care.

Of course, when medically necessary, c-sections are absolutely a life saving procedure. But, they are surgical procedures with their own risks. Consider this like you would any other consumer data - car evaluations, a/c rating, etc - it all is part of the calculation of making an informed choice!

The full c-section press release is available here: http://vcr.csrwire.com/node/9704

The hospital by hospital intervention rates are here: http://www.choicesinchildbirth.org/nyshlis/year.htm?year=2006

Finally, The Birth Survey has ratings for providers and facilities - you can use it as a resource or take the survey if you've had a baby in the last 3 years: http://www.thebirthsurvey.com/the survey is for NYC now, and will be going national in the fall.


Rebecca Benghiat, Executive Director New Space for Women's Health http://www.newspacenyc.org/

Posted by Juliette Aiyana, L.Ac., Founder Aiyana Acupuncture & Chinese Herbs