Malpractice Suits, Other Factors Contribute To Rise In Caesarean Births, Experts Say

Main Category: Litigation / Medical Malpractice
Also Included In: Pregnancy / Obstetrics
Article Date: 19 Jun 2009 - 6:00 PDT

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Many doctors believe that the increase in caesarean section births in the U.S. over the last decade has been fueled by three main factors -- fear of malpractice lawsuits, a decrease in vaginal births after c-sections and rising rates of obesity -- the St. Petersburg Times reports. According to the Times, 31.8% of U.S. births were c-sections in 2007, compared with 21% a decade earlier, making c-sections the most commonly performed procedure in the nation's hospitals.

A few decades ago, c-section births were relatively rare, representing only 4% of U.S. births in 1965. According to the Times, c-section rates began to increase when it was believed that many cerebral palsy cases were the result of infants being deprived of oxygen during traumatic vaginal deliveries, which led to malpractice suits against doctors. At the same time, advancements in neonatal care and electronic fetal monitoring in recent decades have helped make the procedure safer and therefore more common. Robert Yelverton, a physician and board member of the Florida Obstetric and Gynecologic Society, said that doctors "tend to opt for the method of childbirth most likely to withstand a legal challenge." Whereas doctors in the past were more likely to use techniques such as vacuum extraction or manually turning an infant during a difficult birth, doctors today automatically opt for a c-section, according to Yelverton. According to the Times, one study found that 76% of U.S. obstetricians reported at least one litigation event, with an average award of $2.3 million for negligence in childbirth.

An increase in obesity and a decline in VBACs also have driven the rise in c-section births, the Times reports. VBACs have declined from nearly 30% in the 1990s to 7.9% in 2005, which some doctors say is a result of fear of litigation because of the chance for rare but serious complications during birth. Similarly, obesity puts women at an increased risk for gestational diabetes, delivering prematurely or having larger infants, which can make birth more risky, the Times reports. More than one-third of U.S. women of childbearing age are overweight or obese (Martin, St. Petersburg Times, 6/17).

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