34% of all single births in the USA were Cesarean section (C-section) compared to 27% in 2002, a rise of about 25% in seven years, according to a new report called "HealthGrades 2011 Obstetrics and Gynecology in American Hospitals" issued by HealthGrades. The states with the highest rates were Texas, New Jersey and Florida, while Utah, Colorado and Wisconsin had the lowest.

HealthGrades is an independent health care ratings organization with information on physicians, dentists, and 5,000 US hospitals.

The report also rated maternity and gynecological quality in 19 US states over three years where data on hospital patient outcomes could be gathered. Hospitals were designated a star system, with five stars being the highest.

Divya Cantor, MD, MBA and HealthGrades Senior Physician Consultant, said:

"Women today have a wide array options when it comes to reproductive health and choosing a health care provider who aligns with their personal preferences. From pregnancy and childbirth to more serious interventions such as hysterectomy, surgeries to treat incontinence, ovarian and other cancers of the reproductive organs, women can optimize their chances for receiving the highest possible quality of care by researching and comparing the clinical outcomes of hospitals and doctors in their area."

Highlighted findings from the reports include (in the 19 states were data was gathered):
  • 7% of mothers giving birth to a single baby had an inhospital complication. If all hospitals had had a 5-star rating the complication rate would have been 32% lower (141,869 fewer complications).
  • 19% of gynecological surgical interventions developed inhospital complications. There would have been 30,675 fewer complications, or a reduction of 35% if all hospitals had had a 5-star rating.
  • The number of hysterectomies performed in the USA has dropped 31% since 2002. Even so, they still make up 79% of all inpatient gynecologic surgeries.
  • Florida had a C-section rate of 38.6%, New Jersey 38%, while Utah's was 22.4%.
Dr. Cantor said:

"C-sections are rising, and there needs to be a little bit more scrutiny from the person who is having the C-section as well as doctors and hospitals."

Dr. Cantor said both patients and doctors need to think more carefully about C-sections. Physicians need to have a better understanding of when a C-section is necessary, and patients should not go into it blindly.

Experts say that some reasons for the higher rates of C-sections include:
  • Convenience - to be able to plan delivery time. Convenience for both mother and health care professionals.
  • Older mothers - older women have a higher likelihood of needing a C-section when giving birth.
  • Risk factors - obesity and/or diabetes raise the risk of needing a C-section. More pregnant women today are obese and/or have diabetes.
  • Multiple births - there are more multiple births today, because of more fertility treatments.
  • Doctor attitude - doctor's appear more willing to perform C-sections these days.
  • Ignorance - a significant percentage of women are unaware of the potential hazards linked to C-sections. These can include blood clots, longer recovery times, bladder injury, infection, and excessive bleeding.
  • Women's attitudes - more pregnant mothers are asking for C-sections today.
  • Labor practices - using epidural medications, inducing labor and other labor practices raise the need for C-sections.
"HealthGrades 2011 Obstetrics and Gynecology in American Hospitals"

Christian Nordqvist