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Special Delivery

Why Doctors Are Pushing So Many C-Sections

The number of babies delivered by Caesarean section surgeries in the United States is at an all-time high. Although there are several factors involved, it’s clear to us that the higher prices charged for C-sections provide plenty of motivation for doctors and hospitals to push women toward a procedure that might not be necessary.

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Rachel Wintringham never thought giving birth would leave her bankrupt. Then again, this 28-year-old mother from Louisville, Ky., never expected that she would need a Caesarean section—the birth of a baby through an incision in the mother’s abdomen, commonly known as a C-section. There were no indications during her pregnancy 2 years ago that she wouldn’t have the natural delivery she preferred. But during labor at the hospital, her doctor changed those plans.

“My doctor told me my son might be larger than usual—possibly up to 10 pounds,” she recalls. She says that the doctor told her that a vaginal birth could create complications for the baby and could potentially expose the doctor to a malpractice lawsuit. She says her cervix was fully dilated, and she was ready to begin pushing. “My doctor insisted on a C-section even though my body was ready for a natural birth,” she says.

Wintringham’s son weighed just more than 8 pounds and was delivered by what Wintringham believes was an unnecessary C-section. But her troubles were just beginning. Because of an infection she acquired during surgery, she had to stay in the hospital for 6 days rather than the 2 days typically required for a vaginal birth. When she finally returned home, she was too drained to lift her child or even get out of bed by herself. Unable to work, she took 2 months’ leave from her job as a bank teller—and was eventually fired, because she couldn’t return when her maternity leave ended.

“It was then that my financial problems kicked in,” Wintringham says. “Without the income from my job, my husband and I couldn’t cover my $350 monthly car payments, pay off my $3,000 credit-card debt or pay back $5,000 in medical bills from my unexpected C-section. Too weak to return to work, I was forced to file for bankruptcy even though I’d always paid my bills early and always had a perfect credit score.”

Wintringham and her son both recovered physically from the ordeal. But even though she now works as a bond processor for a national package-delivery company, she says she’s still technically bankrupt. “I can’t qualify for the new home loan or new credit cards that my husband and I would like to obtain,” she says.

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Wintringham’s story is just one example of how consumers are getting stiffed by C-sections, which have increased by 40 percent since 1996. These operations are now the most common surgeries performed on women in the United States. Why do C-sections account for 31 percent of the 4 million births in the United States each year—even though World Health Organization (WHO) says that the rate should be no higher than 15 percent, and even though U.S. Department of Health and Human Services and American College of Obstetricians and Gynecologists (ACOG) voice concern about their prevalence? Why are doctors performing these surgeries in cases where they wouldn’t have been considered necessary in the past?

Unfortunately for women—and all consumers—the answer is money.

Health advocates say that for doctors, C-sections are less risky legally, more profitable and more convenient scheduling-wise than vaginal births. For consumers, however, C-sections bear a high price: They cost more than natural births in terms of medical bills, which can more than double; insurance premiums, which can spike for a woman after she has a C-section; and poorer health outcomes, which can affect mothers and infants alike and can cost tens, if not hundreds, of thousands of dollars.

“It’s gotten to the point where experts say the rise in C-section rates is a financial crisis as well as a legal and medical one,” says Dr. Bruce Flamm, professor of obstetrics and gynecology at University of California at Irvine and an ACOG spokesperson.

In other words, experts believe that too many C-section births today have little to do with the best interests of the mother or child and too much to do with what makes doctors and hospitals more comfortable.

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