Why the public release of cesarean section rates is so important.
Reason One1: C-section is the most common surgical procedure in the U.S.
-The c-section rate in the U.S. is alarmingly high- 32.3%.
-Oklahoma’s c-section rate is 34.2%. Oklahoma ranks as the 12th highest c-section rate in the U.S.
-The Oklahoma and National c-section rates are over TWICE the 15% that the World Health Organization recommends. This is the highest c-section rate in history.
Reason Two2: C-sections carry risks for mom, baby and future pregnancies
-Risks for mom include blood loss, infection, possible injury to nearby organs (intestines and bladder for instance), blood clots, postpartum depression, delayed breast milk production, poor bonding with baby
-Risks for baby include possible preterm (early) birth, respiratory (breathing) problems that may lead to a NICU stay, poor bonding, difficult time breastfeeding
-Risks for future pregnancies include scarring on the uterus that may lead to problems with another placenta implanting in the wrong place (placenta previa or accreta), increased risk for placenta abruption (the placenta pulling away from the uterus too soon), ectopic pregnancy and uterine rupture.
Reason Three: Women rarely ASK for c-sections
-According to the Listening to Mothers II survey3, less than 1% of those surveyed asked for a c-section (maternal request).
-According to the Listening to Mothers II survey3, 45% of women were interested in VBAC yet 92% of them had a repeat c-section because they felt pressured into into one.
-Studies estimate anywhere from 3-30% of c-sections are UNNECCESARY4.
Reason Four: VBAC is difficult to access in Oklahoma
-In Oklahoma our access to obstetrical care, especially midwifery and VBAC, has decreased over the past 20 years. Women in Oklahoma have fewer and fewer choices each year.
-Vaginal Birth After Cesarean (VBAC) is difficult to access in Oklahoma, accounting for only 2.8% of birth in 20085. With the decreased access to VBAC, our c-section rates rise every year.
-In Oklahoma our VBAC rates have dropped drastically from 21.6% in 1997 to 2.8% in 20075.
Reason Five: Delivery data is readily available in other parts of the country and is available in Oklahoma for SoonerCare births
-Recently, the Oklahoma Health Care Authority (OHCA) starting releasing c-section data by hospital for SoonerCare (Oklahoma Medicaid) births5.
-Information on many types of pregnancy and birth related data (delivery type, common medical interventions such as episiotomy and induction rates) are available by hospital in New York online6.
-Surgical infection rates are available online in Oklahoma along with many other quality measures7. Why not birth data? This will help families in Oklahoma make informed decisions about their health care.
1. National Center for Health Statistics Data Brief, Number 35, March 2010. Retrieved March 14th, 2011 from http://www.cdc.gov/nchs/data/databriefs/db35.htm
2. Best Evidence: Cesarean Section. 2011. Childbirth Connection. Retrieved March 14th, 2011 from http://www.childbirthconnection.org/article.asp?ck=10166
3. Declercq, E., Sakala, C., Corry, M., Applebaum, S. (2006). Listening to Mothers II: Report of the Second National U.S. Survey of Women’s Childbearing Experiences. Childbirth Connection. Retrieved March 14th, 2011 from http://www.childbirthconnection.org/pdf.asp?PDFDownload=LTMII_report
4. Oklahoma Health Care Authority Cesarean Section Quality Initiative (2011). Retrived March 14th, 2011 from http://www.okhca.org/providers.aspx?id=12541
5. National Center for Health Statistics, final national data. Retrieved March 14th, 2011, from www.marchofdimes.com/peristats.
6. New York City Department of Health and Mental Hygiene. Retrieved March 14th, 2001 from http://www.health.state.ny.us/facilities/hospital/maternity/index.htm
7. Oklahoma Hospital Authority. OK Hospital Quality. Retrieved March 15th, 2011 from http://www.okhospitalquality.org/
Resources for Cesarean Information:
Childbirth Connection’s “What Every Pregnant Woman Needs to Know about Cesarean Section”:
International Cesarean Awareness Network (ICAN): http://www.ican-online.org/
OHCA Cesarean Section Quality Initiative: http://www.okhca.org/providers.aspx?id=12541
Childbirth Connection’s VBAC or Repeat Cesarean:
ICAN’s VBAC Ban Database: http://www.ican-online.org/vbac-ban-info
Oklahoma Birth Network: www.OklahomaBirthNetwork.com
This document was prepared jointly by the chapter leaders of Oklahoma BirthNetwork and ICAN of Central Oklahoma.
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