A recent article in the NY Times describes how one New York City hospital dramatically cut its Cesarean rate simply by refusing to perform elective Cesareans prior to 41 weeks and encouraging VBACs: http://www.nytimes.com/2010/04/20/nyregion/20bigcity.html However, this “low” rate of Cesareans is 23%! That’s about the same as the national average in 2000!
Cesarean rates are like gasoline prices, they just keep getting higher. Natural birth advocates were horrified a decade ago by a cesarean rate of 23%. Now we’ve seen a 50% increase in the national cesarean rate to nearly 33%. Where’s the outrage? We’re like frogs in a pot, not noticing that we’re getting cooked. Here in my neck of the woods, South Shore Hospital has the highest Cesarean rate in the state at a whopping 44.3%. Yikes. To find your hospital’s rate, check on pages 41-42 of this state document: http://www.mass.gov/Eeohhs2/docs/dph/research_epi/birth_report_2007.pdf
In contrast, this homebirth study- http://www.bmj.com/cgi/content/full/330/7505/1416?ehom- found that women planning a homebirth had a 3.7% Cesearan rate. Now wait a minute, you say, that’s a self-selecting population of low-risk women! True. But a 2005 CDC report- http://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_04.pdf – took that into account. In 2003, (the latest year that stats were available for this report) the total Cesarean rate was 27.5% for all women and 23.5% for low-risk women. So, even correcting for risk factors, the national cesarean rate was more than six times the cesarean rate for homebirthing women. Ponder that.
Great post…nice job pulling together the study data!