Thursday, April 22, 2010

Public Citizen Spotlights Unnecessary Cesarean Sections in New York State

by Melissa Garvey, ACNM Writer and Editor

Some of you may remember Public Citizen’s 1997 report “Nurse-Midwifery: The Beneficial Alternative.” Yesterday, the group released a new report called “Guide to Avoiding Unnecessary Cesarean Sections in New York State.”

They chose to spotlight New York not because of its high rate of cesarean births (At 33.7%, only nine states have higher rates than NY), but because it is one of only two states that tallies intervention rates for obstetric procedures all the way down to the facility level.

What they found is that the cesarean section rates vary widely throughout the state and nearly a third of cesarean sections may be unnecessary. That estimate is based on the fact that the state’s 10 hospitals with the lowest cesarean rates had an average rate of 20.8%—more than one third lower than the average rate for all New York hospitals.

The report contains a myriad of useful information, including birth statistics by county, tips for women who want to avoid an unnecessary cesarean section, and even guidelines for health departments and hospitals seeking to reduce unnecessary cesarean sections. Before you dive in, I’d like to highlight one of my favorite quotes from the Public Citizen press conference, which was held yesterday morning. This comes from Dr. Jacques Moritz, an obstetrician at St. Luke’s-Roosevelt, Roosevelt Division:
“The model of obstetrical care in this country is all wrong. The model of an overtrained obstetrician attending to a normal birth is all wrong. The proper model is for all low-risk mothers to be managed by a certified midwife with a midwife-friendly obstetrician as back-up. This works in other industrialized countries, but not in ours.”
Susannah Donahue-Negbaur, CNM, MPH, a midwife at Roosevelt Hospital, New York City, drove the issue home:
“Choosing a midwife is one good way a woman can reduce her chance of a cesarean section. Research shows that low-risk women who use midwives are more likely to have a safe and healthy birth for themselves and their babies, and are less likely to undergo an induction of labor, cesarean or episiotomy than low-risk women who use doctors.”
Read more of Susannah’s comments about how maternity care works best as a partnership between midwives, physicians, and families here.

What do you like most about Public Citizen’s latest report?

1 comment:

michelle_rn said...

According to the NY DOH website, NY's 2008 c/s rate is 36.4%. Pretty sobering. Link is to my local hospital's rate as compared with the state.

http://hospitals.nyhealth.gov/browse_view.php?pfi=977&p=svc&subpage=maternity