C-section Debates

This article appears in the March 2012 issue of HealthLeaders magazine.

There have been more calls to reduce the number of C-section deliveries in the United States because of potential complications and healthcare costs.

For the first time in more than a decade, the cesarean delivery rate nationwide declined in 2010, but only slightly: to 32.8% of all births in 2010, from 32.9% in 2009, according to the Centers for Disease Control and Prevention's report on preliminary data for 2010 births.

That contrasts with a steady rise of cesareans reported from 1996 to 2009, the CDC report shows.

At Lovelace Women's Hospital in Albuquereque, NM, the C-section rate is 19%—far lower than the national average. The hospital has consistently reduced the incidence of C-section deliveries through education programs and long-standing protocols involving physicians and midwives, says Joel Teicher, MD, medical director of labor and delivery at Lovelace.

By having a collaborative focus with midwives and nurses solely responsible for obstetrics issues, "there is constant education with the patient who had a C-section and is hoping to deliver vaginally about what to expect, what to go through. And there is more time for prenatal visits. That's built-in," he says.

Involving midwives in the process was not only important for the care of the pregnant women, but also for the financial outcomes, Teicher says. "We have skilled, certified midwives—and we can have three or four for the cost of one physician," Teicher says. "We have physicians supervising and involved in complicated operating deliveries. They have a collaborative focus and coordinated relationship and that has been ongoing."