The Big Debate
According to a report from HealthGrades, a healthcare-information company, the number of elective c-sections -- first-time, preplanned c-sections with no medical need -- rose 36 percent between 2001 and 2003. And since l996, our nation's c-section rate has almost doubled to an all-time high of just under 30 percent, which means that nearly one baby in three is born via surgery. Within the obstetrics community, patient-choice cesarean is controversial. Some doctors believe that patients should be able to choose a c-section if they prefer, while others adamantly oppose performing surgery when it isn't necessary. "A c-section is major abdominal surgery with all the risks and complications associated with it," says Bruce Flamm, MD, a clinical professor of obstetrics and gynecology at the University of California, in Irvine. "Without medical cause, I generally wouldn't do it." Critics of elective c-sections point out that the procedures not only put the mother and child at risk, but they also waste medical resources and increase costs. A cesarean delivery can cost approximately $7,000 more than a vaginal one, and c-section moms spend twice as long in the hospital, resulting in higher medical bills. It's estimated that cutting the current cesarean rate from 30 percent to 15 percent could yield an annual medical savings of $1 billion.
In 2003, the American College of Obstetricians and Gynecologists (ACOG) released a statement essentially approving elective c-sections if a doctor believes the procedure is in the best interest of the patient. The debate, however, continued and became so heated that in March 2006, the National Institutes of Health (NIH) convened a panel of experts to examine why more women were having c-section births and what the inherent risks were. In the end, they found no reason to dissuade women from having elective cesareans as long as they don't plan on having more than two children (women who have repeat c-sections increase their risk of developing complications like placenta previa).