Money the Motivating Factor in More Cesarean Sections

A scary new study suggests the high number of cesarean sections may have more to do with doctors' greed than the patient's need. According to a story by NPR, "about 1 in 3 babies born are now delivered via C-section, compared to 1 in 5 in 1996. During the same time period, the annual medical costs of childbirth in the U.S. have grown by $3 billion annually." That's worth repeating: an increase of $3 billion—that's with a "B"!

In a paper published by the National Bureau of Economic Research, economists found that in many cases, doctors are paid hundreds more for performing a C-section over a vaginal delivery, and hospitals can be paid up to thousands more.

Health care economists Erin Johnson and M. Marit Rehavi hypothesized that OBs might be less likely to perform C-sections for financial incentives if the patients had significant knowledge about childbirth and its risk factors. So they looked at how many doctors had C-sections while giving birth to their own kids as opposed to non-doctors—who would likely know much less about whether a C-section was the right birth method for them.

The findings were that in cases where financial incentives were involved, pregnant doctors are about 10 percent less likely to get C-sections than their non medically-trained counter parts, which points to the fact that when armed with knowledge about whether a cesarean section is really necessary, women are likely to push back if they think it is more of a doctor's elective surgery.

In situations when vaginal delivery is first tried, and for whatever reason doesn't go as planned, women without a medical degree are more likely to have cesareans—which makes sense because during that time all you hear is "there is a problem," and the rest of your mind shuts down. You of course trust your doctor and presume he or she knows a hell of a lot more than you do in this situation, so in most cases you are going to do exactly what they say.

Interestingly, in instances where doctors were paid flat rates whether they did a vaginal birth or surgical birth (so there were no benefits to the doc for performing a c-section), pregnant physicians actually had more C-sections than non-doctors, which could mean that when there aren't financial incentives doctors are less likely to give women c-sections (often a longer and more difficult procedure) even when they need them.

Neither the study nor I are saying that all doctors are evil or that they would all do an unnecessary surgery just for the extra bucks. But the reality is that it does happen, whether subconsciously or not. So the best thing you can do for your and your baby's health is to read up as much as you possibly can about births and emergency procedures, or even hire an impartial doula or midwife if you can afford it (many insurance companies don't pay for them), so if and when you are put in that situation you can make the most informed decision possible.

TELL US: Do you believe doctors would be more likely to perform a cesarean section because of the bigger paycheck? Do you suspect your doctor steered you into having one?

Image of doctor courtesy of Shutterstock.