In the news: cesarean rate rises and VBAC rate declines

Well, huh, this isn’t really news, but better late than never: a very well balanced article from the New York Times examines many of the issues which contribute to the declining rate of VBACs in this country, including doctors’ rising fear of uterine rupture, hospitals’ difficultly in staffing the necessary number of qualified doctors to support and provide VBACS, women who are more than happy to schedule their second, third and fourth (and primary!) cesarean, and women who desire a VBAC and feel betrayed by the lack of options available to them in their area.

    Many women are willing to take the risk [of having a VBAC], and the hospitals’ stance has become a charged issue, part of a larger battle over who controls childbirth. Some women say their freedom of choice is being steamrolled by obstetricians who find Caesareans more lucrative and convenient than waiting out the normal course of labor. Doctors say their position is based on concern for patients’ safety.

Meanwhile, a story from yesterday’s New York Daily News charts the rising cesarean rate in hospitals, citing which five hospitals in New York city have the hightest rates: New York-Presbyterian Hospital Columbia (a whopping 39.6%, which still seems monumental even when you factor in that NY Presb handles many of the highest risk births in this city—the method of handling them is obviously cesarean), St. Vincent’s Hospital Staten Island (39.5%), Brooklyn Hospital Center (38.5%), New York Presbyterian Weill Cornell (37.1%) and finally, Flushing Hospital (37%).

Powerful numbers, indeed. If this continues, the Healthy People 2010 goal of a 15% cesarean rate for first time mothers and an increase the VBAC rate to 63% will seem laughable, rather than even remotely attainable.

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