A C-Section is a Terrible Thing to Waste

ACOG's recent change of heart about C-section and VBAC has prompted excitement and debate. You can read about it here.

We should be excited about this change- but we should also be aware of some of the big obstacles to lowering the c-section rate. Here are just a few of them.
-C-sections are necessary (some of the time)-
This seems obvious, but because, like many other interventions surrounding birth, they are sometimes needed, it is hard to get rid of them. It can be hard to tell if somebody REALLY needed a c-section or if the doc just jumped the gun. We can not nor should we get rid of the c-section all together. But we also need to be wary of the doctor who talks all the time about how often they are necessary.

-C-sections are so incredibly convenient (for the doctor and the hospital)-
Can you imagine a job where you get called at any time of day or night (probably most likely at night) and on any holiday so you can show up and watch somebody for HOURS labor just in case they need you? Then, when the baby finally does come there is a huge mess.

I love that so many people are willing to do this for a living. I don't think it is an easy lifestyle. I wish people would just stay the heck out of obstetrics if they were not willing to live this way. But the truth is, most OB's no longer practice this way.

And the very sad truth (and one that is driving c-sections and induced managed labors) is that scheduling birth makes more money. Lots more money.

This article is worth the read and has some great info. Here is a quote from it:
"Childbirth has the potential for being made more predictable by manipulating labor (induction, active management of labor) or by scheduling cesarean sections. From 1989-1997 births have become more frequent on weekdays compared to weekends, and "Births delivered by repeat cesarean and vaginal births that were induced are especially likely to occur on weekdays."" (From H. Goer and S Hodges)
-C-sections are very expensive- and insurance companies pay for them-

C-sections cost much much more than a vaginal birth, and considerably more than a home birth.
Consider this table from the same article posted above:


Home Birth $2,300 - $5,000
Birth Center $3,500 - $8,300
Hospital $4,300 - $16,000
Cesarean Section * $9,300 - $26,000

I think that pretty much says it all folks.
-C-sections equal sicker babies with longer hospital stays-

This might sound like a bad thing for the mom and baby, but it is most definitely a GREAT thing for the hospital. Not only do they make gobs more money, they also get your undying gratitude for saving their baby.

Again, from the above quoted article by Henci Goer and Susan Hodges:

Admitting babies to Neonatal Intensive Care Units (NICUs) is a money-maker, especially if the babies are not very sick. A Ross planning associate said: "We can do a better job of budgeting our staff with these longer stays and increased numbers of patients. ... And we're doing procedures – highly technical procedures that cost a lot and can generate higher revenue based on the same occupancy." (Shearer MH. The economics of intensive care for the full-term newborn. Birth 1980;7(4): 1980. p 235"

-Follow the money and you will find your enemy-

I have been accused of encouraging fear or being bitter and angry about the subject of birth in this country. Honestly, I could not make this stuff up!!! It disgusts me that women and babies are being literally SLICED OPEN and poked and prodded and taken from their mothers for MONEY. But that is exactly what is happening.

I am glad that somebody (the National Institute of Health) finally called on ACOG to do something about the outrageous C-section rate in this country. I am glad that ACOG actually changed their policy. But I do not believe that they have any real motivation to change their ACTIONS despite the fact that they are damaging women and children FOR PROFIT. Yes, they are hurting and endangering women and babies to make more money. This is obvious.

I wish I could tell women to trust their care providers when they say they are for natural birth. I wish I could tell them that their hospital really will support them in doing this. But the sad truth is that I would be giving them false hope. You need to fight for this. You need to be educated and you need to be strong. It will only happen because of you.


Barbara said…
Great post! I work with women (as ayurvedic physician) and I'm starting a group that is all about education: to empower women, to give information and new options. I live in Brazil and we have a rate of 70% of c-section in public hospitals and 80% in private hospitals. It's a huge shame. I hope, work and pray for a change... Let's see what the future will bring to our women.
Gretchen said…
Barbara -

If you want to tap into an existing organization that is already doing what you want to do, check out ICAN (http://ican-online.org) -- we are mostly in N. America but have a few chapters in other countries (and the number is growing). We can offer you support as you look to start something in Brazil - and yes, Brazil definitely needs something. Email our International Director at international@ican-online.org and I know she'd be thrilled to talk to you.

Gretchen Humphries
Advocacy Director, ICAN
Mama Birth said…
Brazil- what a shame, I know it is awful there-
I have a fantastic video about squatting births from Brazil though-
Gretchen- thanks for your work- ICAN is a great group=
Barbara said…
I'm looking the ICAN's website and it's great! Thank you!
Anonymous said…
I would say I love this post, but I don't. I hate it. I hate that you're right. I hate this is the way it is in America. It's so terribly tragic. BUT, I have hope that because of women like us, who value birth, many more women will experience birth as it was meant to be. :)