Why are New Jersey c-section rates so high?

I have been obsessed with all kinds of pregnancy, labor and birth related research, particularly digging into various interventions which can snowball into c-sections. And I’m not talking about those medically necessary c-sections or true emergency c-sections. I’m talking about the majority of c-sections – those that could have been prevented and never had to happen…

First, let me say – thank goodness for c-sections because they do save lives when serious maternal or fetal problems arise during pregnancy and labor, or when placental abnormalities restrict vaginal delivery (i.e. placenta previa).

However, these medically necessary c-sections (including emergency c-sections) should only be performed when medically necessary or when emergencies arise. Don’t say “duh” … because they happen way more than any of us would like.

World Health Organization (WHO) suggests the rate of c-sections should be between 10-15%. Once the 15% line is crossed, maternal mortality rises. Why? Because a c-section is a major abdominal surgery with many risks, hence should not be preformed when not necessary.

Here comes the shocking validation of the link between high c-section rate and high maternal mortality rate – New Jersey has the highest c-section rate out of all 50 states, it is almost 40%. Maternal death rate in New Jersey is 60% higher than the US average!!

And that’s still nothing…

In 2011, maternal mortality in the US was 24 deaths per 100,000 births. In the same year, the average maternal mortality in Europe was around 8 deaths per 100,000 births (depends on the country). This means that in the USA, it is 3 times more likely a woman will die when complications arise around the time of her labor and delivery.

C-sections, besides higher chance of maternal mortality, also carry many other maternal risks, such as infection (at the incision site, uterus, and other pelvic organs), hemorrhage and increased blood loss, injury to organs (such as the bowl or bladder), adhesion (causing future pregnancy complications such as placenta previa or placental abruption), uterine rupture, extended hospital stay, extended recovery time, depression, and risk of additional surgeries (such as hysterectomy, bladder repairs or another cesarean).

Besides maternal risks, there are significant risks to the baby as well. They include: premature birth (if due date was not calculated properly), breathing and respiratory problems, low APGAR scores, and fetal injury (the baby can be nicked or cut during the incision).

Then there are several inconveniences for both the mother and the baby, such as no immediate skin-to-skin contact for bonding and breastfeeding initiation (unless you have planned for a natural c-section and your operation team is accommodating). Usually, the mother receives her baby in the recovery room, which may be 1-2 hours after the birth. And that first hour after the birth is SO crucial.

After going through all this, someone please tell me why they cut-open women so often. Why has c-section become the delivery method of choice for so many hospitals when it is clearly linked to higher maternal mortality? Perhaps, money is the answer. Or convenience. Or fear. Or all of the above.

Many of you know I am from Europe where healthcare is practically free and available to everyone. Here, in America, I learned a new equation:

healthcare + pharmaceutics = business

Yes, sadly, our lives and lives of our children, health and personal preferences have been suppressed by greed. On average, the payment a US hospital receives from an insurance company is around $7,000 for a vaginal delivery, while it can be over $20,000 for a cesarean delivery. Looks like hospitals can get 3 times more money for way less time (c-sections are quick – we’re talking in minutes vs. normal labor & vaginal birth can take days). Also, it can be conveniently done by the end of one’s shift (did you know most c-sections in the USA, including emergency c-sections, happen during business hours from Monday – Friday?). Creepy, to say the least.

Another thing I learned in America is that everyone can sue anyone for anything. Normal labor and vaginal birth are unpredictable which is a scary word for many obstetricians. Many, therefore, prefer c-sections to lower their chances of malpractice lawsuits associated with birth defects and poor birth outcomes in general. But why should I care for what is more convenient for you? You are inconveniencing me and my baby here while putting our lives and health in danger. Didn’t you take the Hippocratic Oath swearing to practice medicine ethically and honestly? How is it ethical that you rather cut through my abdomen and uterus to pull my baby out so you can be home by dinner time while your employer cashs more money for it? This makes me sick to my stomach.

Ladies, if you are pregnant, learn about your choices during labor and birth – often you have more than just 2 options. Do lots of research to be able to make informed decisions. Because chances are you end up in one of the following three NJ hospitals where you will face a 50/50 chance of a c-section…

Meadowlands Hospital, Secausus, New Jersey: 53.9% c-section rate

Christ Hospital, Jersey City, New Jersey: 50.7% c-section rate

Hackensack Hospital, New Jersey: 50.3% c-section rate

To see the full list of 2011 c-sections rates in New Jersey hospitals, visit ICAN of NJ.

Research, self education and information give you the power to stay in charge during labor and birth. And although labor is a very vulnerable place to be and I can understand how some doctor’s opinion may sway a mind of a fierce woman in transition, don’t just take anyone’s shit.

How to get the information? Besides endless internet search or the informational assistance of your doula, you can read some books dealing with this issue. I recommend the following two:

Pushed

The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block

Born in the USA

How a Broken Maternity System Must Be Fixed to Put Women and Children First by Marsden Wagner

If reading sounds too time-consuming to you, check out these two movies:

The Business of Being Born

Orgasmic Birth

The Best Kept Secret (an eye opening and empowering movie)

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Featured image via ParentsASK.com

2 thoughts on “Why are New Jersey c-section rates so high?

  1. Nothing gets me more aggrevated than this topic. Just 6 months ago my doctor was pressuring me into having a c-section because I had a “big baby.” They estimated his weight to be over 9 lbs (they “offer” c-sections for babies over 9 lbs). I thought so what? We have big babies in my family, that’s not odd. Thankfully I had great support from my family & a doula and I didn’t let my doctor cut me open. I had absolutely no problem giving birth to my 8 lb 10 oz boy. But I wonder how many women listen to their doctor and end up having an unnecessary c-section. Even I, with so many support in my corner was feeling tons of pressure. Those who aren’t as educated on the subject would just trust their doctor and have a c-section.

    • I agree, Cindy, the fact that many doctors offer cesarean to so many women is despicable. It is a major surgery with many risks and should only be performed due to serious complications compromising the health or life of the baby or the mother. A 9 pound baby certainly is no life threat, both of my babies were big (not quite 9 pounds but still above average) and many of my friends/clients had babies way over 9 pounds (vaginally). Your body won’t give you what it can’t handle.

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