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Can the Financial Crisis Help Lower the C-Section Rate?

Posted Aug 11 2009 10:19am

Money and C-sections. They go together like, uh– well, they don’t really go together. Unless you notice that cesareans cost a lot more than vaginal births. Add to that recovery time in the hospital for mama and babe, medications, and follow-up care, and you can almost hear the cha-ching!

Washington state has a new cost-cutting program that may also dramatically lower the rate of C-sections.

They’re going to start paying the same amount for an uncomplicated C-section as they do for a vaginal birth.

And because C-sections in that state cost on average $5000 more than vaginal births, this will help make sure the motive for the surgery–the most common in the United States besides circumcision –are the best interests of the patient.

We are choosing to improve quality mostly by using carrots rather than sticks.

Washington, like many other states, is facing budget problems. This is just one measure, tucked deep into the new budget, designed to save the state money. The state will pay $1000, the same as a vaginal birth, for an uncomplicated C-section.

Of course some C-sections are medically necessary. But currently, one half of all C-sections in the States are elective. Every year for the past 11, we have set a new record in the number of cesareans performed. At 31.8% of all births ending in surgery, we’re way over the WHO’s recommendation of a 15% C-section rate.

Cesareans usually take longer to recover from than vaginal birth and generally require more post-op medications. Also, there is new evidence that a VBAC is safer for that baby than a second C-section. It logically follows that if there are fewer C-sections, there will be fewer costs associated with follow-up care.

Could this actually change the birth outcome in Washington? Yes. Half of all births there are paid for by Medicaid. And on top of that, it is estimated to save that state and the federal government $2 million each annually. I think both fiscal conservatives and natural birthing advocates could agree on this measure.

So is this Dick Morris’s worst nightmare: are we “forcing” vaginal births because of health care reform? I think not. I think this will give more women a chance to labor without anyone prepping surgical tools while they wait.

I heard about this story through the Midwife Monologues, the blogsite of a pair of local (to me) midwives. They’ve delivered babies I love.

There original story is here.

Image: tifhermom on Flickr under a Creative Commons License.

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