25 May 2010

C-section rates down to doc preference

The number of Caesarean sections performed at hospitals is highly variable, Canadian researchers have found.

The number of Caesarean sections performed at hospitals is highly variable, Canadian researchers have found.

Even when accounting for differences in women's preferences and conditions that could complicate vaginal delivery, C-section rates varied from less than 15% to morethan 27% of all births.

"Thus, our results illustrate what we believe to be 'unwarranted variation,'" the researchers write in the latest issue of the journal Obstetrics and Gynaecology, noting that mothers requested C-sections in only 2% of the cases.

According to the new report, earlier studies have found marked variation in the United States as well. Both Canadian and US experts agree that the current Caesarean rate -- in the US, one-third of all births -- is too high.

Unclear why rates vary

It is not entirely clear why the rates vary so drastically, but the Canadian researchers, from the University of British Columbia in Vancouver, suggest that limited resources at smaller hospitals may lower the bar for C-sections to avoid emergency surgeries.

Among the more than 100 000 deliveries that they analysed, the most common reason for C-section was difficult labour, which accounted for one-third of the surgeries, and was also highly variable between different areas.

As a result, the researchers write, "we suggest that revising the current guidelines regarding the management of (difficult labor) may be a good starting point on the road to decreasing unwarranted variation in cesarean delivery and assisted vaginal delivery rates." - (Reuters Health, May 2010)


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