Cesarean Rates in Some Counties Soar

May 13, 2009

An article appearing in last week’s Miami Herald provides the somewhat stunning news that last year, more babies in Miami-Dade county in Florida were born by c-section than were born vaginally. While the c-section rate for the U.S. hit a record high in 2007 at 31.8% – a level and trend of increases that alarms many advocates – the rates were over 50% for Miami-Dade county, and nearly 44% in nearby Broward county.

A table of c-section rates by institution in South Florida accompanies the article and shows most hospitals with a rate greater than 40%, with many greater than 50%. In Kendall Regional in Miami-Dade county, the percentage of cesarean births was 70.3%.

The article notes that costs are also higher in south Florida than elsewhere, saying that: “Data from the Florida Agency for Health Care Administration shows cesareans in South Florida hospitals range from $11,000 and $30,000 — about twice the $5,000 to $16,000 range for natural births.”

While some of those interviewed for the piece note the risks of c-section, particularly for women planning to have multiple children, one physician described the outcomes for women who had cesarean sections thusly: “They’re happy and pain-free and walking around the first day.”

I’d be really interested in hearing from women – with any type of birth – who describe themselves on the day they gave birth as “pain free.”

Several considerations are raised in the piece in an attempt to explain the high c-section rate in south Florida, including risk, malpractice concerns, a local culture of “aggressive” practice of medicine, maternal demand (which is thought to be a fairly small factor), and lack of options for VBAC once a woman has had an initial cesarean. The reader comments on the article raise a different set of issues, such as being pressured by providers to have a cesarean section and being held to strict “due” dates.

Relatedly, Lynn Paltrow of the National Advocates for Pregnant Women recently wrote a piece for the Huffington Post, “Concerned About Coerced Abortions? Try Saying No to Cesarean Surgery.”  She notes that while anti-choice activists put much energy and attention into so called abortion coercion laws (measures that create barriers to women obtaining abortions, ostensibly to prevent them from feeling “coerced” into abortions), they don’t pay the same attention to women who are coerced into c-sections.

Paltrow argues that:

…if protecting pregnant women and the “unborn” were really the goal, the legislation would not focus on abortion exclusively, but rather would make it illegal to pressure or coerce a pregnant woman to have any medical intervention. This would include policies that force pregnant women who have had previous cesarean surgery to have repeat surgery whether they need it or not.

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