C-Section Rates Up Across NYC; Average Near 31% Manhattan Shows Sharpest Increase; Staten Island Has Highest Rate
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8.06.2008 - 08:30am ET
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New Space for Women's Health
C-Section Rates Up Across NYC; Average Near 31% Manhattan Shows Sharpest Increase; Staten Island Has Highest Rate
Latest Data in New NYC Guide to a Healthy Birth
(CSRwire) NEW YORK,NY. - August 6, 2008 - New York City's cesarean section rate has
increased by 24% over the past six years to an average of nearly 31%, and
rates are on the rise at nearly every single city hospital, according to
new data released by Choices in Childbirth, a New York-based nonprofit
that works to enable women to make fully informed maternity decisions.
Most city hospitals are not addressing the potential causes of the
increase in c-section rates.
The new data includes a breakdown of c-section rates at every hospital in
all five boroughs, demonstrating the change from 2000 to 2006, and is
included in the new 2008-09 edition of Choices in Childbirth's annual New
York Guide to a Healthy Birth. In Manhattan, the c-section rate increased
by 29%, to an average rate of 30%; in Staten Island, it increased by 20%
to an average rate of 34%; in Queens, it increased by 27% to an average
rate of 33%; in Brooklyn, it increased by 26% to an average rate of 32%;
and in the Bronx, it increased by 28% to an average rate of 26%. This
follows statewide trends, where the rates of obstetrical interventions
(including c-sections, inductions, episiotomies, epidurals, and other
routine practices) are continuing to climb despite the release of multiple
studies indicating the need for moderation.
The U.S. c-section rate for 2006 is 31%, an increase of 41% since 2000.
This reflects a steady increase every year of the past decade-and New
York's rising rates offer a microcosm of the national trend. The World
Health Organization recommends that the c-section rate for industrialized
nations should not exceed 15%. A safe range, as determined by WHO experts,
is 10-15%—well below New York City's average rate.
"Certainly there are times when a c-section offers women, their families
and healthcare providers a necessary and lifesaving birthing solution,"
said Elan McAllister, president and co-founder of Choices in Childbirth.
"However this alarming citywide increase underscores how c-section has
become a method of convenience rather than necessity, even though it can
present tremendous risks for an expecting mother. Just as alarming, our
city's hospitals have no strategy to reduce the rate. We urge families and
the medical community to remember that the highest level of medical
intervention is not always required, and is not necessarily the safest
option for the mother and child."
Cesarean section is a major surgical procedure that increases the
likelihood of many risks for mothers and babies in comparison with vaginal
birth. The c-section rate in New York City is on the rise for a number of
reasons, which may include medical care that does not offer the informed
choice of vaginal birth, increasingly casual attitudes towards surgery and
c-section surgery, limited awareness of the risks associated with
c-section, and provider fears of malpractice and lawsuit.
"I'm really concerned that the c-section rate continues to rise at so many
of our city's hospitals," said New York City Public Advocate Betsy Gotbaum.
"We're making some positive strides, as New York's hospitals are finally
complying with the legal requirement to release this data. However,
there's much more work to be done to ensure that women receive the best
and most medically appropriate care, and that hospitals take strong steps
towards reducing the c-section rate. Information is essential –
especially when you're dealing with the health of mothers and children.
This is why I have introduced legislation which will require the city to
create an online database to allow mothers to find hospital information
quickly and easily, and help them make safe, informed decisions."
Two myths prevail about the increase in c-section rates. First, that more
women are requesting the procedure. However, a national survey by
Childbirth Connection (www.childbirthconnection.org)
found just one incidence in 1,600 of a planned c-section, for no underlying
medical reason. The second myth, that the increase in c-section rate is a
reflection of the increase in childbirth among older women who may have
more frequent complications, is similarly unfounded. Cesarean section
rates are going up for all groups of birthing women, regardless of age,
the number of babies they are having, socio-economic status, health
problems, race/ethnicity, or other criteria.
"The American healthcare system is increasingly dependent upon medical
interventions to address what is, most often, a normal and safe
physiological process – natural childbirth – and this new data shows
that New York City is mapping to the trend," said Rebecca Benghiat,
executive director of the New Space for Women's Health, a new women's
birth and health center in New York City. "Quite often, women are not
fully informed of the risks associated with commonly performed obstetrical
interventions, nor do they know there are options beyond hospital birth.
However, as New York City women are becoming more aware of the state of
standard maternity care in this city, we have seen an incredible increase
in demand for services outside of the hospital."
"We should be concerned about the long-term risks of having so many women
in the United States undergo major abdominal surgery, particularly those
who do so when they are young," said Wendy Brooks Barr, MD, MPH, MSCE,
research and co-maternity care director, Beth Israel Residency in Urban
Family Medicine, Institute for Family Health, and assistant professor of
Family and Social Medicine, Albert Einstein College of Medicine, Yeshiva
University. "I urge my colleagues and peers across the city to be open to
innovative means of changing how maternity care is delivered in New York,
and to help develop solutions that work towards reducing the c-section
rate."
For a copy of the new Choices in Childbirth 2008-09 New York City Guide to
a Health Birth, to access 2000-2006 cesarean section statistics and to view
the rates of other obstetrical interventions for hospitals in the New York
Metro area, please visit www.choicesinchildbirth.org.
About Choices in Childbirth
At Choices in Childbirth, our mission is to improve maternity care by
providing the public, especially childbearing women and their families,
with the information necessary to make fully informed decisions relating
to how, where, and with whom they will give birth. www.choicesinchildbirth.org.
About The New Space for Women's Health, a project of Friends of the
Birth Center
The New Space for Women's Health grew out of the community of the
Elizabeth Seton Childbearing Center, which, challenged by insurance
demands and increasing costs, closed in 2003. Once open, the center will
create an environment where midwives, mental health professionals, family
educators and a community of other professionals will provide more than
20,000 women and families each year with prenatal and postpartum care,
childbirth education, gynecological services, social work, and
psychological care in a welcoming and environmentally sustainable setting.
www.newspacenyc.org.
For more information please contact:
Andrea Retzky
Retzky Communications
917-587-5473
Lara Miller
New Space for Women's Health
212-867-9646
newspacenyc.org
www.newspacenyc.org
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