Past Years The Rate Of Cesarean Sections example essay topic

Outline Thesis: Hospitals constantly allow their doctors to result on cesarean sections for every complication pregnant women have. With the outrageous number of cesarean sections rising, the hospitals are questioning if the surgeries are necessary. I. Introduction A. The question of whether or not a cesarean section is necessary B. Many cesarean sections are unneeded II. History of the Problem A. The victims of unnecessary cesarean sections B. Reasons why patients are having cesarean sections 1. Previous cesarean sections 2. Dystocia 3.

Breech position 4. Fetal distress C. Statistics 1. Past rates 2. Present rates. Present condition of the problem A. Dramatic rate of cesarean sections B. Higher rates have been determined 1.

Hospitals that operate for profit 2. Patients with private insurance 3. Increasing hospital size 4. Higher socioeconomic level 5. Presence of neonatal intensive care unit IV. Arguments opposing unnecessary cesarean sections A. Organizations B. Consumer Groups C. Support Groups V. Solution to the problem A. Questions pregnant ladies can ask B. Answers that doctors should provide VI.

Future of the problem VII. Conclusion Unnecessary Cesarean Sections Hospitals constantly allow their doctors to result on cesarean sections for every complication pregnant women have. With the outrageous number of cesarean sections rising, the hospitals are questioning if the surgeries are necessary. In the past years the rate of cesarean sections has begin to rise. Many doctors are now realizing the cesarean sections are a much easier procedure as oppose to vaginal deliveries. Many pregnant women are going into the hospital with minor complications and are being rushed to have a cesarean section.

With all of the technology there is today, why are so many physicians resulting on cesarean sections? Many of the cesarean sections that have been made in the past years have been unnecessary, but the pregnant women are not questioning the doctor's judgment because they assume that the doctor knows what he is doing. Many doctors that are performing unneeded surgeries have taken advantage of pregnant ladies and are simply performing these operations because it may be easier, or because they may be receiving much more money as oppose to vaginal deliveries. Cesarean sections have been a key issue in many arguments in the past years. Many patients that have been victims of unnecessary cesarean sections are now forming groups and coming together as one to resolve this issue. Many reasons contribute to the rise of cesarean sections; these are previous cesarean sections, dystocia, breech position, and fetal distress.

One article stated that, "Cesarean section is the most common hospital surgery procedure in the United States". Cesarean sections have reached a very high rate in the past years. "The rate of cesarean delivery in the U.S. now approaches 25 percent of all births". (Well, Andrew) Also "Not only does recent research clearly demonstrate that c-section rates are too high, but there is little doubt that an optimal, much lower rate could be achieved while preserving or even improving maternal and infant health". (Public Citizen Health Research Group) There are many states that contribute to the dramatic rise in the United States.

"The five highest statewide cesarean section rates were for Arkansas (27.1 percent in 1989 and 27.8 percent in 1990), Louisiana (27.3 percent in 1990), New Jersey (27.0 percent in 1989), and the District of Columbia (26.6 percent in 1990)". While, "The three lowest cesarean rates were Minnesota (17.6 percent in 1990), Wisconsin (17.5 percent in both 1989 and 1990), and Alaska (15.3 percent in 1990 and 15.2 percent in 1989)". These statistics show that while there are a few states that continue to have cesarean section after cesarean section, there are still a few that are doing their part to stop this epidemic. This problem has been around for the past couple of years.

It wasn't a big problem until women started to question why they needed to have cesarean section when they felt that they could have had a vaginal delivery. That's up from 5 percent in less than 20 years". (Weil M.D., Andrew) With figures like that many people began to question the reason to why many doctors are performing cesarean sections. "There were 967,000 cesarean sections performed in the U.S. in 1988, representing almost 25 percent of all births. The raise of cesarean sections quadrupled within the past 20 years, raising concerns about current obstetric practice.

Thirty six percent of cases were repeat cesarean sections, and only about 13 percent of women who underwent a previous cesarean section had a subsequent vaginal birth". (The Journal of the American Medical Association) This quote displayed that there is a dramatic increase in cesarean delivery. Cesarean sections have been contributed to increased health care costs and many have been reported unnecessary. "Higher rates of cesarean section have been associated with hospitals that operate for profit; patients with private insurance; increasing hospital size; higher socioeconomic status; and the presence of a neonatal intensive care unit". (The Journal of the American Medical Association) Hospitals have been abusing the patients with more money as well as the economic status the patients may be involved in. There are many organizations that are trying to halt the national epidemic and resolve the issue of unnecessary cesarean sections.

There are many consumer groups around the country, such as ICAN, formerly the Cesarean Prevention Movement, have grown tremendously in membership and activism. Many groups publish newsletter, hold conferences, produce their own educational materials, and work toward preventing unnecessary cesarean surgeries in their area. Also a handful of Blue Cross; Blue Shield programs around the country, including some in Illinois, Kansas, Minnesota, North Carolina, Pennsylvania, and Rhoda Island, now reimburse physicians at the same rate for vaginal delivery as for cesarean. Consumer groups are working to make information on increase cesarean rates routinely available to women and their partners.

"In 1985, through the work of C / SEC (Cesarean Support, Education, and Concern) and other organizations, the Massachusetts legislature passed a bill (Chapter 714) mandating that hospitals provide consumers with hospital cesarean rates and other important maternity information. This bill served as a model for the maternity information bill eventually passed by New York State in 1989... ". (Public Citizen Health Research Group) Also cesarean reduction programs at several U.S. hospitals have successfully reduced cesarean section rates while maintaining or even improving infant and maternal health. "St. Luke's Hospital in Denver, Mt. Sinai Medical Center in Chicago, University Medical Center in Jacksonville, West Paces Ferry Hospital in Atlanta, North Central Bronx Hospital in New York City (where all primary care for birthing women is provided by certified nurse midwives), and the Kaiser Permanente health maintenance organization's hospitals in southern California have developed strategies aimed at preventing unnecessary cesareans and other inventions, as well as improving women's overall childbirth experiences".

(Public Citizen Health Research Group) There are many active groups that are helping to put this serious problem to a stop and with the help of the victims of this epidemic people are beginning to understand the corruption behind the medical field. There are many ways that women can educate themselves to be prepared for either cesarean section or vaginal birth. There are questions that women can ask the obstetricians about obstetrical interventions, including cesarean section, and other issues that may affect their childbirth experience. The questions are, 1.

What is your c-section rate? Doctors with high risk practices should have rates of no more than 17 percent, and doctors with low risk practices should have rates under 10 percent. If it is possible patients should avoid doctors with cesarean rates over the national rate of approximately 24 percent. 2.

Do you offer "trial of labor" (attempted vaginal delivery) to women who have had a previous cesarean section? If so what percentage of them deliver vaginally? Approximately 80-90 percent of women with a prior cesarean section should be encouraged to undergo a trial of labor, and approximately 60 to 90 percent of these women should be able to deliver vaginally, meaning that 50-80 percent of women with prior cesareans could subsequently have a normal delivery. 3. Do you consider and independent second opinion for elective cesarean sections good medical practice?

If the doctor gets angry or defensive when you ask questions, including this one, the lady should consider changing physicians. 4. How do you monitor labor of low-risk patients? Of high-risk patients? Do you routinely use electronic fetal monitoring (EFM) to monitor certain groups of patients? Do you use fetal blood sampling or fetal stimulation tests to confirm fetal distress indicated by EFM?

5. If a patient presents with a fetus in breech position, do you attempt to turn the fetus manually to head first position after 37 weeks? 6. Are you concerned about the high c-section rate in this country (or in this hospital)?

Do you follow policies designed to reduce this rate? (Public Citizen Health Research Group) These questions are designed to help the patient be aware of the problems that the hospital may have. And allow the doctor to realize that there are patients that will ask questions and will not always believe their doctor's word. The rates of cesarean sections have continued to rise in the past years causing many people to question is the surgeries are in fact necessary. Unnecessary cesarean sections are a serious problem in the United States and people are now forming groups and organization to put a halt on the problem. Many pregnant women are now being educated on the facts of the cesarean section rate and insurance agencies are now reimbursing the hospitals with the same amount of money as if the doctors performed a vaginal delivery.

People are now taking action to this type of malpractice and are making a difference in many people's lives. With the help of organizations and consumer groups, one day women will not have to worry about being a victim of the medical corruption of unnecessary cesarean sections.

Bibliography

1. Liber man, Adrienne B. Giving Birth. New York: St. Martin's Press. 1993 2.
McCabe, John. Surgery Electives: What to know before the doctor operates: A guide for those considering elective surgery. Santa Monica. California: Car mania Books. c 1994.
3. Public Citizens Research Group. "Unnecessary Cesarean Section: Halting a National Epidemic" Health Letter. Online. SIRS. September. 1992.
4. Stafford, Randall S. "The impact of nonclinical factors on repeat cesarean sections". The Journal of the American Medical Association. January 2, 1991.
p 59 (5). 5. Stoppard, Miriam. Conception, pregnancy, and birth. London. New York: Dorling Kindersley. 2000.
6. The editors of Consumer Guide with Northwestern University Medical Schools and Gary J., Martin. The doctor's book of symptoms and treatments: Your guide to aches, pains, and other physical problems, illness, medical tests, and surgeries. Lincolnwood. N.J. : Publications International. C 1997.
7. Todd, James S. "More Malpractice than lawsuits: What can be done about it?" Health Facts. Center for Medical Consumers, Inc. May. 1990 8.
Well M.D., Andrew. "Warning: 11 Medical Practices to Avoid". Natural Health: The Guide to Well Being: 58-63. Online. SIRS. September. 1992.