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HEALTH & SCIENCEC-section rate climbs as options diminishThe medical liability crisis is cited for the spike in cesarean deliveries, but some still ponder whether it's necessarily bad.By Victoria Stagg Elliott, AMNews staff. Aug. 11, 2003. Recent statistics indicate a trend in which women increasingly are delivering babies by C-section. These numbers raise the question of why cesarean deliveries occur more often and what it means to physicians and patients. The answers might center on women's diminishing access to the option of vaginal birth after cesarean (VBAC). A survey conducted last year by the Maternity Center Assn. found that more than 40% of women with a history of C-section were denied the option of a vaginal birth. And, according to the Centers for Disease Control and Prevention data released in June, the overall C-section rate increased to just more than 26%, the highest since the agency started tracking the rate in 1989. "You can expect it to keep going up," said Mary Burke, MD, an ob-gyn in Klamath Falls, Ore. Experts say this trend is being driven by a combination of medical liability issues and the resources VBAC requires. Dr. Burke, for instance, recently attended a mandatory seminar conducted by her insurer. The subject: Reducing medical liability lawsuits. And one of the take-home messages: Doctors no longer should offer VBAC as a delivery choice. "They told us that we had two options: an easy vaginal or an easy C-section," said Dr. Burke. "I am very pro-VBAC, and it makes me very sad that we don't offer it." Oregon, where Dr. Burke practices, is one of the states the AMA considers to be in medical liability crisis. Klamath Falls also is a rural area. "We're a small community with only four obstetricians, five anesthesiologists and four ORs," said Tom Hottman, public information officer for Merle West Medical Center, the only area hospital. "It's not practical. Unless it's an emergency, VBAC is no longer an option." [...]Full text of AMNews content is available to AMA members and paid subscribers.
Copyright 2003 American Medical Association. All rights reserved.
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