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C-Sections – Are They Sending Maternal Mortality Rates Soaring?

By bethanysanders |

845205_94150512A new report out of California highlights an alarming trend in the U.S.:  Maternal mortality rates have tripled in the state in the last 10 years.

Still a relatively rare event, up from 5.6 out of 100,000 women to 16.9 per 100,000 women, experts also say that the reasons that women die during or in the six weeks following childbirth are mostly preventable:  hemorrhage, blood clots, and underlying heart disease.

So why does the U.S. rank so low in maternal health, behind over 40 other countries?  That’s a big questions experts are trying to answer.

Some blame the rise in obesity, saying that obese mothers are higher risk of complications like gestational diabetes, or may already have chronic underlying conditions.  But the more likely factor may be the high rate of c-sections currently being performed in the U.S.

“If the risks of a Cesarean birth are small, they’re magnified greatly when you add many more Cesarean births each year,” Dr. Elliot Main, chairman of the California Maternal Quality Care Collaborative, told ABC News. “Not that many women actually choose to have an elective C-section at the beginning, but it’s easy to fall into a pattern of care that ends up resulting in a C-section.”

This finding might also explain the rising number of home births in the U.S.

Health officials are charged with not only finding the cause, but with implementing simple changes that would prevent at least half, say experts, of these deaths. Compression boots, for instance, can prevent blood clots in the legs.

For more on the California report, visit CaliforniaWatch.org.

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0 thoughts on “C-Sections – Are They Sending Maternal Mortality Rates Soaring?

  1. Laure68 says:

    I wonder if this has more to do with how many women do not have health insurance. The unemployment rate in California is over 12%, and when people are unemployed they are more likely to go without insurance.

    The knee-jerk reaction seems to be to blame everything on C-section, it is a real tragedy that so many people go without health coverage and many people seem to have no problem ignoring this issue.

  2. Louise says:

    Laure68, that’s a great point…I hadn’t considered that, but it seems likely that people that don’t have insurance are less likely to follow up on warning signs, perhaps less likely to have had good prenatal care, etc.

    You know, it’d be interesting to dig into the numbers to find out whether a disproportionate number of these women had C-sections. However, even if we found that to be the case, that relationship may be correlation without causation (i.e., the health factor that led to the C-section might also have led to the death of the mother, rather than the C-section leading to the death of the mother).

  3. Penn Girl says:

    There is a HUGE difference between correlation (two events becoming more frequent at the same time) and causation. I’m not even sure this article shows any correlation, beyond the bare bones statement that maternal death is on the rise, and c-sections are on-the-rise. I suspect there are many causes associated with a higher maternal death rate in the US (and especially in California): poorer maternal health in general (not just obesity, but a high migrant population that may only receive emergency medical care, if any), lack of insurance or insurance policies that do not have the best interest of the mother in mind (such as a 48-hour hospital stay limit for post-partum recovery), advance maternal age, etc. C-sections might play into it as well, but the author doesn’t back up her assertion (that c-sections are leading to more deaths) with any sort of fact or statistic that c-section deliveries result in a higher risk of death to the mother.
    I think this article is rather irresponsible in drawing this conclusion.

  4. jenny tries too hard says:

    Laure68, California has one of the most inclusive reduced-cost medical programs in the country, MediCal. Pregant woman who are unemployed/low income also qualify for CHIP and Medicaid. I think a good deal of the women presenting with no or little prenatal care in California (and other Southern border states) are likely coming from Mexico. I know that Thomason in El Paso regularly admits laboring women who arrive by ambulance from the medical center in Juarez, as well as women who come over well before labor starts and then go to the hospital in labor. I imagine that CA is probably the same.

    I do agree with you, though, that poor prenatal care is likely to play a big part in increasing the number of c/s and the risks.

  5. [...] last month, we reported that the maternal mortality rate in the state of California tripled in the last 10 years and that, [...]

  6. Micky says:

    According to the World Health Organization, there is a semi-causal link between increased c-section rates and increased maternal death rates. They estimate that the optimal c-section rate for a society is around 12-15%–which is where maternal death rates tend to stabilize. Substantially less than that, and it increases, apparently because it indicates lack of access by women who require the procedure. Substantially more than that and it increases, apparently because its overuse introduces health risks (of infection, hemhorraging, etc.) in otherwise low-risk births.

    I have never seen any evidence that there is a problem with access to c-sections. Indeed as our rate is over twice what the WHO recommends, that would seem counter to the evidence presented here.

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