Insurance Companies Urge Doctors & Hospitals to Ease Up on C-Sections

Major insurance companies, including Aetna and Cigna, are asking obstetricians and hospitals to ease up the number of c-sections.

Research shows that c-sections–which now account for one-in-three births in the US–can lead to increased complications as well as costs. Recent studies have showed increased risk for early (>39 weeks), elective inductions and c-sections.

“We’ve known the risks of these procedures for a long time, yet the rates continue to rise,” Maureen Corry,  executive director at Childbirth Connection, a New York-based advocacy group focused on maternity care,  told, “The payors are finally saying, ‘Enough is enough. This is crazy.'”

Though life-saving under specific circumstances, many experts consider the US c-section rate of 33.5%, too high. The World Health Organization has suggested that the c-section rate be no higher than 15% in the industrialized world. Once c-sections eclipse this rate, one can argue that the risks of the surgery start to outweigh the benefits.

C-sections run approximately twice what a vaginal birth costs. Aetna and Cigna will offer incentives for hospitals to reduce c-section rates: Aetna will adjust costs for cesareans;  Cigna is considering this and bonuses for hospitals that bring their rates down. Insurance companies are working with advocacy organizations to figure out how to bring the c-section rate down. In 2009 United Health Group Inc,, the biggest U.S. health insurer, gave $60,000 towards a symposium on maternity care run by Childbirth Connection.

Here’s a good quote from Business Week about the incentives for doctors to perform surgery:

“Insurers are trying to shift what Main* calls the ‘perverse incentives’ that push doctors to speed up deliveries. C- sections not only pay more; along with inductions they also allow doctors to cluster births and schedule other visits around them, he said. And they assure a physician will be on hand for a delivery — and get the insurance payment — when a baby arrives. Wary of litigation, many hospitals also refuse to do vaginal births if a mom has had a prior C-section, even when natural delivery is a viable option, Main said.”

(*Elliott Main is the chairman of obstetrics and gynecology at California Pacific Medical Center in San Francisco.)

It will be interesting to see how rates of c-sections (and complications) change once these incentives are in place.


Ceridwen Morris (CCE) is a childbirth educator and co-author of the pregnancy and birth guide, From The Hips. Follow her pregnancy and birth blogging on Facebook.



photo credit: Michael E Clarke/Flickr

Article Posted 4 years Ago
share this article
facebook twitter tumblr pinterest
See Comments
what do you think?
share this article
facebook twitter tumblr pinterest
See Comments
what do you think?
what do you think?
close comments
Subscribe to the
Follow us on