With C-Section Rates At A High, Patient Advocates Want Pregnant Women To Speak Up

Caesarean sections have been on the rise over the last two decades, but the health care industry is working to reverse the trend.

Stephanie Teleki, director of learning and impact for the California Health Care Foundation, is working with the state and several maternal health groups to help women avoid unnecessary c-sections.

“Over time, our culture and society have become a little cavalier about c-sections,” she said. “We all know somebody who’s had a c-section, most people do fine, and we’ve lost the fact that this is major abdominal surgery with a lot of risks associated with it.”

About one-third of California women had C-sections in 2014, up from one-fifth in 1998, according to research from the foundation. 

Dr. Elliot Main, an OBGYN and medical director of the California Maternal Quality Care Collaborative at Stanford University, said c-sections became a popular alternative to natural birth as busy doctors sought quicker, more predictable procedures.

“If the progress isn’t going very fast, there’s pressure to move on, get back to the office, get back to your family,” he said. “So there are subtle ways that communication will occur and you will end up with a c-section perhaps earlier than needed.”

Advocates said they aren’t trying to eliminate the procedure — it’s definitely necessary in some high-risk cases. But they want low-risk, first-time moms to start asking for natural births if their doctor is presenting a c-section as a default.

Whether or not a woman is given an unnecessary c-section varies significantly between hospitals. One of the goals of Main and Teleki’s new project is to get hospitals to be more transparent about how many c-sections they perform.

The movement has set a new bar for the delivery industry. This spring, the state’s individual insurance marketplace told hospitals they need to be performing c-sections on less than a quarter of women, or they’ll be kicked out of the Covered California network.

Some physicians worry that reaching a target rate will be difficult for hospitals that care for large numbers of high-risk women.

The education campaign, launched this month, focuses on messages for women about how to choose a hospital, who to include on a birthing team and ways to talk to physicians about delivery options.

Capital Public Radio gets support from the California Health Care Foundation