Why Caesareans are Increasing

Soaring Caesarean rates today are mostly influenced by non-medical factors. Where medically related, it’s due to a weakness – improper medical care and to protect doctors’ interests!

To boost doctors’ earnings

In CHINA, it is reported that one of the reasons for the sharp rise in Caesareans is because doctors recommend C-section delivery to boost their earning power (Xinhua Economic News 15.2.07).

“Caesarean sections earn doctors higher profits so doctors tent to persuade pregnant women to have a Caesarean,” a doctor there was quoted as saying.

In Beijing’s hospitals, the operation and hospital tees for a Caesarean section are 3 – 4 times higher than that of a natural birth.

In some countries it has been observed that Caesarean rates are higher for women who have private medical insurance, are private rather than public clinic patients, are older, are married, have higher levels of education and are in a higher socio-economic bracket.

As noted by the WHO: “In the United States the profit motive explained hospital specific Caesarean section rates that were high even by United State standards.” (Wagner 2000)

In BRAZIL, where Caesareans accounts for 82% of the childbirth paid for by medical plans, a sociologist, Jacqueline Pitanguy, revealed: “For more than 20 years now the federal government has been taking measures.. to combat the money effect.. but it didn’t have much of an effect.”

In TAIWAN, a recent study commissioned by the Bureau of Medical Affairs and conducted by the Taiwan Association of Obstetrics and Gynecology, found that 1 of the top 4 reasons women choose C-section by the national health insurance program.

For doctor's own convenience

by the WHO: “In the United States the profit motive explained hospital specific Caesarean section rates that were high even by United State standards.” (Wagner 2000)

In BRAZIL, where Caesareans accounts for 82% of the childbirth paid for by medical plans, a sociologist, Jacqueline Pitanguy, revealed: “For more than 20 years now the federal government has been taking measures.. to combat the money effect.. but it didn’t have much of an effect.”

In TAIWAN, a recent study commissioned by the Bureau of Medical Affairs and conducted by the Taiwan Association of Obstetrics and Gynecology, found that 1 of the top 4 reasons women choose C-section by the national health insurance program.

As a form of defence for doctors

Many doctors point the concern over increased malpractice risks for vaginal delivery as the cause for increasing Caesareans today. For example failure to perform C-sections early enough to save a distressed baby can bring on big lawsuits.

According to Dr Joshua A.Copel, director of Maternal and Fetal Medicine at Yale University School of Medicine, the disturbing trends in Caesarean birth owe themselves to “malpractice”. He believes that a decision favoring Caesarean delivery is but an offshoot of the doctor’s fear of litigation. “Not much has changed about the American population to account for (its) increase in Cesarean birth”.

Unlike for a natural birth, it is difficult to take action against a doctor for having carried out a Caesarean birth done unnecessarily, says Jorge Francisco Kuhn dos Santos, a professor of obstetrics at the federal University of Sao Paulo.

“Even it there’s complication, people thing: “at least the doctor used the best technology available”, he says. This same doctor could be questions judicially if he had opted, under the same circumstances, for a normal birth.