This booklet is a joint project of the Pennsylvania Department of Health and the Pennsylvania Health Care Cost Containment Council, and addresses the issue of Cesarean section (C-section) deliveries in Pennsylvania.
This report is designed to track Pennsylvania's progress in meeting the C-section goals of Healthy People 2000.
Healthy People 2000, a project of the U.S. Department of Health and Human Services, has advocated a national goal of reducing the C-section rate to 15 per 100 deliveries (15%) by the year 2000, and increasing the number of VBACs to 35 per 100 deliveries (35%).
Cesarean Section Deliveries in Pennsylvania can aid group purchasers, policy-makers, and health care providers in identifying opportunities for cost reductions and quality improvement. Given the cost of cesarean delivery compared to vaginal delivery, as well as the increased recovery time and complications associated with C-sections, a reduction in the utilization of C-sections could help to reduce overall health care costs, and improve the quality of care received by maternity patients.
This guide can also help to raise public awareness about the issue of C-sections, and foster a more informed dialogue between consumers and medical providers.
Over one fifth (20.2%) of all Pennsylvania hospital deliveries in 1995 were through a cesarean section. As the most frequently performed major surgical operation in Pennsylvania, the total hospital charges for C-section in 1995 were $209,447,400. The average hospital charge for a C-section was $7,300, compared to $3,700 for a vaginal delivery. The average length of stay for a C-section was 3.5 days, compared to 1.7 days for a vaginal delivery.
From 1970 to 1987, C-section deliveries in Pennsylvania increased more than four-fold from 5.7% to 24.1%. This fell to 20.2% in 1995. Between 1989 and 1995, the VBAC rate (the percentage of mothers who had a previous cesarean birth who deliver vaginally) rose from 20.5% to 35.1%.
When medically possible, vaginal deliveries are preferable to C-sections for many reasons. Compared to vaginal deliveries, C-sections require a longer hospital stay for mother and baby, a longer recuperation time, carry an increased risk of complications, and cost more.
A cesarean section is a surgical procedure associated with childbirth in which the infant is removed through an incision made in the mother's abdominal and uterine wall. In the past, physicians performed repeat C-sections automatically due to fear that a women's uterus would rupture during labor. However, almost all C-sections done today are performed with a transverse incision (bikini cut) low in the uterus, which greatly reduces the risk of rupture during labor in a later pregnancy.