Rate rose dramatically for recent C-sections

Elective Cesarean sections and inductions have become much more common in the past three decades, notes Roberta Carroll, ARM, CPCU, MBA, CPCU, CPHQ, CPHRM, senior vice president with Aon Risk Solutions, a consulting firm in Odessa, FL. In 1965, the U.S. cesarean rate was measured for the first time and it was 4.5% (4.5 C‐sections per 100 primary deliveries), Carroll says. In 2002, the C‐section rate was 27% and by 2009 it had increased to 34% of single live deliveries. (Some of these C-sections occurred at 39 weeks or later).

Carroll says the rise in C‐sections has been associated with many factors  including:

• Common labor practices that can increase the likelihood of needing a C‐section, such as induction of labor or having an epidural early in labor; convenience in delivery timing for the provider or the mother; increasing willingness of physicians to perform C‐sections; limited understanding by the mother of the potentially serious complications of C‐section; maternal‐requested C‐sections;

• Physician fear of malpractice claims if they do not perform a C‐section; established physician practice patterns.

Despite the popularity of C-sections and inductions among patients and physicians, many organizations oppose them and are pushing for the elimination of induced labor and C-section before 39 weeks without medical indication. These groups include the American Congress of Obstetricians and Gynecologists, The Joint Commission, the Agency for Healthcare Quality and Research, the Institute for Healthcare Improvement, and the Leapfrog Group.


• Roberta Carroll, ARM, CPCU, MBA, CPCU, CPHQ, CPHRM, Senior Vice President, Aon Risk Solutions, Odessa, FL. Telephone: (813) 926-8069. E-mail: roberta.carroll@aon.com.