C Section
Some British hospitals in the NHS system are banning any cesarean sections for non-medical purposes. Image from Wikimedia Commons.

The practice of elective cesarean sections is a controversial one; many feel a “designer birth” is against sound birthing practices. A growing number of hospitals in England also feels putting medically unnecessary cesarean sections on the public’s tab is not fiscally sound, either.

Budget constraints lead British hospitals to follow Oregon’s lead

A group of hospitals in the American state of Oregon recently announced they were putting a “hard stop” to elective cesarean sections before a full 39 weeks of pregnancy. Those hospitals asserted that delivering a baby earlier than full-term was not medically sound and too costly to allow. A group of hospitals in Great Britain is following suit, according to the Daily Mail. A small number of hospitals that are part of the National Health Service, the public health care service of Britain, are no longer going to fund any cesarean sections that aren’t being performed for medical reasons. Critics say NHS hospitals banning medically unnecessary c-sections interferes with the right to choose birthing methods. However, NHS officials counter that asking the public to fund unnecessary major surgeries is unfair.

Much more expensive than traditional birth

According to USA Today, the cost of a c-section was 75 percent higher than a vaginal birth in 2008. In 2003, according to BizJournals.com, the U.S. Agency for Health care Research and Quality found the average cost of a c-section without complications was $11,524, compared with $6,239 for a vaginal birth without complications. The same relationship between costs is true for Britain. The typical cesarean section in an NHS hospital cost the NHS 2,600 pounds. A vaginal birth costs the NHS 1,200 pounds. Studies by economists found that reducing the number of NHS-funded elective c-sections by just 1 percent would save Britain 5.6 million pounds per year. The NHS is having 20 billion pounds cut from its annual budget over the next four years, according to The Guardian. One-quarter of births in the U.K. are via c-section, compared to 9 percent in 1980. The World Health Organization has voiced concern in recent years over the high number of c-sections, and has stated that no more than 15 percent of births should be by c-section in developed countries.

Complex issue

One of the controversial aspects of cesarean sections has to do with subsequent pregnancies and births. Once a mother undergoes a c-section, the risks of a uterine rupture during a vaginal birth after a c-section, or VBAC, are thought to be greater. According to WebMD, there is a less than 5 percent risk of a uterine tear during a VBAC, and according to Kansas.com, website for the Wichita Eagle, the risk is closer to 1 or 2 percent. Between 60 and 80 percent of VBACs are successful. However, fewer doctors are allowing them, as the rate of VBACs among women who have previously undergone a c-section fell from 28 percent in 1996 to 8.5 percent in 2006. Multiple c-sections put women at higher risk of infections, hemorrhaging and increases the chances of needing a hysterectomy.


Daily Mail: http://www.dailymail.co.uk/femail/article-2028443/Hospitals-ban-pregnant-women-having-c-sections-cost-cutting-move.html

USA Today: http://www.usatoday.com/news/health/2008-01-07-csections_N.htm

BizJournals: http://www.bizjournals.com/seattle/stories/2006/05/15/focus4.html

The Guardian: http://www.guardian.co.uk/society/2011/aug/18/nhs-waiting-times-soar-cuts

WebMD: http://www.webmd.com/baby/guide/vaginal-birth-after-cesarean-vbac-overview

Kansas.com: http://www.kansas.com/2011/08/16/1975653/factors-to-consider-before-second.html


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