C-Birth Rates Above Average

By Eric Eyre

ericeyre@wvgazette.com

West Virginia has the fourth-highest Caesarean section rate in the nation, and the number of women in the state who have the procedure is growing, speakers at a children’s health conference Tuesday in Charleston said.

One of every three babies across the state is delivered by C- section, according to the state Bureau for Public Health.

"It has now become unfashionable to go to term," said Dr. Robert Nerhood, chairman of the obstetrics and gynecology department at Marshall University’s medical school. "Physicians don’t want patients to go to term [when a baby's due]. Patients don’t want their babies to go to term. It’s bringing babies in younger than they need to be when they’re born."

Nerhood and other doctors said Tuesday that frivolous malpractice lawsuits are driving up C-section rates in the state.

"People don’t get sued for doing Caesarean sections," said Nerhood, speaking on the final day of the Growing Healthy Children conference in Charleston. "They get sued for not doing Caesarean sections."

West Virginia also has a high number of women who are obese and smoke during pregnancy, which leads to medical complications that require Caesarean sections.

"We have some of the most obese patients I’ve ever encountered," said Dr. Brenda Dawley, vice chairwoman of the West Virginia section of the American College of Obstetrics and Gynecology. "No one wants to do a stat emergency Caesarean section on a 400-pound woman at two in the morning."

Also, many West Virginia hospitals decline to deliver babies vaginally after women have had a baby through C-section. Less than 1 percent of natural births in the state were from women who previously had a Caesarean.

Dr. Peter Cherouny, an expert on high-risk pregnancy who works at the University of Vermont’s medical school, said Tuesday that natural births after C-sections can be safe, even at rural hospitals.

He said such births should be attempted only at hospitals equipped to handle emergencies and with doctors immediately available.

West Virginia’s high rate of induced labor during births was another reason cited for the C-section increase.

Studies have found that induced labor, especially when done before mothers reach their due dates, leads to more Caesarean sections, higher health care costs and longer hospital stays.

More than 33 percent of West Virginia women have induced labor, compared to 21 percent nationally, according to the Centers for Disease Control and Prevention.

Dawley said hospitals with high C-section rates should be identified and examined to determine the reasons.

Hospitals where babies are delivered also should provide 24-hour obstetric coverage, she said.

Dawley added that medical residents in training should be encouraged to do vaginal births. Nurses also need additional training, she said.

"In West Virginia, our Caesarean section rate is unacceptably high," Dawley said.

To contact staff writer Eric Eyre, use e-mail or call 348-4869.

(c) 2007 Charleston Gazette, The. Provided by ProQuest Information and Learning. All rights Reserved.