Editorial: C-Section Rise Speaks to Other Concerns

Saturday, June 15, 2013, Vol. 6, No. 25

More than a third of the babies born in 2011 at the 69 hospitals that deliver babies in Tennessee were born by cesarean section, according to the Tennessee Department of Health.

The rates are rising for women across categories of race, ethnicity, age and weight throughout the country.

As our cover story points out, there is evidence that cultural factors and labor management practices play a significant role in what should be a medical decision. And that is the cause for concern. Is fear of a lawsuit and the ensuing impact on insurance costs for physicians prompting a move to a medical procedure that is not necessary and may not be a mother’s first choice?

The truth is someone can file a lawsuit over anything. And a lawsuit that is dismissed as soon as a judge looks at it is still expensive. But C-sections as defensive medicine aren’t even an effective defense and they are unethical when done solely for those reasons.

We acknowledge the complexity of the issue and the need for baseline data. Any focused look at cesarean sections at the hospital level and the factors that lead to them is likely to have the effect of a more detailed medical explanation.

We hope medical practices will acknowledge the need to talk with women more on this issue in a two way exchange that not only informs women but also influences business practices.

More importantly, a woman’s health must never be a secondary consideration to business practices.

Women looking at the data have a right to be concerned about what the data show so far.

We had no problem in our cover story finding doctors who acknowledged medical malpractice carriers are playing a role in decisions like whether women whose first child was born by cesarean should attempt a vaginal birth if they have other children. Local doctors say the carriers strongly discourage the practice even though most medical experts agree most women can safely attempt such a birth.

While we are acknowledging reality, let’s acknowledge that far too many doctors view patients who look things up or ask questions as a questioning of their authority.

We constantly hear that you should take questions to your doctor. Take the things you see when you Google something or find it online. They won’t mind.

But how many of us see a doctor dismiss it out of hand or appear to just barely tolerate such an inquiry?

Doctors are right when they insist that there are too many barriers between the doctor-patient relationship.

Knowledge about the practice of medicine on a broad basis is not one of those barriers. Neither are legitimate questions raised by statistics about how business practices affect decisions on how and when to treat a patient.

If this is business and we are consumers, then dealing with questions about the business should be par for the course.