April 20, 2009

New Report Documents Trends in Hospital Birth, Increase in Repeat C-Section

A newly released statistical brief from the Healthcare Cost & Utilization Project (HCUP) reports a 40% increase in repeat cesarean sections, from 64.7% in 1997 to 90.3% in 2006

The freely available report, Hospitalizations Related to Childbirth, 2006, examines data on childbirths occurring in U.S. community hospitals in 2006 as well as from 1997-present. Also among the findings:

  • The percent of childbirths by c-section increased 51%,  from 21.0% in 1997 to 31.6% in 2006.
  • There was a 73% decline in VBAC, from 35.3% of childbirth-related hospitalizations in women with a previous c-section in 1997 to 9.7% in 2006.
  • C-sections were, “overall, the most commonly performed operating room procedures in U.S. hospitals” in 2006.
  • From 1996 to 2006, the use of forceps decreased by 37%, and there were 55% fewer episiotomies.”
  • Uninsured patients had the lowest percentage of c-section deliveries. C-sections accounted for 33.7% of privately insured deliveries, 29.8% of Medicaid deliveries, and 25.4% of deliveries among the uninsured.

The report authors also provide this information about cost:

“On average, hospital deliveries cost $3,500 per stay, but the mean cost per stay was highly variable depending on the mode of delivery. C-sections tended to be more costly than vaginal deliveries ($4,500 versus $2,600 without complications, and $6,100 versus $3,500 with complications, respectively). However, vaginal delivery with an operating room procedure had the highest average cost ($6,900)—nearly double the cost per stay for all types of delivery ($3,500). In total, vaginal deliveries accounted for 55 percent of annual hospital delivery costs ($8.2 billion), and C-sections accounted for the remaining 45 percent ($6.6 billion).”

It’s not entirely clear from the report what would be included in “vaginal delivery with an operating room procedure,” except that these exclude sterilizations and D&C procedures. A press release from the Agency for Healthcare Research and Quality (HCUP’s parent agency) points out that, “although C-sections account for 31% of all deliveries, they account for 45% of all costs associated with delivery.”

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