Is the fear of lawsuits responsible for the rising C-Section rates?

Posted on Apr 05, 2010
On April 3, 2010, the Albany Times-Union reported on the front page that "Cesarean Section birth rates keep rising" with a sub-title, "More babies delivered by surgical procedure hits 11-year high; fear of lawsuits cited as possible reason". A recent analysis from the U.S. Centers for Disease Control reported that the national rate of Cesarean Sections has hit an all-time high for the 11th year in a row.

The Cesarean rate in New York is 36 percent, higher than the national average.  Cesarean rates vary from hospital wtih a reported 21 percent at St. Mary's Hospital/Seton Health to 45 percent at the Albany Medical Center Hospital. The rate of Cesarean Sections has risen at Albany Medical Center from 24% in 2000 to 45% in 2009, an increase of 89% over ten years.  The rate of Cesarean Section rates in the Capital District has followed the national trend, according to the Times-Union article.

Albany Medical Center  Hospital has the highest rate of C-Sections because it is the regional center for high-risk births.  A high risk labor and delivery may involve mothers over age 35, babies with low birth weights, multiple births (twins and triplets) and mothers transferred for emergency Cesarean Sections.  Since Albany Medical Center focuses on high risk births, the hospital does not have as many low risk pregnancies to offset the high Cesarean statistics, according to its director of high risk obstetrics.

Predictably, the doctors blame the legal climate as a major force in driving up the number of cesarean sections.  Doctors have almost stopped using forceps and vacuums in the delivery room because of the risks of their use and guidelines now discourage vaginal delivery of babies in the breech position. The doctors interviewed for the article say, When things go wrong "a lawyer will say 'you could have done a Cesarean. Why didn't you?'" The doctors claim that changing the medical legal system is the answer.

This article by Cathleen F. Crowley of the Albany Times-Union presents one-side of the story.  Fortunately juxtoposed with this article, is a settlement by John K. Powers, Esq. of Powers & Santola, LLP, wherein it was reported that Albany Medical Center Hospital paid $5.2 million for the death of a 32 year old mother of two, who bled to death after the mishandling of a Cesarean Section on September 3, 2007.  It was reported to be the largest malpractice cash settlement in upstate New York for a woman who died in childbirth.

The family refused to have their silence bought by the settlement, as most malpractice law firms will do. The settlement requires that Albany Medical Center fund for the next 20 years a Diane McCabe Memorial Quality Lecture series focused on topics relating to enhanced patient safety. It also requires the hospital to buy a maternal and neonatal simulator to be used in staff training on the labor and delivery unit and to change procedures on the use of a machine that monitors a patient's vital signs during childbirth.

The article about the McCabe settlement counterbalances the one-sided article about C-Sections and it helps show how lawsuits can be responsible for improving patient safety.