Early Elective Deliveries Down in California, Still More Work to be Done

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Doctors, advocates also working to reduce rates of babies born by caesarian-section. (Getty Images)

By Brittany Patterson

In California, about 500,000 babies are born every year. Statewide efforts to reduce early deliveries and maternal death have netted improvements, but more work is still to be done, said advocates who gathered this week to share notes on how to improve maternal and child health across the state.

One specific bright spot was reduction of early elective deliveries — where a woman chooses to deliver her baby early, defined as between 36 and 39 weeks. These are scheduled deliveries that are not medically necessary. But babies born before 39 weeks are more likely to have feeding and breathing problems, trouble keeping themselves warm, and infections.

In 2010, 14.7 percent of births in California were scheduled before 39 weeks. Today, in-part because of intense campaigning, that rate has dropped to less than three percent of total births at about half of the state’s hospitals. The effort to decrease the practice was spearheaded by the March of Dimes, but strengthened by data collected and synthesized by the California Maternity Data Center. Continue reading

Money May Be Motivating Doctors To Do More C-Sections

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(Getty Images)

By Shankar Vedantam, NPR

Obstetricians perform more cesarean sections when there are financial incentives to do so, according to a new study that explores links between economic incentives and medical decision-making during childbirth.

About 1 in 3 babies born today is delivered via C-section, compared to 1 in 5 babies delivered via the surgical procedure in 1996. During the same time period, the annual medical costs of childbirth in the U.S. have grown by $3 billion annually. There are significant variations in the rate of cesarean deliveries in different parts of the country — in Louisiana, for example, the C-section rate is nearly twice as high as in Alaska.

Obstetricians in many medical settings are paid more for C-sections. In a new working paper published by the National Bureau of Economic Research, health care economists Erin Johnson and M. Marit Rehavi calculated that doctors might make a few hundred dollars more for a C-section compared to a vaginal delivery, and a hospital might make a few thousand dollars more. Continue reading