Gotbaum Report: Hospitals Fail to Provide Important Birthing Information
As the rate of Cesarean section births continues to rise, New York City hospitals are still failing to provide legally mandated information on C-section deliveries, according to a report released today by Public Advocate Betsy Gotbaum.
Citing the most current state data available, the report notes that the rate of C-section deliveries in New York City public and private hospitals increased from 26.6 percent in 2003 to 28.6 percent in 2004. The C-section rate at several hospitals was more than twice the 15 percent maximum rate recommended by the World Health Organization, and three times the optimal rate cited by researchers. No hospital met that target. In 1970, only 7 percent of deliveries in the United States involved cesarean section.
Gotbaum’s report, a follow-up to one the Public Advocate released last year, found that all 44 New York City hospitals offering labor and delivery services are still failing to comply with the New York State Maternity Information Act. The law requires hospitals to provide expectant mothers with a pamphlet describing C-sections and other birthing procedures, including labor inductions and episiotomies, and information about the rates at which each of these procedures is performed.
“Pregnant women need accurate information about all their birthing options in order to make informed decisions,” Gotbaum said. “Our hospitals are doing a great disservice to expectant mothers by failing to comply with state law and provide detailed information on C-section deliveries.”
“The best research evidence is clear: unless there’s a compelling and well-supported reason for Cesarean-section, vaginal birth is the safest way for women to give birth and babies to be born,” said Maureen Corry, MPH, Executive Director of Childbirth Connection, formerly Maternity Center Association. “Women need full and accurate information well before labor about what is at stake in decisions about how to give birth, along with access to hospital-specific data to assist them in selecting a hospital that best suits their needs.”
“We call on New York City hospitals to comply with New York State law and provide to the public, without condition, information related to their obstetrical intervention rates,” said Elan McAllister, President of consumer advocacy group Choices in Childbirth. “In this current era of alarmingly high rates of Cesarean sections, inductions, and other potentially risky obstetrical interventions, transparency in hospital maternity care practices is essential. The Maternity Information Act is designed to provide that critical information to consumers so that they are able to make fully informed maternity care decisions.”
A C-section is an invasive surgical procedure in which a baby is delivered through the abdomen or uterus of the mother. Although maternal mortality rates in the United States are low, the mother’s risk of death resulting from a C-section is two-and-a-half times greater than from a vaginal delivery. In addition to the increased mortality rate, other concerns include increased risk of infection, injury to other organs and infertility. Though rare, life-threatening risks such as serious bleeding and blood clots or the need for an emergency hysterectomy are increased in C-section deliveries.
Overall, the City’s public hospitals had lower C-section rates than privately operated facilities. The increase in Cesarean rates in the City mirrors the nationwide increase from 27.5 percent in 2003, to 29.1 percent in 2004.
