Sunday, June 12, 2011

C-section Caps Cost Lives and Money

I was appalled to read this story in the Express this morning, "Op Cutbacks Put Mothers At Risk". 
In it, Lucy Johnston writes:  "The Sunday Express has learned a growing number of health authorities have said they will not cover the cost of caesareans if they exceed the national average of 23 per cent. They will instead pay only the rate for a normal delivery, which means hospitals could lose up to £1,300 each time."

And I couldn't agree more with some of the comments quoted in the report:

"Nick Morris, a top consultant obstetrician, said: “This could put the lives of mothers and babies at risk. Financial considerations should not be allowed to interfere with clinical judgment.

"Professor Sabaratnam Arulkumaran, former ­president of the Royal College Obstetricians and Gynaecologists said: “It is wrong to set these ­targets without recognising that one reason caesarean sections are on the increase is because we are dealing with more complex cases such as obese women who develop problems and then need an op to deliver their child."

This is the comment I added to the article:

"This is exactly what I've been warning for years - there is an unhealthy obsession with 'cesarean rates', and it is endangering the lives of mothers and babies. In terms of cost, you only need to look at the NHS Litigation Authority figures to see how much we end up spending (hundreds of millions of pounds) trying to avoid and delay life-saving c-sections. This 'national average' 23% target is a disgrace."

Where is it happening?

According to the report, this target of achieving a 23% cesarean rate in its hospitals (despite there being NO evidence-based research that indicates 23% as an optimum rate) has already been announced by primary care trusts in Surrey, Kent and Sussex, and now NHS South West London is adopting the same approach.

When, oh when, will this obsession with the ''cesarean rate'' number be eclipsed by a more healthy obsession with gathering high quality data on different cesarean types, and ensuring that women have healthy and satisfactory (read: live, healthy baby and mother) birth outcomes?

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