Dr. Bender explains the complex answer to a common patient question: what is your rate of cesarean delivery? Learn more about why cesarean delivery rates are higher than in the past, the importance of choosing an obstetrician you trust, and more.
Dr. Bender explains what patients should know about cesarean delivery rates. Many patients ask their OBGYN what their cesarean delivery rate is, but both Dr. Fox and Dr. Bender explain that the answer to that question is nuanced.
Dr. Bender says that he typically first asks patients exactly what they mean. For example, are they curious about scheduled C-sections or C-sections after a patient has been laboring and attempting to deliver vaginally? These two groups are very different. Maternal Fetal Medicine Associates’ overall C-section rate, for example, is 32%, while the rate for women who labor and attempt to deliver vaginally before ultimately having a C-section is just 12%.
This discrepancy is why Drs. Bender and Fox emphasize the importance of “comparing apples to apples.” More factors will show the details of cesarean delivery rates, including whether patients have delivered by cesarean before, whether they are having twins or multiples, and whether the baby is delivering head-first. In addition, a doctor or practice may have a higher cesarean delivery rate simply because of the specific type of patient they typically see. Those who see more high-risk patients or whose patients tend to be older will likely have a higher rate of C-sections, for example.
Dr. Bender also explains why in recent years the rate of cesarean delivery has increased overall. He states that until the widespread use of antibiotics (beginning in World War II), C-section survival rate for mothers was significantly lower. This means that they were traditionally performed as a last-resort, especially if the mother had already died. In addition, it is becoming more common for patients to choose to have a scheduled cesarean delivery as a “repeat cesarean” after a previous, successful C-section. Electronic Fetal Monitoring may also play a role, with doctors opting for a cesarean delivery because of unsure signs when in retrospect this may not have been necessary.
Overall, Dr. Bender and Dr. Fox note that more useful question a woman can ask her obstetrician is “what is your cesarean rate for someone like me?” This will help her understand what she can reasonably expect during delivery. In addition, Dr. Fox notes the importance of choosing a doctor that you can trust, as it’s critical that you trust they will be patient enough to wait and make the right decision and knowledgeable enough to know when opting for a cesarean is truly necessary.
Dr. Samuel Bender is a board-certified OBGYN, diplomat of the American Board of Obstetrics and Gynecology, and a Fellow of the American College of Obstetricians and Gynecologists. He is a Clinical Assistant Professor at Mt. Sinai School of Medicine. Learn more about Dr. Bender in this episode: “Go Cubs Go! – Meet Dr. Sam Bender”.
