I wouldn’t myself call them underreported simply because they found their way into the mainstream press. I am sure there are other iatrogenic catastrophes that were NOT reported at all.
What really annoys me about the CDC preliminary data release notice is that it embeds the 31.1% cesarean rate in a press release about teen pregnancy! So while these stories may not totally qualify – in my definition – as underreported, per se, these stories and the ones that didn’t even receive media attention did not make the impact on the general population that they should have.
Then there’s this morsel (link goes to abstract) that appeared in my google alert this morning. Postmortem cesarean? Mother killed herself in labor?? Thank God the child is physically sound at age 4. I wonder how he is doing emotionally? Maybe he doesn’t know his birth story yet.
In September I posted twice about local birth statistics. You can read them here and here. Since the CDC released a preliminary report for 2006, I thought I should review some interesting data from 2004 and 2005 (source).
Montana (state-wide) cesarean rates:
2004 – 25.3%
2005 – 25.7%
2006 – 28% (preliminary estimate)
I find it interesting that 85% of Montana cesareans in 2004 and 86% of cesareans in 2005 took place in counties with 100,000 or more residents. Granted, high-risk pregnancies would transfer to larger hospitals and might be more susceptible to cesarean delivery.
Montana (state-wide) VBAC rates:
2004 – 1.4%
2005 – n/a
2006 – n/a (yet?)
I’m not sure why the CDC didn’t provide the 2005 VBAC figures. Could it be that VBAC is so rare that it was statistically insignificant to report?
Only 16 VBACs took place at Missoula’s Community Hospital in 2006. That was about 1% of their live birth population. Yikes! Double yikes when you consider that Community is one of a small handful of hospitals across the state that still allow VBACs.
Place of delivery (2005):*
57 of 1850 births in Missoula County took place outside of a hospital. And I’m not sure that the Birth Center was even up and running at that time. This accounts for 3.1% of the live birth population. This slim percentage is at least twice the national average, from what I’ve heard.
44 of 240 births (18.3%) in nearby Ravalli County took place outside of a hospital. Now I call that statistically significant!
The state out of hospital rate was 2.5%.
Although Montana’s cesarean rate is a few percentage points below the national average (estimated at 31.1% in 2006), it still greatly exceeds the recommended level of 10-15% established by the World Health Organization. Cesarean rates above 15% reflect an abuse of the life-saving medical procedure. Cesarean surgery is a major abdominal surgery with its own tangible list of risks.