<html> <head><style type ="text/css">body { font-family: "Bloomberg Prop Unicode I", Verdana, sans-serif; font-size:125%; letter-spacing: -0.3pt; color: #FF9F0F; background-color: #000000; text-align: left; } p {line-height: 1.25em; max-width:900px; width:expression(document.body.clientWidth > 900? "900px": "auto" );} h1, h2, h3 { text-align: left; font-weight: normal; color: #FFFFFF; } h1 { font-size: 130%; } h2 { font-size: 115%; } h3 { font-size: 100%; } #bb-style { font-size: 90%; max-width:900px; width:expression(document.body.clientWidth > 900? "900px": "auto" ); } b, strong { font-weight: bold; } i, em { color: #FEC54A; } pre { font-family: "Andale Mono", "Monaco", "Lucida Console"; letter-spacing: -0.3pt; line-height: 1.25em; } table { border: 0; font-size: 90%; width: 100%; margin-left: auto; margin-right: auto; } td, tr { text-align: left; } td.numeric { text-align: right; } a:link { color:#53B2F5; text-decoration: none; } a:visited {color:#53B2F5} a:active {color:#53B2F5} a:hover {color:#53B2F5} </style> </head> <body> <p>By Lisa Beyer</p> <p>It's been <a title="link to previous editorial" href="http://www.bloomberg.com/news/2012-12-04/hospital-incentives-help-babies-determine-own-birth-dates.html">clear for some time</a> that, apart from putting babies and mothers at <a title="link to website" href="http://www.childbirthconnection.org/pdfs/evidence-based-maternity-care.pdf">unnecessary risk</a>, the excessive use of cesarean section in the U.S. is taxing the health system. Data from a comprehensive <a title="link to study" href="http://transform.childbirthconnection.org/wp-content/uploads/2013/01/Cost-of-Having-a-Baby1.pdf">new study</a> quantifies that cost: about $5 billion a year.</p> <p>The study, by the research firm <a title="website" href="http://truvenhealth.com/default.aspx">Truven Health Analytics</a>, found that c-section births generally cost 50 percent more than vaginal deliveries. For those with commercial insurance, the average cost of a c-section birth in 2010 was $27,866, compared with $18,329 for a vaginal delivery. For those covered by Medicaid, the respective costs were $13,590 and $9,131.</p> <p>The three advocacy groups that sponsored the study -- <a title="link to website" href="http://www.childbirthconnection.org/">Childbirth Connection</a>, <a title="link to website" href="http://www.chqpr.org/">Center for Healthcare Quality &amp; Payment Reform</a>, and <a title="link to website" href="http://www.catalyzepaymentreform.org/">Catalyst for Payment Reform</a> -- calculated that <a title="link to press release" href="http://www.childbirthconnection.org/pdfs/CostofHavingaBaby_PressRelease.pdf">$5 billion a year could be saved</a> if the current cesarean rate of 33 percent of births was reduced to 15 percent. The lower level would reflect cases of genuine medical necessity, according to the World Health Organization. Four million babies are born in the U.S. annually.</p> <p>A number of hospital systems and states have enacted reforms that are reducing elective cesareans. Most hospitals in Oregon and Oklahoma only allow the procedure at 39 weeks of gestation in cases of medically necessity. Texas Medicaid <a title="link to statement" href="http://www.tafp.org/news/stories/11.08.02/obstetrics">no longer pays</a> for it, except under those conditions. The Truven study should prompt other health systems to follow these examples.</p> <p>The result would not only be financial savings but healthier babies. The elective use of c-sections has contributed to babies being born too early. From 1990 to 2009, the percentage of U.S. babies delivered at 37 to 38 weeks <a title="link to CDC stats" href="http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf">grew</a> to 27 percent from 19 percent. A growing body of <a title="link to website" href="http://www.ncbi.nlm.nih.gov/pubmed/19110225">research</a> shows these babies, while not technically premature, are fragile. According to a <a title="link to study" href="http://journals.lww.com/greenjournal/Fulltext/2011/06000/Term_Pregnancy__A_Period_of_Heterogeneous_Risk_for.5.aspx">2011 study</a>, children born at 37 weeks are twice as likely to die in their first year as those born at 40 weeks. They suffer from significantly more <a title="link to study" href="http://www.nejm.org/doi/full/10.1056/NEJMoa0803267">health problems</a>, including respiratory ailments and sepsis.</p> <p>(<a href="http://topics.bloomberg.com/lisa-beyer/">Lisa Beyer</a> is a member of the Bloomberg View editorial board.)</p> <p>Read more breaking commentary from Bloomberg View at the <a href="http://www.bloomberg.com/view/the-ticker/">Ticker</a></p> </body> </html>