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Hospitals seeking a reduction in medically unnecessary C-sections

The Detroit Free Press reports that hospitals in Michigan are taking on a project that helps reduce the number of medically unnecessary C-sections in the state.

The project “considered a national model is helping women avoid medically unnecessary C-sections and contributing to healthier outcomes for their babies, project organizers report,” according to the Free Press.

The rise of medically unnecessary C-sections has been little discussed problem in the U.S. even as rates continue to climb.

As of last year, the state of Florida had the highest Caesarean rate in the country. Miami has the highest number of hospitals that are delivering more babies via C-section than natural deliveries.

According to a recent HealthGrades Obstetrics and Gynecology in American Hospitals report, Florida’s C-section rate was 38.6 percent in 2010 — the highest in the nation. The lowest rate belonged to Utah, which had a 22.4 percent C-section rate. The national C-section rate between 2002 and 2009 rose from 27 percent of all single births to 34 percent. HealthGrades says this “an all time high.” However, unlike Michigan, there have been no recent expansive statewide efforts among hospitals to reduce the number of C-sections.

According to the Free Press:

The Michigan Health and Hospital Association Keystone obstetrics project has triggered major changes at the 65 Michigan hospitals as they move to eliminate many Caesarean births and use of labor-induction drugs before the 39th week of pregnancy.

Under the project, elective or scheduled C-section births are discouraged unless the mother has a chronic disease or is carrying more than one baby, or her baby is small and developing slower.

At Oakwood Hospital and Medical Center in Dearborn, where the idea for the project began, doctors have seen improvements in babies’ birth scores and fewer in the neonatal care unit.

Hospitals all over the state have reportedly made a commitment to the project. “About 65 Michigan hospitals — nearly every major birthing center in the state — are active in the C-section reduction campaign,” the Free Press reports.

So far, researchers say the results of the project are positive:

The doctors and researchers say preliminary data are promising, showing a sizable reduction in elective C-sections and use of labor induction drugs.

Even more encouraging are reports of better Apgar scores — a measurement of a baby’s health taken a few minutes after birth — and fewer instances of infants requiring special care at the hospitals.

The results are preliminary, and a larger study awaits publication in December in a national journal about patient quality initiatives. Early data show elective C-sections before 39 weeks of pregnancy fell to 6% from 24% of all births, and use of labor-induction drugs dropped to 7% from 20% of all births, according to data collected from March 2010 to March 2011.

The March of Dimes 2011 Mission Report for Florida says that in an average week in Florida “1,710 babies are born by cesarean section.” The group has started its own project addressing the C-section problem in Florida. According to the group’s website, the Florida Perinatal Quality Collaborative began “a pilot program designed to eliminate c-sections and inductions in Florida that are scheduled for non-medical reasons before 39 weeks of pregnancy.”

“Beginning on January 3rd, 2011, six hospitals in Florida have implemented policies to prevent non-medically indicated deliveries before 39 completed weeks of pregnancy (a normal pregnancy lasts 40 weeks),” the website says.

There are currently six hospitals in Miami alone with a C-section rate of over 50 percent, according to data from the Agency for Health Care Administration.

Manuel Fermin, the CEO of the Healthy Start Coalition of Miami-Dade, has told The Florida Independent that hospitals in Miami reporting these types of numbers are not looking out for women.

“Here in Miami, this has become a business,” Fermin says.”It is so out of whack it’s scary. You don’t find this anywhere else in the U.S.”

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