How to Bring Down the C-Section Rate Without a Government Mandate

This article is specifically about Florida, but the issues it raises come up in health care debates everywhere:

Some doctors say too many C-sections are performed in this country. […]

“I personally think that the rate has gotten to be higher than it needs to be,” said Dr. Roger Freeman, a retired ob-gyn from California, who chaired a 2000 task force that examined the soaring C-section rate.

But others say it should be solely up to doctors and parents to decide how a baby is born — mirroring the overall health care reform debate.

I’m in favor of leaving the decision up to doctors and patients. However, there are things concerned groups could do, in and out of the realm of policy, to bring down the incidence of c-sections without infringing on anyone’s personal choices.

For example, the shift towards health savings accounts (HSAs) could lead more patients to choose vaginal deliveries. C-sections are considerably more expensive, so patients who cover the cost with a savings account will probably think twice if their only reason to have a c-section is convenience. Advancing the cause of HSAs will discourage costly procedures when they aren’t medically necessary.

Another way to influence patients without resorting to rationing care is to advertise. Although often maligned, adverisements can be a useful means of spreading medical information. Infomercials about the risks of c-sections could change behavior, as could advertisements promoting hospitals’ delivery rooms. “Vaginal delivery” doesn’t mean the same thing everywhere;  some hospitals allow women to walk around during labor, while others keep patients flat on their backs and moniter labor intensively. Letting patients know about the options that are out there will help them make better decisions.