Cesarean delivery rate levels off

For the last three years, the U.S. cesarean delivery rate has held steady at 31.3%, according to a report from the U.S. Department of Health & Human Services. The cesarean delivery rate among singleton births hit an all-time high in 2009 at 32.9%, which marked the end of 12 years of consecutive increases. The overall rate of cesarean deliveries remained constant; however, cesarean rates for births at 38 weeks fell by at least 5% for all maternal age groups from 2009 to 2011. On the other hand, cesarean delivery rates among births at 39 weeks were at least 1% higher in 2011 than in 2009 for all maternal age groups. It may not be a coincidence that the numbers jump at 39 weeks. The American College of Obstetricians and Gynecologists (ACOG) also developed clinical guidelines aimed at reducing non-medically-indicated cesarean delivery and labor induction prior to 39 weeks. According to the ACOG, infants born between 36 and 38 weeks may weigh and appear to be the same as those born later, but they are more likely to have serious lung problems and other medical conditions resulting in admissions to the neonatal intensive care unit (NICU). Early deliveries put babies at risk and add to the high cost of perinatal care. The average cost of a NICU stays is $76,000, and the long-term conditions associated with early deliveries can continue to cost families thousands throughout their child’s life. Private and public health plans have also been working to make early elective deliveries less financially attractive. For example, UnitedHealthcare makes incentive payments to hospitals that take steps to limit early deliveries without medical cause and can demonstrate a drop in their rates. Medicare has also started to collect data from hospitals on rates of elective deliveries before 39 weeks. Starting in 2015, Medicare will penalize hospitals whose rates remain high. As a reaction, several hospitals no longer allow elective delivery prior to 39 weeks. Their efforts aim to reduce the cost of childbirth, which is the highest in the developed world.