27% of low-risk births in Ohio done by C-section | chillicothegazette.com | Chillicothe Gazette

BY JESSICA ALAIMO • CentralOhio.com • January 11, 2010

More than a quarter of the low-risk babies born in Ohio to first-time mothers are born by a Caesarean section.
There is also a wide disparity in these numbers within state hospitals, according to 2008 data just released by the Ohio Department of Health. The rates range from 6.6 percent to 60 percent.
Women who undergo C-sections face the normal risks of surgery -- infection, blood loss and an extended recovery time. Babies have a greater chance of respiratory problems or injury from the incision, medical professionals say.
Genesis Bethesda Hospital in Zanesville is near the state average. Dr. Bijan Goodarzi, an obstetrician at Bethesda, said the hospital also handles riskier pregnancies referred from elsewhere.
The hospital does not perform vaginal births with a previous Caesarian.
C-sections are frequently justified in low-risk situations, Goodarzi said. Women or unborn children might have physical reasons why surgery is needed, such as a contracted pelvis or fetal hemorrhaging.
Others are determined on a case-by-case basis. Once, Goodarzi said, a woman's husband was ready to be deployed to Afghanistan. While she wasn't ready to go into labor, doctors determined a C-section could be performed safely, so she could give birth before her husband left.
Licking Memorial Hospital in Newark has one of the lowest rates in the state --16 percent.
Dr. Elizabeth Koffler, an obstetrician at LMH, said the rise in the national rate, which is at 32 percent, has to do with more women having twins or triplets and also maternal obesity.
Women who request a C-section tend to have a fear of labor and also a fear of future complications, Koffler said.
Unlike some hospitals, Licking Memorial does do vaginal births after Caesarians, she said.
At Coshocton Hospital, nurse Amanda Poorman said C-sections are performed when they are medically necessary or directed by the obstetrician.
"For most of our primary (Caesarian sections), moms have at least had a trial of labor," Poorman said.
Twenty-nine percent of births were done by C-section there, but only 20 percent are primary operations -- meaning 9 percent had previously given birth by surgery, Poorman said.
At Berger Hospital in Circleville, the number of C-sections has remained constant at about 17 percent, said Barb Poole, director of maternity services.
Miami Valley Hospital in Dayton has the state's lowest C-section rate among first-time, low-risk births. Of these 1,315 births, 88 were Caesarians, a rate of 6.6 percent.
The hospital specializes in high-risk births, so there are a number of specialists on staff, said Dave McKenna, a maternal fetal medicine specialist at Miami Valley.
"Some hospitals are too quick to do C-sections," McKenna said. "Babies do better after vaginal delivery. There is a lower rate of admission to the neonatology critical care unit due to low rates of respiratory problems ... they're more likely to successfully breast-feed."
Jessica Alaimo can be reached at (740) 328-8576 or jalaimo@nncogannett.com.

27% of low-risk births in Ohio done by C-section | chillicothegazette.com | Chillicothe Gazette