Health system hurting from C-section trend
Labour fears prompt many to opt for costly surgery, report finds

One in four Canadian babies now arrives with the help of a doctor's scalpel as more women "too posh to push" opt for caesarean sections at high cost to the medical system, according to a national report.

The report says rising rates of medical intervention - 24 per cent of Canadian babies now arrive by C-section, compared to 17 per cent in the early 1990s - has helped drive up the cost of childbirth to more than $1 billion a year. The figure is based on the cost of inpatient care, but does not include most of the fees paid to midwives and physicians.

C-sections cost 60 per cent more than vaginal births, according to the report by the Canadian Institute for Health Information released Wednesday. It pegs the cost of a caesarean at $4,600 and a vaginal birth at $2,800. Doctors say the rising rate of C-sections is driven, in part, by fear of childbirth and the too-posh-to-push phenomenon that sees women request the surgery even though they have no recognized medical problems.

In some cities, such as Vancouver, doctors say the caesarean rate is approaching 30 per cent - almost twice as high as considered medically necessary by the World Health Organization.

"We have women coming in with the impression that caesarean section is an easier alternative to vaginal birth," says Dr. Jan Christilaw, obstetrician and head of specialized women's health at B.C. Women's Hospital. She says celebrities like singer Britney Spears, who had a caesarean last year, have helped drive the trend.

"A lot of information out there is completely skewed and it is very unfortunate that it is out there," says Christilaw, who noted some women have the mistaken impression that C-sections offer an "esthetic advantage."

The reality, she says, is that vaginal birth is not only safer and cheaper but also easier on the body. "And if women are frightened of vaginal birth, it is because they don't appreciate that we can take care of pain in labour. If things go wrong we can do a C-section if we have to," Christilaw says.

Christilaw worries Canadian rates could continue climbing towards U.S. rates, where close to 35 per cent of babies are delivered by C-section. "Even if it rises two- to three- per cent more, the cost would be staggering," says Christilaw, who stresses the benefits of vaginal births at every opportunity.

"For women it can be so empowering and so beautiful," she says. "If you end up pushing your baby out in the most natural manner possible that's best for women and babies. That's the bottom line here," says Christilaw, a member of the expert panel that helped produce the new report, Giving Birth in Canada: The Costs.

By Margaret Munro, CanWest News Service