Last month, Childbirth Connection issued Cesarean or Vaginal Birth: What Is At Stake for Mothers and Babies, a best evidence review cataloging dozens of adverse outcomes made more common by cesarean surgery. Maternal infections, prolonged pain, life-threatening complications, and childhood chronic illnesses – evidence demonstrates cesarean increases the likelihood of each of these. These risks are appropriate tradeoffs in some circumstances when cesarean offers a clear benefit. But a growing chorus of obstetric leaders and maternity care reformers are warning that the c-section rate is too high. For the benefit of public health – for the 4 million women who give birth every year and their 4 million babies – we must work to safely rein in the overuse of c-sections.
Today, we learn the extent to which c-section overuse is driving up health care costs, too. Together with Catalyst for Payment Reform and the Center for Healthcare Quality and Payment Reform, we have issued The Cost of Having a Baby in the United States, prepared by Truven Health Analytics.
What is at stake for payers? Not only do unwarranted c-sections create greater health risks for women and babies, this study shows that they also dramatically increase costs for employers and, through Medicaid programs, state and federal budgets. Medicaid programs paid nearly $4,000 more for c-sections than vaginal births, while for commercial insurers the difference topped $9,500. The World Health Organization recommends a c-section rate of 15% or less for any country. If the U.S. c-section rate was reduced from 33% to 15%, national spending on maternity care would decline by more than $5 billion each year.
This was just one of the important findings in The Cost of Having a Baby in the United States. Download the report to view more. These data provide needed groundwork for improvement programs to align maternity care payment and quality. As governments and businesses work to balance budgets, and zero in on the costly maternity care segment, we must target the areas where we can reduce cost while simultaneously improving health and safety. High-quality, high-value care is within reach. We must rapidly spread innovation and best practices to improve the health of women, babies, and families. We can’t afford not to.