An American study has found that the presence of hospital-based obstetricians dedicated full-time to labour reduces the rate of caesarean delivery rates. It is the first study on the effects on patient experiences and outcomes in hospitals that have adopted ‘labourist’ programs, and is published in the American Journal of Obstetrics and Gynaecology.
"Our results may have important implications on care for delivering mothers and the future of labourist programs and obstetrics training within the United States,” said the study's co-author, Dr Brian Iriye of the High Risk Pregnancy Centre and Sunrise Medical Centre in Las Vegas.
Caesarean delivery is major surgery associated with uncommon but increased risk of medical complications such as infection, bleeding, and blood clots that can occur in the lower extremities or lungs.
“These medical complications lead to increased financial costs in addition to the risks upon maternal health,” said Dr Iriye.
The study found that there was a 27% decrease in C-sections in hospitals with the labour program, compared with those without full-time obstetricians.
Dr Iriye said that caesarean delivery also increases hospital stay for recovery leading to added costs even in uncomplicated cases.
The overall rate of C-sections in the USA in 2009 was 32.3%, a 60% increase since 1996. In Australia, the rate is only marginally less at 30.8% at an annual cost of approximately $40 million. The OECD average is 25.8%, while the World Health Organisation has stated that the rate of C-sections “should not be more than between 10 and 15%".
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