Thanks, Unnecesarean, for this horrific report.
2009 Cesarean Rates by State
Two-thousand-and-NINE. NINE. As in NINE, TEN and now it's ELEVEN.
How much worse is it really? Right now? TWO YEARS LATER?
I feel faint.
Of course, Florida is right up there with the worst of them. at least we're consistent.
And I see NJ is 2nd- lovely! All the more reason I want to become a midwife!
Proud to be in UT where the rate is only . . . wait, 22.8? Well, at least we're at the bottom of the list, even if it is still too high of a number!
It is no coincidence that of the 4 friends who have birthed in the past 4 years (all in hospitals, but all women marginally to very interested in/prepared for natural birth), the only one NOT to end up with a C/S was in New Mexico, the state with the lowest rate.
I have said before that it always seems the poorest and richest seem to have the highest intervention rates. The poorest because-- in addition to underlying conditions correlated with the actual need for interventions-- they are so often pushed through underfunded hospitals in conveyor-belt-like fashion (direct forms of racism and classism help too). The richest because the "top" hospitals (many of them truly excellent for pathological conditions) are so over-reliant on the use of "state of the art" technology-- which so often hurts more than it helps in a normal birth.
In any event, I believe I am seeing that here-- on the top of the list are lots of states with very high per capita incomes (even adjusting for cost of living), as well as the poorest states. I see NJ, NY and CT all in the top 10, as well as MS, LA, WV, KY, AL...
Perhaps there's some other correlation as well, but my theory is exactly why I believe someone with a low-risk pregnancy in a big city is actually a significantly better candidate than average for HB. I live in a big city and virtually all of the hospitals around here are "top" teaching hospitals with extremely high C/S/intervention rates or underfunded hospitals serving poor women, also with astronomical intervention rates. I believe this makes hospital birth more risky than average for someone with a low-risk pregnancy.
And on the other side of the coin, living in a big city, in most cases, means you have more choice when it comes to HB midwives, because there are more to support a larger population, and most of the time, they are within a 15-30 minute drive, even with traffic. In addition, the fact that most people in big cities live within 3 miles of a hospital makes homebirth even less risky in cases of emergency or need for transfer. (I actually live within a 10 minute WALK of one of those "top" hospitals-- about a 3 minute drive or a 90-second ambulance ride. I joke that it is almost as though I live in a distant wing of that very hospital.)
Just noodling (and sorry for the tangent), but as I'm planning a HB here, I really do believe that HB in a big American city is actually an even BETTER choice for most women than it would be in many other parts of the country.
I live here in New Mexico, and I'm proud that we're at the bottom of the list. I mean, 22.8% is still high, but for once we're not in the worst ten. Drunk driving and drug abuse, on the other hand... Ugh.
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