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Elective cesareans increase repeat cesareans, maternal morbidity and mortality rates as well as cost

Obstetrics & Gynecology 2000;95:745-751
Cost-Effectiveness of Elective Cesarean Delivery After One Prior Low Transverse Cesarean
WILLIAM A. GROBMAN, MD, ALAN M. PEACEMAN, MD and MICHAEL L. SOCOL, MD

I bolded a particularly interested sentence….

“Results: The consequences of routine elective cesarean delivery for a second birth are significant, with an additional 117,748 cesarean deliveries, 5500 maternal morbid events, and $179 million incurred during the reproductive life of 100,000 women. The prevention of one major adverse neonatal outcome requires 1591 cesarean deliveries and $2.4 million. Sensitivity analysis confirms the robustness of the analysis. Conclusion: Routine elective cesarean for a second delivery for women with a prior low transverse cesarean incision results in an excess of maternal morbidity and mortality and a high cost to the medical system.”

I think it’s so interesting that insurance companies pay for these elective surgeries.  I wonder how many women would make the same choice if they had to pay out of pocket for their elective cesareans?

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