• Hospital Management May Increase C- Section Risk
  • September 22, 2017
  • The Harvard T.H. Chan School of Public Health has published a new study that examines the link between hospital management style and rates of cesarean deliveries. Over the course of one generation, the rate of C-sections in the United States has increased by 500 percent. On average, one out of every three babies are delivered this way. Cesarean delivery puts the mother at risk of surgical complications and often results in longer hospital stays, increased rate of hemorrhage or infection, and costs on average 45 percent more than vaginal births.

    The researchers from Ariadne Labs, a joint center of Harvard T.H. Chan School and Brigham and Women’s Hospital, are part of the Delivery Decisions Initiative which aims to identify the key drivers of dangerously high C-section rates. Across different hospitals, health results for mothers who deliver by C-section varies dramatically. There is a ten-fold variation in the rate for C-section delivery, which researchers have not been able to attribute to women’s health or preferences.

    The study looked at 53 diverse hospitals and interviewed 118 nurse and physician managers about unit culture management and how staff communicate and collaborate. Nursing management, which includes maintaining adequate nurse staffing levels, and patient flow management, or adjusting to deal with the ebb and flow of patient arrivals were also included in the study. They categorized the hospitals according to whether the hospitals had “proactive” or “reactive” management practices. Proactive hospital management practices try to reduce the number of problems before they occur whereas reactive practices address management problems as they arise.

    The results of the study showed that women considered low-risk who were delivering their first child had a higher risk of cesarean delivery, postpartum hemorrhage, blood transfusion, and prolonged stays at hospitals that had the most proactive unit culture management. A possible reason for this surprising outcome is that these hospitals are concentrated on goals other than the mother’s health, such as neonatal results or financial performance.

    Senior author Neel Shah, the obstetrician who leads the Delivery Decisions Initiative at Ariadne Labs, said about the study, “It is hard to predict when women will go into labor, how long labor will take, and which women may require critical resources like the operating room or blood bank. The way managers address this uncertainty appears to be an independent risk factor for a woman getting a C-section.” According to the study approximately 45 percent of cesarean deliveries may be avoidable.

    Other studies echo the findings of the results at Ariadne Labs. A Consumer Reports investigation looked at 1,300 hospitals across America and found that the rate of cesarean deliveries for low-risk mothers varied dramatically between hospitals, even for those in the same community. The choice of hospital and how busy it is when the mother arrives to deliver is now seen as a risk factor for having a C-section.

    New Jersey Medical Malpractice Lawyers at Eichen Crutchlow Zaslow & McElroy, LLP Advocate for Victims of Medical Malpractice
    If you or someone you know has suffered medical complications from an unnecessary C-section or other surgical procedure, you may be eligible for compensation. Call Eichen Crutchlow Zaslow & McElroy, LLP at 732-777-0100 to speak with an experienced medical malpractice lawyer in New Jersey about your legal options. You can also contact us online to schedule a free consultation. We have offices in Edison, Toms River, and Red Bank to serve you.