For immediate release: August 21, 2008 (08-141)

Contacts:
Joe Campo, Research Section Manager 360-236-4321
Allison Cook, Communications Office 360-236-4022

Puget Sound region highest in the state for C-sections

OLYMPIA ¾ Cesarean sections, or C-sections, have increased by 60 percent in low-risk births from 1997 to 2005 in the state — similar to national trends. C-section rates are higher in the Puget Sound region than in the rest of the state.

These are two key findings in a report the state Department of Health released today. The report titled Cesarean Sections in Washington State: Trends and Geographic Variations (http://www.doh.wa.gov/ehsphl/CHS/chs-data/Public/CSectionsInWA.pdf) can be found online.

The agency’s Center for Health Statistics looked at birth certificates and hospital billing records to identify regions with higher than expected C-section rates. The study focused on low-risk births. Low-risk is defined as a first-time mother having a single child that is positioned head down in the womb.

The Centers for Disease Control and Prevention suggest that no more than 15 percent of low-risk births should be C-sections. Washington came close to this goal in 1996, when 17 percent of low-risk births were C-sections. Since then there has been an increase in the C-section rates for both the nation and our state.

“While C-sections should always be available to a mother in need, having a C-section is risky to both mother and child,” said Dr. Maxine Hayes, Washington State Health Officer. “A woman having a C-section faces a higher risk of infection and infertility. Her newborn faces a higher risk of asthma and other respiratory problems. Once a mother has a C-section, chances are high that any future births will also be C-sections.”

While most Cesarean sections are life saving measures for mother or child, this report raises the question about the 14 percent — about 2,200 — C-sections per year that may be preventable. The report found that women who had C-sections in the past were likely to deliver by C-section again. It also looked at health factors linked with C-sections, like diabetes, hypertension, and obesity. Women with these health factors were much more likely to have a C-section than those without.

The report identified geographic areas where these risk factors were present. The findings were based on hospital records from all community and military hospitals in the state and all community hospitals serving Washington residents in Oregon. Between 2002 and 2005 maternal obesity rates were much higher in the Olympic peninsular region. During the same period, maternal hypertension rates were higher in Whatcom and most of Skagit Counties. The report also identified other regions with higher than expected risk factors for C-sections.

On average, women living in the Puget Sound region had 275 (about 10 percent) more C-sections per year than would be expected when compared to women living outside the region. These women were giving birth to a single child and had no prior C-sections or noted risk factors. While the research doesn’t explain the cause of the regional differences in rates, it provides more information for public health and its partners in the discussion of these procedures and about overall differences in health care use in the state.

Women considering pregnancy should talk with their health care provider about what they can do to have a healthy pregnancy and a healthy baby. This is even more important for women who are overweight, have diabetes, or who are hypertensive. Once a woman knows she’s pregnant, it’s important that she get prenatal care early and see her provider regularly.

More information can be found on the department’s Center for Health Statistics’ Web site (http://www.doh.wa.gov/ehsphl/chs/chs-data/main.htm).

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