1. C-Section Rates Too
High in China
By Dr. Lori Gore-Green / Obstetrics and Gynecology Physician

3. According to a commentary recently published in
BJOG: An International Journal of Obstetrics and
Gynecology and summarized in an article completed
for Science Daily, the rate of cesarean sections in
China is far too high and efforts need to be made to
reduce the reliance on the procedure.

4. The research completed for the commentary
indicates that, of the sixteen million babies born in
2010, approximately half of them were delivered
through cesarean section.

5. However, the article did acknowledge that the exact
rate of births by cesarean section, but the literature
available on the topic in China indicates that the rate
of C-sections could range anywhere between thirty
six percent and fifty eight percent.

6. Several reasons for the priority placed on cesarean
sections are discussed. With the existing high
number of deliveries occurring in the nation, cesarean
sections may simply be the preferred method, due to
the advantages of managing an enormous volume of
births with limited resources.

7. There are also a series of financial incentives for
hospitals and physicians who engage in cesarean
sections as opposed to traditional vaginal deliveries.
Insurance is more willing to cover the costs of
childbirth, if the baby is delivered by cesarean
section.

8. Physician and hospital revenues are also increased with
the procedure as well; in addition, physician salaries are
often supplemented, based in patient volume and
collections. In this sense, cesarean sections allow for a
higher salary for physicians, as they collect more than
traditional vaginal deliveries.

9. Money also plays a role in the staffing influences
over choosing cesarean sections as the preferred
method of delivery. Staffing levels in China public
hospitals are low and limited, due to government
regulation. Per one thousand people in the
population, there is only one and a half nurses or
midwives.

10. As cesarean sections require less nursing hours
when compared to vaginal deliveries, it makes sense
to pursue this avenue in the interest of staffing.
Finally, training is varied and inconsistent in
obstetrics and gynecology in China; less than two
percent of physicians complete a masters or PhD
level in their training.

11. There is also a factor of patient preference. Since the
One Child Policy has been passed, mothers demand
perfect outcome on the one and only attempt,
particularly in wards that don’t offer pain control,
epidurals or much nursing support.

12. Fundamentally, there is a fear of labor that inclines
mothers towards cesarean sections. However, in
November, a less strict version of the One Child Policy
is expected to go into action, which would allow for
the birth of a second child.

13. With the increased number of births would come an
increased reliance on cesarean sections; therefore,
the commentary postulates that this will force
medical professionals to return once more to
traditional vaginal deliveries, as to cut back on the
risks in childbirth.