PENNSYLVANIA Counties are near Caesarean average
The rate of vaginal birth after Caesarean-section deliveries varies widely from hospital to hospital in Pennsylvania.
By WILLIAM K. ALCORN
VINDICATOR STAFF WRITER
HARRISBURG -- Mercer and Lawrence County hospitals are near or below the statewide Pennsylvania average rate of 21.1 percent of Caesarean-section births per 100 deliveries in 1999.
According to a joint report made public today by the Pennsylvania Health Care Cost Containment Council (PHC4) and the Pennsylvania Department of Health, however, the rate of vaginal births after Caesarean (VBAC) that year varied substantially from hospital to hospital locally and across the state. In Lawrence County, the VBAC rate at Ellwood City Hospital was 13 percent; at St. Francis Hospital in New Castle, 13.8 percent; and at Jameson Memorial Hospital in New Castle, 52.5 percent.
In Mercer County, the VBAC rates at Sharon Regional Health System, UPMC Horizon and United Community were 48.2 percent, 39.5 percent and 25.5 percent, respectively.
The study also noted that C-section deliveries in Pennsylvania and nationally are increasing after declining for many years because of concerns over risk and cost.
The study said that 21.1 percent of all hospital deliveries in 1999 were C-sections, up from 19.5 percent in 1997 and 19.9 percent in 1998.
The considerable variation in C-section rates, even after separating deliveries by risk, indicates a lack of consensus among health-care providers about the proper approach to the procedure, Marc P. Volavka, PHC4 executive director, said.
Contributing to the increase of C-sections in Pennsylvania was the rise in low-risk repeat C-section deliveries, from 57.1 percent in 1996 to 62.7 percent in 1999. The report notes that the possibility of uterine ruptures is a factor leading to repeat C-sections, but that ruptures occurred in only 0.1 percent of all deliveries in Pennsylvania in 1999, and none of those was fatal.
"Our data show that the primary factor in having a C-section is if you had one before," Volavka said. The increasing low-risk repeat C-section rate signals a need for additional discussion research and potential action, he said.