Study: Births by Caesarean soar in Washington

The percentage of Washington women opting for Caesarean sections rose dramatically in the past decade, a recent study has found.

The state Department of Health estimates a 60 percent increase between 1997 and 2005 in C-sections for low-risk births. A quarter of pregnant women in Washington opt for C-sections, according to the study. Puget Sound hospitals reported the highest rates; Yakima County reported the lowest.

Whether the growth was fueled mainly by women's preference or need remains unclear.

According to the study, about 14 percent, or 2,200, C-sections in Washington could be avoided every year.

Some experts have attributed the change to a growing perception that C-sections are less risky — for the mother and the child — than vaginal birth. C-sections can also allow busy women a more predictable, and more easily planned childbirth.

The procedures can be necessary for high-risk pregnancies. Women over 35, as well as obese women, often have to forego vaginal births.

Researchers disagree on how safe C-sections are.

"If there is this perception out there that C-sections are somehow safer or better, we wanted to point out that's not completely the case," said Joe Campo, research section manager for the study.

Studies have shown that once a woman undergoes a C-section, she likely would have to undergo another if she becomes pregnant again. Campo also pointed to research that indicates C-sections can increase the risk of respiratory disease in children.

Some researchers argue that the risks involved with C-sections have been overstated.

Jane Uhlir, medical director for women and infants at Swedish Medical Center in Seattle, said that the increase in the procedure at her hospital is due in part to a growing number of women in their late 30s and older giving birth for the first time. She attributes that to a higher-than-average number of career-oriented women in Seattle.

"We're a bunch of old, educated career women here," she said.

Uhlir said very few women at Swedish undergo C-sections "just because they want them."

Despite the procedure's popularity, recent studies have found little evidence to support the notion that many women choose C-sections simply for convenience — the so-called "too posh to push" phenomenon. A study conducted in 2005 by Childbirth Connection found that just one woman out of roughly 1,600 surveyed nationwide had a C-section without a medical reason.

Uhlir encourages her patients to avoid C-sections without a medical need.

"A Caesarean section is a surgical procedure," she said. "It has more risk of bleeding, more risk of infection, and scarring that can affect future pregnancy or the health of the mother in general."

Caesareans generally cost about $5,000 more than vaginal births, Campo said.

Women in more-affluent neighborhoods showed higher-than-expected C-section rates, he said, and the lowest rates were found in women on Medicaid.

Robert Faturechi: 206-464-2393 or rfaturechi@seattletimes.com