The percentage of caesarean section deliveries at New York City hospitals increased from 26.6% of all births in 2003 to 28.6% in 2004, according to a report released on Monday by the Public Advocate for the City of New York, the New York Post reports (Campanile, New York Post, 12/5).

The nationwide c-section rate increased from 27.5% in 2003 to 29.1% in 2004. The report, written by Public Advocate Betsy Gotbaum, says the c-section rate at several of the 44 city hospitals offering labor and delivery services was more than twice the 15% maximum rate recommended by the World Health Organization and three times the preferred rate cited by researchers.

Although the city’s public hospitals had lower c-section rates than privately operated facilities, all 44 hospitals failed to comply with the New York state Maternity Information Act, according to the report (Public Advocate release, 12/4). Under the law, hospitals are required to provide data on the number of c-section deliveries they perform to any patients who request it (Kaiser Daily Women’s Health Policy Report, 7/14/05).

Recommendations, Reaction
The report recommended:

  * The New York State Department of Health oversee and assess New York City hospitals’ adherence to the Maternity Information Act;
  * The New York City Health and Hospitals Corporation collaborate with the city health department to ensure the city’s 12 public hospitals offering labor and delivery services comply with the law;
  * The city health department make efforts to gather, calculate and redistribute figures on deadline; and
  * The city health department works with the New York City Department of Health and Mental Hygiene to make all information required by Maternity Information Act accessible on their respective Web sites.

“Our hospitals are doing a great disservice to expectant mothers by failing to comply with state law and provide detailed information on c-section deliveries,” Gotbaum said, adding, “We’re seeing an increase in c-section deliveries, and women need to understand the potential risks involved with this procedure” (Public Advocate release, 12/4). Hugh Randall, vice chair of New York University’s ob-gyn department, said physician concern about malpractice lawsuits is a “significant factor” for the increase in the c-section rate (New York Post, 12/5).