Canadian health system paying high cost for women who are 'too posh to push’

OTTAWA (CP) - The Canadian health system is paying a high cost for pregnant women who are "too posh to push," suggests a study released Wednesday. The report by the Canadian Institute for Health Information shows that hospitals typically spend 60 per cent more to care for a mother who has a caesarian section, or about $4,600 compared with $2,800 for a vaginal birth.

The soaring rate of C-sections shows the influence of Hollywood stars, said Jan Christilaw, head of specialized women's health at the Women's Hospital of British Columbia.

"All these celebrities seem to have caesarian sections because they seem to have this idea that it's better, and it's not," she said in an interview.

The number of C-sections in Canada rose to about 25 per cent of all births in 2002-03, from 17 per cent a decade earlier, says the report. Canadian hospitals spent more than $1 billion on childbirth costs in that year.

The C-section rate in trendsetting British Columbia last year was between 27 and 30 per cent, says Christilaw. But that's still below the U.S. rate of 35 per cent.

"We know there's pressure in that direction. You can just imagine what happens if we take another jump up from where we are now to 35 per cent. It's going to be disastrous for the system."

The preference for C-sections is "almost silly," she said.

"If you think you're going to have a better figure if you have a C-section rather than a vaginal birth, you're realistically wrong. It'll take longer for your abdominal muscles to get back into shape and of course you'll have a scar on your abdomen."

As for the notion that C-sections maintain vaginal muscle tone, "we know that by six months, women who have vaginal births have just as strong pelvic floors as women who have C-sections.

"There's really no suggestion when you look at the statistics for the whole population that having a C-section is actually going to make sex better for you in the long run."

Then there's convenience: "You have a busy life, you check into the hospital on Friday at five o'clock, have your C-section and you're done as opposed to having to wait for the natural process to get started some time over a two-week period.

"It may take 12 to 24 hours before you have your baby. You never know when that's going to happen. If you're flying your mother-in-law in from Australia, well it's not too convenient."

Christilaw questions whether doctors should be interfering with a natural process to suit a woman's social schedule.

"I think what this data says is, look, there's very good reason to suggest that we should be trying to do the best we can to make normal births the best possible experience for women.

"If we don't we will have hell to pay in terms of the costs of birth."

She stressed that C-sections are sometimes medically justified but they should not be done unnecessarily.

"We are very good at what we do in Canada. We have the lowest maternal mortality in the world. We have very low neonatal mortality.

"But having said that, our intervention rate has gone up a lot in the last 20 years and especially in the last five years. I think we have to keep a close eye on that."

© The Canadian Press, 2006