EDWARDS, C-SECTIONS & CHILDBIRTH DEATHS

A couple of months ago, I linked to a post that featured some interesting physician comments regarding the culpability of personal injury lawyers in the increased use of C-sections. Many of the docs mentioned one such attorney by name:

Edwards specifically has made much of his fortune suing doctors for not performing C-sections, arguing that they help prevent cerebral palsy in children … Now doctors do C-sections “just to be safe,? meaning safe from lawsuits, though the procedure is not so safe for mothers. 

This AP article indicates that, for the first time in decades, the number of mothers dying in childbirth is on the rise. And it would appear that the rising frequency of C-sections is partly to blame: 

Some researchers point to the rising C-section rate, now 29 percent of all births–far higher than what public health experts say is appropriate. Like other surgeries, Caesarians come with risks related to anesthesia, infections and blood clots.

So, physicians are doing more C-sections to protect themselves from potential lawsuits by Edwards or one of his accomplices, and the losers are expectant mothers.

I suspect that, if  the families of those mothers understood the connection between their tragedies and Edwards’ depredations, they would have harsher words for him than any he has heard from conservative pundits.

Comments 12

  1. Marc Brown wrote:

    Surely you must realise that caesarean rates have risen all over the developed world and that there are several factors in play, such as older women having babies, the increase in multiple births after IFV and the demand from women for an elective (and increasingly safe) op. And in the US, it is more profitable for hospitals to carry out caesareans.

    So – ‘physicians are doing more C-sections to protect themselves from potential lawsuits’ – how many would this be?

    Posted 26 Aug 2007 at 3:57 pm
  2. Catron wrote:

    And in the US, it is more profitable for hospitals to carry out caesareans.

    First, “hospitals” don’t decide whether or not to do C-sections. Physicians make that decision.

    Second, please produce some (objective) data suporting your “more profitable” assertion.

    Posted 26 Aug 2007 at 4:51 pm
  3. Marc Brown wrote:

    ‘First, “hospitals? don’t decide whether or not to do C-sections. Physicians make that decision.’

    You’re being pedantic. Hospitals are inanimate objects – of course it’s people who make decisions.

    ‘Second, please produce some (objective) data suporting your “more profitable? assertion.’

    Since when has objective data bothered you? How about you go first with your objective data on how many ‘physicians are doing more C-sections to protect themselves from potential lawsuits’?

    But for now I’ll say that as i’ve said before the US is the world leader in unnecessary overtreatment, and quick search reveals:

    ‘A healthcare organization’s financial status may also play a role in the decision-making process. “Obstetricians and hospitals have found that high-intervention birth, warranted or not, is very profitable,? Jamois says. “So there is a tremendous financial incentive to bypass the clinically optimal approach, and opt for convenience and profit. For example, many hospitals across the country have eliminated facility-based midwifery practices simply because the low-intervention approach, while clinically sound, does not bring in as many dollars.?’

    From http://www.fortherecordmag.com/archives/ftr_082905p34.shtml

    Posted 26 Aug 2007 at 5:22 pm
  4. Catron wrote:

    Perhaps you should look up the definition of objective data (hint: the above quote doesn’t qualify).

    The reality, Marc, is that C-sections have a lower contribution margin than vaginal deliveries.

    Posted 26 Aug 2007 at 6:42 pm
  5. Matt wrote:

    Catron,

    Can you point to any case of Edwards’ where the verdict was not supported by the facts of case?

    It’s interesting how loose you are with statistics that even imply they support your preconceived notions, but are terribly skeptical of those that don’t. A bit hypocritical, don’t you think?

    Posted 26 Aug 2007 at 8:25 pm
  6. Catron wrote:

    Can you point to any case of Edwards’ where the verdict was not supported by the facts of case?

    Yep. In his most famous case, he convinced a jury that a C-section would have prevented a case of cerebral palsey. But there is no credible scientific data showing that the incidence of cerebral palsy is affected by the C-section choice one way or the other.

    It’s interesting how loose you are with statistics that even imply they support your preconceived notions, but are terribly skeptical of those that don’t.

    No one in this comment stream has produced any statistics. All Marc offered was the gratuitous assertion of an ill-informed windbag.

    Posted 26 Aug 2007 at 8:57 pm
  7. Marc Brown wrote:

    And you have offered nothing on the number of c-sections performed because of potential litigation. Where is your objective data, David?

    Also is Tonya Jamois, president of the International Cesarean Awareness Network, really an ill-informed windbag? Would you like to explain?

    I note too you linked to the Ann Coulter ‘faggot’ comment on John Edwards – what is your reason for this?

    Posted 27 Aug 2007 at 4:28 am
  8. Catron wrote:

    Nice try, Marc. Switching the burden to me won’t get you off the hook on your “more profitable? claim.

    Posted 27 Aug 2007 at 7:21 am
  9. Marc Brown wrote:

    have a read of this:

    http://cfmidwifery.org/Resources/Item.aspx?ID=32

    ‘The fact that more cesarean sections are performed when reimbursement is higher, shows that this intervention is done at least some of the time for economic reasons. For example, in 2000 cesarean sections were performed on 24.4% of patients covered by private insurance (which reimburses at the highest rates), on 20% of patients covered by Medicaid, and on 18.65% of women who were uninsured (?Care of Women in U.S. Hospitals, 2000″ HCUP Fact Book No. 3).’

    Posted 27 Aug 2007 at 12:06 pm
  10. Catron wrote:

    “Reimbursement? does not equal profit, Marc. What you get paid has meaning only in relation to your costs. I guess you aren’t familiar with the term “contribution margin? that I used above. Here’s a link that explains it.

    Posted 27 Aug 2007 at 12:16 pm
  11. Marc Brown wrote:

    Ah, I get it – they up the c-rate to cover their costs. Thanks for making that clear.

    Posted 27 Aug 2007 at 3:20 pm
  12. Catron wrote:

    No, I’m afraid you don’t get it.

    Posted 27 Aug 2007 at 3:31 pm

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