As the rates of cesarean sections (C-sections) climb elsewhere, Winona Health has succeeded in delivering a greater percentage of babies naturally than any other medical group in the state and avoiding the high risks, high costs, and long recovery times of the surgical procedure. Minnesota Community Measurement (MCM), a health insurance consortium that reviews care providers, reported that only 14 percent of mothers preparing to give birth at Winona Health last year had C-sections compared to a 26 percent statewide average.
Winona Health obstetrician Dr. Scott Birdsall said that while C-sections are sometimes necessary, they are his "last resort" because of the risks of surgery. Other obstetricians are more open to C-sections, and there are "two different camps" within the obstetrics community on the issue of whether C-sections should be Plan A for would-be mothers, Birdsall explained.
MCM has made its stance clear. "Lower rates indicate better performance" when it comes to C-sections, its report said. An MCM spokesperson clarified, "The goal is to maximize the number of healthy, normal births in Minnesota."
The difference in C-section rates between Minnesota care providers is remarkable. The practice with the lowest rate in the state performed C-sections for less than 10 percent of its patients in 2012 while the two practices with the highest rates in Minnesota performed C-sections for more than half of their patients, according to MCM.
Birdsall said he and his associate Dr. Troy Shelton were pleased with their recent recognition. However, Birdsall qualified the 14 percent figure, pointing out that numbers will vary from year to year and that Winona Health does not deliver extremely premature babies, which could "skew our numbers downwards a little bit." Still, those numbers represent the work Winona Health has done over the years to have successful, natural births when possible, he added.
C-section rates are trending upwards nationwide, Birdsall said. While determining why patients are having more C-sections is difficult, he said, "some of it has to do with convenience, both from a professional standpoint and a patient's standpoint. Sometimes people are requesting them because it's more convenient for their schedules.
"There is a quicker move to a cesarean if there is anything going wrong with labor course, and many of the women who have had a cesarean go back for a repeat C-section rather than a vaginal birth," he continued.
At times, Birdsall does have mothers who want a C-section. Those patients are "usually scared of the labor process or worried about how their baby is going to do," he said. "I assure them that this is a natural process, not something to be afraid of, and something we want to go for, if possible."