Arkansas has one of the country’s highest rates of cesarean births among low-risk pregnancies. A year ago, the Arkansas Perinatal Quality Collaborative (ARPQC) wrapped-up an initiative to change that high C-section rate.
As Little Rock Public Radio’s (LRPR) sister station KUAF originally reported, the ARPQC co-founder and executive director is Dr. Jennifer Callaghan-Koru, PhD. She explained that Arkansas’ high rate of C-section births follows a growing national trend.
She elaborated, “Cesarean births are life-saving procedures when they are medically necessary. But what we’re seeing in the United States is that in the early 2000’s, the rate of C-sections rose pretty dramatically.” Dr. Callaghan-Koru examined contributing factors in such cases and concluded a large number of them could have been avoided.
Why Arkansas and other states are experiencing a surge in C-section births are complex, according to Dr. Callaghan-Koru. She said a major factor involves the overall health of the mother. “Is she at a healthy weight? Does she have other chronic conditions?”
In a state with the 5th highest rate of obesity and 4th highest rate for heart disease [among just some of the rising pre-existing risk factors of Arkansas residents], Callaghan-Koru said such factors can lead to complications during birth.
So the collaborative established one clear goal during their initiative with participating hospitals: that more than 70% of those hospitals will be at or below the targeted 23.6% low-risk first-birth cesarean rate.
The result? “Unfortunately, we didn't quite get to that goal. As a state, the C-section rate were pretty much where we started. So before the initiative, we were at about 28% [that result in a C-section in Arkansas], and currently at a state level, we're at 28% again.”
Arkansas exceeds that national average of 26.6% for low-risk cesarean delivery. The state’s current overall C-section rate stands at 34.0% of all lives births. That too is higher than the national rate of 32.5%.
As Callaghan-Koru explained to KUAF’s Aiden Dixon with “Ozarks at Large,” last week, she strongly suspects that their efforts at the ARPQC to support Arkansas hospitals by making birthing care improvements kept rates steady in their state, nationally, C-section rates having been trending upwards.
According to the Mayo Clinic, the most common reasons for a C-sections include “a stalled or prolonged labor (“failure to progress”), distress regarding the baby’s heart rate, abnormal baby positions (such as breech), or a prior history or cesarean deliveries.”
Long-term risks for the mother can include severe hemorrhage in cases where the presence of a previous cesarean scar increases the risk of tearing open the uterus during future labors or pregnancies. Another example is a uterine scar that may increase the risk of abnormal placental implantation, along with other potential risks for mothers down the road.
For more information on ARPQC’s C-section research on births in Arkansas go to ARPQC.org.
