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Partnership Advising Women on C-Section Options

Pregnant woman

(Greyerbaby, Pixabay)

27 June 2016. An academic-business initiative is providing pregnant women with more information on birth options, particularly Cesarean section surgery. The project brings together Ariadne Labs and the company Square Roots, along with fertility/pregnancy app developer Ovuline, Harvard Medical School Department of Health Care Policy, and Blue Cross Blue Shield of Massachusetts.

Cesarean section, or C-section, is surgery to deliver a baby, where the baby is brought out through the mother’s abdomen.  C-sections are often advised when the mother faces health problems, the baby is in distress, or the baby cannot fit through the vagina or is not positioned properly for vaginal birth. National Library of Medicine says in the U.S., about 1 in 4 women have their babies with a C-section, but Ariadne Labs says that percentage is now higher, about 1 in 3, and growing at an unsustainable rate.

Ariadne Labs itself is a joint venture in Boston of Brigham & Women’s Hospital and Harvard University’s School of Public Health that studies health care system performance at critical points in people’s lives, including childbirth. Leading Ariadne’s research on childbirth overtreatment is Neel Shah, a specialist in obstetrics and gynecology at Beth Israel Deaconess medical center in Boston and a faculty member at Harvard Medical School.

“C-section rates have surged 500 percent in just one generation,” says Shah in an Ariadne Labs statement. “A hospital’s C-section rate is an important indicator of a woman’s risk of having an unnecessary C-section at that hospital.”

In their initiative, Ariadne Labs and Square Roots are studying ways to engage expectant mothers in making informed decisions on choosing a hospital for their delivery, particularly facilities where C-sections are more routine. “Choosing the wrong hospital can increase the risk of a C-section significantly,” adds Shah. “This information is important, and we want to learn the best ways to make this information accessible and understandable to expecting women.”

Square Roots, in New York, is a company providing information and technology resources to improve the likelihood of healthy birth. Earlier in June, the company unveiled its Birth40 project, a 4-year plan to bring better information on healthy birth choices — including ratings of hospitals — to expectant mothers in 40 U.S. cities. In their new initiative, Square Roots plans to provide access to messages about healthy birth options prepared by Ariadne Labs, through the company’s city networks and technology platforms.

Both Square Roots and Ariadne Labs believe the state of birth health in the U.S. is growing worse. In a white paper published earlier in June, Square Roots says the U.S. spends more per birth than any country in the world, but the country’s maternal mortality rate is rising. Expecting mothers in the U.S., says the paper, are 75 percent more likely to die from complications today than at the end of the last century. Unnecessary C-sections, note Ariadne Labs and Square Roots, are responsible for 20,000 complications in low-risk women and an additional $5 billion in health care costs per year.

“As a clinician, I’m concerned by the overall trends across the board,” says Shah. “We need new approaches to ensure that women get the care they need, but are also not getting harmed by unnecessary surgery. Involving women in the process is an essential part of the solution.”

Shah tells more about the work of Ariadne Labs in reducing unnecessary C-sections in the following video.

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