Twice as many private-pay patients schedule cesarean sections as compared to publicly funded patients, according to a new study published in the British medical journal, BMJ Open. The authors of the study said that private patients were not at greater health risk than the public patients, so they wanted to find out why private patients had cesarean sections more often.

Normally, doctors suggest a planned cesarean section to reduce the risk of damage to the woman’s pelvic floor. In this study, however, very few requests for C-sections cited this as a reason for the procedure.

The researchers reviewed the records of about 30,000 women who delivered babies at a large, urban hospital in Ireland, where hospitals offer both public and private healthcare. Historically, 80 percent of patients are public pay and 20 percent private. Of the study participants, 24,574 were public-pay and 5,479 were private-pay.

The scientists were interested in how social, medical and obstetric factors influenced the decision between C-section and vaginal birth; they were especially interested in learning whether the source of funds affected the choice.

The Results
The scientists found that privately funded participants had planned cesarean sections or surgical vaginal deliveries twice as often as women who used public funds. Surgical vaginal delivery procedures include the use of forceps or vacuum. The disparity between the two groups of women was true even after the researchers adjusted the figures for age, medical health, obstetric conditions, and social differences. They found the increased rates for C-section were unrelated to social, medical and obstetric factors.

The researchers learned that participants who held private insurance tended to be older, wealthier, and better educated. They were also less likely to be single, childless, or experiencing an unwanted pregnancy. Private-pay women also book obstetric care promptly.

The private-pay women were healthier than were their public-option counterparts, but the private group were more likely to have had fertility treatments, miscarriages, stillbirths or infant deaths.

The study results raise significant questions about the equity of care between public and private patients.

Source: Murphy, D.J. "C-Section Rate for Private Patients Is Double That of Publicly Funded Patients." BMJ Group Blogs. 25 Nov. 2013. Web. 20 Dec. 2013.