The Baby Business: Is Money Motivating Doctors To Do More C-Sections?


When you find out you’re pregnant, the first big decision you have to make involves finding the right doctor or healthcare provider.

You want to find someone you feel comfortable with, someone you trust to look out for you and your baby’s best interests.

Which is why the conclusions of a new study published by the National Bureau of Economic Research are especially scary.

Health care economists Erin Johnson and M. Marit Rehavi found that obstetricians perform more cesarean sections when there are financial incentives to do so, which means the nation’s soaring C-section rate could be partly related to the fact that doctors get paid more to perform the procedure.

According to NPR, in 1996, one in five babies in the United States were born via C-section. Today, it’s one in three. While many are medically necessary and warranted, critics have raised concerns that some mothers are getting them when it’s not needed.

Johnson and Rehavi tracked half a million births in California and Texas, and found that doctors were 10 percent likely to get C-sections when they themselves gave birth. This means that obstetricians appear to be treating their physician patients differently than their non-physician patients.

Why does this matter?

NPR’s social science correspondent Shankar Vedantam made an analogy to what he called the Car Mechanic Rule:

“Let’s say you took your car in and the mechanic told you that you needed a transmission fluid flush. The only way that you can be sure that you’re not getting ripped off by your mechanic is if you knew something about your car. You apply the same rule to medicine. Who are the patients who actually know whether a C-section is actually needed? It’s other doctors.”

The study found that there was no disparity in scheduled C-sections, but the bias came into play when physicians had to make a judgment call – when natural labor is attempted but isn’t going well.

So how should people deal with this information?

Researchers believe the real takeaway is the importance of better patient knowledge and empowerment.

“If you’re going to a physician you should actually be asking a lot of questions and try and understand as much as you possibly can about what’s going to happen to you when you give birth,” said Vedentam.



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