Within just a couple of years, one-fifth more mothers have chosen to have their babies delivered by C-Section. The healthcare monitoring group “HealthGrades” surveyed “patient-choice” caesarean births — those done because of the client’s preference, not for any medically-urgent reason. Dr. Samantha Collier says throughout most of the 1990s, the number of C-section births slowly had been going down, under pressure from insurance companies, federal agencies and advocates who pointed out the complication rate is higher for the surgical procedure. She says just stating a number to limit C-sections might put women at risk who really need one, and they may be rising because women not only feel more empowered to ask questions, but there’s less pressure simply to hold down the c-section rate. Dr. Collier says HealthGrades does not take a position on issues it surveys, but simply gathers data and analyzes trends. Collier she says advocates for C-section birth compare it to cosmetic surgery, a personal choice. She says the woman of childbearing age is becoming more sophisticated about managing her own health, overall a good thing. She says there are quite a few women interested in avoiding labor, and want to know exactly when their baby’s going to arrive, but clearly obstetricians are deeply split on the issue. Dr. Collier says risks to the mother like infection and death have declined, though it’s still more dangerous than “natural” childbirth. And she says a more informed consumer is making the choice. She says those who exercise patient choice are more concerned with future risks from vaginal delivery like bowel and bladder damage and loss of sexual function, than the risks from C-section surgery. HealthGrades offers clients searchable databases to find a doctor, clinic, hospice or hospital, and also does studies of the inspections at healthcare facilities to report how they stack up. Iowa’s one of 18 states that collect hospital data and make it available for research. Surf to their site at www.healthgrades.com