Assemblywoman Amy Paulin (D-Scarsdale) submitted a letter last month to the Medicaid Redesign Team urging them to consider reducing the number of cesarean sections as a method for shrinking Medicaid costs. As a result, a proposal to limit the reimbursement for c-section births to the average reimbursement for vaginal births was included in the final 79 proposals sent to the Governor.

The rate of c-sections has risen steadily over the past decade. Thirty four percent of women who gave birth in New York in 2007 did so via c-section rather than vaginal birth. Both the World Health Organization and the U.S. Department of Health and Human Services recommend a cesarean rate of no more than 15% of all births.

After a c-section, mothers are more likely to experience emergency hysterectomies, longer hospital stays, infections related to surgery, return hospital visits, prolonged pain following labor, and bowel obstruction. Babies delivered via c-section are more likely to suffer from respiratory problems and asthma. Because of these complications, SFY 2010 Medicaid payments for cesarean sections were 25% higher than those for vaginal births. Using data from Westchester County, the Assemblywoman projects that the state could save more than $31.5 million if the c-section rate were reduced to the recommended rate of 15%.