A Survey of Cesarean Sections in Philadelphia: Comparison Between Years 1931 and 1941

Abstract

Summary A ten year period comparative statistical survey of cesarean sections performed in 45 hospitals throughout the city of Philadelphia is herewith presented. During this period numerous authorities have made a plea for reduction in the incidence of cesarean section, but their efforts have been of no avail as far as the city of Philadelphia is concerned. The decrease in maternal mortality in spite of the increased number of cesarean sections performed, proves that better judgment has been used in the selection of cases for hospitalization, the time element, the type of operation performed, and the anesthesia used. Errors in judgment where these factors were concerned were probably the most frequent causes of fatalities. The decrease in maternal and fetal mortality would indicate that cesarean section is now performed when it is truly the procedure of choice and is not used as frequently as a last resort when trial labors and attempted vaginal deliveries have failed. It has been the consensus of opinion that a statistical survey is of little value, but a comparative statistical survey would seem to be of greater aid in determining whether progress has been made during a definite period of time. In conclusion, it is recommended that a committee be appointed to make suggestions as to standardization of the various indications for the operation of cesarean section so that in future surveys these indications would be more accurate and less confusing. Appreciation is expressed to Dr. Ruth Hartley Weaver, Assistant Director of Health of the City of Philadelphia, and Miss Dorothy Malkiel, Secretary of the Maternal Welfare Committee of the County Medical Society, for their assistance in the compilation of these statistics.