Several women who had undergone what they felt were unnecessary C-sections appeared on camera, one of them stating, “I feel as though I was raped.” The Medical Society argues that this was gratuitous sensationalism. The thrust of the television program was that there are far too many C-sections. The program relied on a study stating half of all routine cesarean procedures might be avoided and another report indicating “a high number” of C-sections were unnecessary and done for the wrong reasons. Two main reasons for unnecessary C-sections were given: hospitals found C-sections more profitable than vaginal deliveries, and doctors and hospitals were fearful of possible malpractice claims if a C-section were not performed. It is within the context of this thesis that the Medical Society contends statistics were unfairly used.

The program stated women are 2-to-4 times more likely to die while attempting a C-section than women who give birth vaginally. The trouble with the statistics is that C-sections are more likely to be used in life-threatening situations, where a mother’s death might be attributable to the underlying medical risk more than to the C-section surgery itself Put in proper perspective, the fact is that childbirth deaths of mothers in Minnesota are very low.

The program also stated that 20 to 40 percent of all women who have C-sections develop post-operative infections. The Medical Society questions these figures, pointing out, for example, that some women who come to the hospital as C-section candidates are already infected. The infection rate also, it appears, needs to be broken down into sub-groups so that the sources of the infection (a fever, bladder, the surgery, etc.?) may be identified. One of the doctors who testified at the hearing indicated the infection rate at his Minneapolis hospital for planned C-section patients was less than 1 percent.

Discussion: This case is a good illustration of the difficulty in using statistics. KARE’s statistics were obtained from reputable sources and are not incorrect. But at the same time, the figures may need qualification and explanation and national and state statistics at times need to be distinguished. Indicative perhaps of the difficulty in determining when a C-section is or is not necessary is the fact, as reported by KARE, that it hired researchers to review 40,000 birth certificates from the Twin Cities area, but that “the results were unclear.”

KARE reported that the number of C-sections nationwide was now at about 25 percent of all deliveries, a considerable increase over the past decade; the station also correctly reported that in Minnesota the C-section rate was only 17 percent. KARE also reported that, for a certain group of doctors at Abbott-Northwestern Hospital, their C-section rate was over double the state average, but again the station duly noted that their rate would be high because this group of doctors takes care of more high-risk babies than any other group of doctors in the state. The program stated that according to one study a high C-section rate was prevalent at for-profit hospitals, suggesting a profit motive for unnecessary C-sections. The Medical Society noted this study was of hospitals in California which, unlike Minnesota, has for-profit hospitals.

The Medical Society does not directly challenge KARE’s thesis that there are too many C-sections. The Society contends, rather, that in view of the many complicating factors, it is difficult to say what a proper C-section rate should be, and it notes the rate in Minnesota is well below the national average. In the final analysis, the Medical Society’s complaint is that despite the program’s concession that C-sections are justified in many instances, the program unduly sensationalized the instances of unnecessary C-sections, particularly as it relates to Minnesota. KARE, on the other hand, points out that the focus of its expose was on the unnecessary procedures and the reasons therefore and the consequences thereof. We think the television program highlighted a legitimate public interest in C-sections, and it was evident the station had devoted a great deal of time and care to the program. In the instances above cited, we feel, however, that the statistics were presented without adequate explanation so that they were susceptible to misleading inferences about C-sections in Minnesota. The Medical Society argues that interviewing the women comparing C-sections to rape was gratuitous sensationalism. We disagree. The woman was expressing her true feelings, albeit in vivid fashion, feelings that evidently are shared by at least some other women as well. While other women might feel differently, presenting this provocative comment on the program was well within the bounds of responsible journalistic practice.

The grievance is denied in part and affirmed in part.

Dissenting: Andy Hilger

- The overall series was well-balanced and provided ample opportunity for competent medical people to affirm or refute the statistics used.