The Tuba City Regional Health Care Corporation’s hospital, run by the Navajo Nation and financed partly by the Indian Health Service, prides itself on having a higher than average rate of vaginal births among women with a prior Caesarean, and a lower Caesarean rate over all.
The national Caesarean rate, 31.8 percent, has been rising steadily for the last 11 years and is fed by repeat patients. In Tuba City, the overall Caesarean rate is only 13.5 percent.
Changes in malpractice insurance might help the rest of the nation reach this goal. The hospital and doctors in Tuba City are insured by the federal government, and therefore insurance companies cannot threaten to increase their premiums or withdraw coverage if they allow vaginal births after Caesarean.
Critics say that doctors are performing too many Caesareans, needlessly exposing women and infants to surgical risks and running up several billion dollars a year in excess bills.