About Joanne Kenen
Contributing editor to Politico Magazine and former health care editor-at-large, Politico, Commonwealth Fund journalist in residence and assistant lecturer at Johns Hopkins Bloomberg School of Public Health.

Courtesy of Neel Shah, M.D.Health reformers are grappling with how to bring down the high rate of cesarean section deliveries in the United States. The U.S. isn’t the only country in the world overusing the procedure, but it does have one of the highest rates.
I recently heard Neel Shah, M.D., an obstetrician at Beth Israel Deaconess Medical Center, the founder of Costs of Care, and associate faculty at Ariadne Labs (more about all of that here) speak about health care quality and delivering babies.
We’ve all heard about unnecessary cesarean sections (and elective induced early births, although that’s a related but not identical set of challenges). Many of us tend to think of it as a doctor-centered issue. Some doctors perform more C-sections than others and there are a host of reasons, ranging from how and where they were trained to how they assess and tolerate maternal risk to time management and financial considerations.
But Shah challenged me to think of unnecessary C-sections as a hospital management or system engineering problem – not just a problem created by individual doctors. Continue reading →
Contributing editor to Politico Magazine and former health care editor-at-large, Politico, Commonwealth Fund journalist in residence and assistant lecturer at Johns Hopkins Bloomberg School of Public Health.