Do insurance premiums influence cesarean delivery rates?

It's possible that such a cause and effect relationship exists among Illinois ob/gyns. In a study published in Obstetrics and Gynecology (12/2007), researchers from Northwestern University looked at how medical malpractice premiums in Illinois (as set by the ISMIE Mutual Insurance Co.) between 1997 and 2002 were associated with the primary cesarean delivery (CD) rates from 1998 to 2003. The results: Premiums rose from $60,766 in 1997 to $83,167 in 2002, while the mean CD rate increased from 126 per 1,000 women eligible in 1998 for the study to 163 per 1,000 women in 2003. Additionally, a multivariable analysis showed that for every year that premiums increased $10,000, CD rates increased 15.7 per 1,000 for nulliparous women and 4.8 per 1,000 for multiparous women.