Where are the Sunday babies? Jacobs scientist proves economizing strategies of German and Swiss hospitals

Two new studies by Alexander Lerchl, Professor of Biology at Jacobs University, show, that the number of babies delivered through elective, planned caesarean sections during the week rises while fewer come into the world on weekends. It appears that hospitals deliberately schedule births during the week when they are fully resourced and staff is working ‘normal’ hours at no extra cost. These findings are now published online in the journal Naturwissenschaften. (DOI 10.1007/s00114-007-0305-4 and DOI 10.1007/s00114-007-0306-3).

[ Sep 25, 2007]  In the first study, Alexander Lerchl shows a direct link between the increase in the number of elective caesarean sections and the decrease in weekend births in Switzerland. By analyzing birth data from almost 3 million babies born between 1969 and 2005, Lerchl and his colleague Sarah Reinhard show that up to 18 % less births than expected occur at weekends. Over the study period, nearly 10,000 babies less than expected were born on weekends as a consequence of the increasing numbers of caesarean sections and elective labor induction, which reached 29% and 20% respectively in Switzerland in 2004.

The second study paints a similar picture for Germany across all 16 states. Weekend births were consistently less frequent, with an average of 15% less births at weekends than expected.

These studies suggest that environmental influence has been superseded by social rhythms. Natural times of labor and deliveries are often not in line with the working hours of hospitals, where the majority of deliveries take place nowadays. Indeed, natural, non-induced labor onset in women is well known to peak during night hours. However, it is more convenient and practical to schedule births at times when the hospitals are fully functional i.e. weekday daytime working hours. Weekend work is also more expensive. In Germany for instance, public service workers are paid on average 25% more for Sunday work. And in Switzerland, caesarean sections are almost twice as expensive as vaginal births.