No, US hospitals do not code C-sections as abortions

During the June 27 presidential debate, former President Donald Trump said that Democrats support abortions "after birth" — a statement that is False and would be infanticide, which is illegal.

However, amid the online rebuttals to Trump’s statement, some people shared other misleading claims.

In response to a June 27 Threads post about the rarity of nine-month abortions, one user wrote that, "Technically there is. It’s called a cesarean section, also know(n) as a c-section. Coded in hospitals as an abortion. Remember abortion means termination/ending of a pregnancy and not murdering a child."

The Threads post was flagged as part of Meta’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Meta, which owns Threads, Facebook and Instagram.)

This is not accurate. C-sections are not coded as abortions in hospitals.

The Threads user linked to a Louisiana Department of Health webpage titled "Types & Risks of Abortion Procedures" with "cesarean section" listed. A department spokesperson couldn’t answer PolitiFact’s questions by deadline on whether the inclusion was an oversight, or whether any of its state’s hospitals would code C-sections as abortions. Meanwhile, the page doesn’t mention hospital coding, and stands in contrast to official coding data, and the input of health organizations and health care providers.

The American College of Obstetricians and Gynecologists told PolitiFact that it has "never heard of this practice" and that C-sections have their own respective codes.

Colleen Kincaid, a spokesperson for the American Hospital Association, a health care industry trade group, also called the claim inaccurate. 

"There are specific diagnosis/procedure codes and diagnoses-related groups that distinguish Vaginal Deliveries, Abortions and C-sections in Major Diagnostic Categories," Kincaid wrote in an email.

A cesarean section, commonly referred to as a C-section, is a surgical procedure that involves delivering a fetus through incisions in the mother's abdomen. Physicians may deem C-sections necessary because of the positioning of the fetus or placenta, or because of other health risks to the fetus or pregnant woman.

The U.S. health care system typically uses CPT or ICD-10 codes to categorize different services and proceduresThe American Medical Association maintains CPT codes, which classify medical, surgical and diagnostic services. Codes 59510-59525 are the range for surgical procedures for maternity care and delivery, sometimes labeled as "cesarean delivery procedures." The word "abortion" is not present in this section.

ICD-10 stands for "International Classification of Diseases, 10th Revision." It’s a classification system "designed to promote international comparability in the collection, processing, classification and presentation of mortality statistics," according to the U.S. Centers for Disease Control and Prevention. The Department of Health and Human Services mandated that health care providers use the codes, which are used to track people through medical data systems, including insurance and the Centers for Medicare & Medicaid Services.

The ICD-10 code for C-sections is Z38.69, with Z38 categorized as "liveborn infants according to place of birth and type of delivery" and the subsection .69 referring to an infant born in a hospital by cesarean. The word abortion does not appear in this section.

Some hospitals will use condition codes to signal whether a C-section was performed electively, or out of medical necessity. For example, Emblem Health, one of the U.S.’ largest nonprofit health insurers, uses condition code 81 for C-sections performed at or after 39 weeks of pregnancy for medical necessity, and condition code 82 for C-sections performed before 39 weeks electively.

Dr. Jonas Swartz, a North Carolina OB-GYN, called the claim baseless.

"I find the wording problematic because it suggests that we are talking about fetuses in the same developmental stage. 90% of abortions occur in the first trimester, 2/3 of cases under eight weeks," Swartz wrote in an email. "These cases certainly do not get a hysterotomy (an  (incision on the uterus). For cases in the second trimester, patients get a D&E, a dilation and evacuation, or an induction abortion."

In general, medical experts said that abortions are provided in one of three ways:

• Medication abortion — This accounts for the vast majority of abortions provided in early pregnancy.

• Procedural abortion — The specific procedures are D&C, Dilation and Curettage and D&E, a dilation and evacuation, depending on the gestational age.

• Induction abortion — The patient gets medicine to induce a vaginal delivery of a pre-viable fetus.

"C-sections require an abdominal incision and a hysterotomy to accomplish a delivery. While they are a very safe surgery, they have many more significant risks than a D&E," Swartz said. "So, at a gestational age where someone might have an abortion, say 18 weeks, for example, we would avoid delivery via hysterotomy (like a C-section). Instead, the patient would be offered a D&E or induction abortion."

C-sections are considered a major invasive surgery, and can carry risks for health complications, such as hemorrhaging. The procedure is not necessary for abortion care and are never coded as abortions, said Dr. Leah Roberts, a reproductive endocrinologist and fertility specialist with Boca Fertility in Boca Raton, Florida.

Featured Fact-check

Carol Alvarado

stated on March 2, 2011 in remarks on the House floor

Says women who need a sonogram in the eighth to 10th week of pregnancy have to get a transvaginal sonogram.

"Theoretically, the only time you would have a C-section and are taking out a deceased baby is if it was a stillbirth at term. But that still wouldn’t be an abortion, that would be management of a stillbirth," she said. "And those are typically vaginal deliveries, not C-sections."

Roberts echoed Swartz on the higher risk of cesareans, and said that the procedure for an abortion later in pregnancy, while very rare, would depend on the situation but would likely be an induction of labor.

"OB-GYNs have their patients' best interest at heart," she said, "and we aren't going to do unnecessary or dangerous procedures that put our patients at risk."

A Threads post said C-sections are coded as "abortions" in hospitals.

Reproductive health experts and doctors called the claim inaccurate. C-sections have their own procedural codes to cover the surgical delivery. These codes do not mention, and are unrelated to, abortion. C-sections can be risky and are not typically used to facilitate abortions, health experts said. 

We rate this claim False.

RELATED: Donald Trump is wrong on Democrats’ abortion stance. They don’t support the ‘execution’ of babies.