Finding and Comparing C-Section Rates by Hospital
By Rachel Walden — November 26, 2007
I learned via ICAN that the New Jersey Star-Ledger has made quite a bit of public data easily available on its website, and these databases include c-section and VBAC rates by hospital.
Although the website does not provide any information on why rates might be what they are for a given hospital (such as the type of facility or relevant hospital policies), it might be useful for women who study birth or are trying to choose a hospital for their own childbearing experience.
For example, we find a wide range of c-section rates – the lowest rate for 2006 was 18% (in a hospital with a 33% VBAC rate), and the highest was 62% (in a hospital with zero VBACs). Even the hospital with the lowest rate of c-section is performing more than the 15% the World Health Organization recommends and the Healthy People 2010 initiative has set as a goal. Historical data is also available going back to 1997, allowing us to see, for example, that Riverview Medical Center, which had a 50% c-section and 4% VBAC rate in 2006, had only a 21% c-section rate and 43% VBAC rate just ten years ago.
C-section rates in general can be difficult to find, with national resources focusing on state-by-state data, many state resources focusing on county data, and facility-level data spread around among numerous websites. Often, the data is too old to be useful in making decisions. However, I was able to find relatively recent by-facility rates for the following states:
- Alabama – Scroll down to “Births by Method of Delivery and Hospital of Occurrence with Cesarean Section and Vaginal Birth after Cesarean Rates” to download PDF tables of c-section and VBAC rates by facility, currently available for 2003, 2004, and 2005.
- Alaska – Rates of VBAC, primary, and repeat c-section by facility for 2005, with data going back to 1990.
- California – On the location tab, you can click “Go” to return the whole state without entering a search. Clicking on the “Maternity” option will return a list of facilities with c-section rate. Clicking on a facility name will indicate whether VBAC is routinely available, although this is a simple “yes” or “no” without additional details. Data is currently from 2004.
- Florida – Download the “Cesarean Deliveries in Florida Hospitals” PDF, produced in 2006 using 2004 data. Detailed data by facility starts on page 32 and includes c-section, primary (first-time) and repeat c-section, and VBAC rates.
- Maine – This is rather unwieldy, but you can choose a hospital and year, and scroll down in the resulting table to see the number of c-sections and vaginal deliveries. If you divide the number of c-sections by the total of the c-sections and vaginal deliveries together, you’ll get an idea of the facility’s c-section rate.
- Massachusetts – The most current 2005 report (PDF) lists c-section rates by facility beginning on page 39.
- New York – View “hospital labor intervention statistics” one hospital and year at a time, with 2000-2005 figures.
- Oregon – 2004 c-section rates by facility, grouped into geographic regions. Although provided via the Oregon Health Policy and Research governmental website, there appear to be some errors, such as the statement that “There is no recommended or benchmark rate for cesarean sections,” and the underlined assertion that “On average, 2.4% of births in Oregon hospitals were delivered by cesarean section in 2004,” despite a rate of 24.3% listed in the table just below the statement.
- Texas – Scroll down to the “utilization Indicators” section to download primary c-section and VBAC rate (by hospital) tables, which currently use 2005 data.
- Utah – Primary c-section and VBAC rates, currently with 2005 data.
While some of these may be one-time reports, the agencies and organizations providing the data may be good sources for updated rate information in future years. Do you know of additional data by hospital that I’ve missed? Please leave a comment, and we’ll update the post.
I love the idea of this, but I know for California at least, the numbers are under-reporting the c-section rate. Hospitals create their own criteria for what needs to be reported. It’s not the total number of surgeries performed (or percentage of the total births in the hospital). I think it’s very misleading. — Granted, I may be a little biased; I’m a homebirth midwife in San Francisco.
One of the issues is that women can’t find this information and have no way to compare it, as you stated. ICAN is working hard on this issue as are many other organizations. NY and MA have laws in place that give women the right to transparency in their maternity care, the Grassroots Action Committee (part of CIMS) is working hard on a transparency project that is currently being piloted in NYC and will go nationwide hopefully next summer, call the Birth Survey (http://thebirthsurvey.com/). This survey will hopefully be able to break it down not only by facility but offer a women a way to search at the practitioner level.
SB, I think you’re probably right that the numbers aren’t 100% accurate, but one hopes they’re better than having no information at all. Are you aware of a more accurate source for your state?
Robin, thanks for the info – keep us posted, will you?
I almost choked on my latte when I looked at the “C-Section rates” here in California! I know that one of our most prominent hospitals has had one of the highest C-Section rates in the country at 51%! Most of our Southern California Hospitals were listed at 25% or lower…not even close!
The rates were so much lower when VBAC’s were encouraged. I had a conversation with one of our perinatologists who is Pro-VBAC. He said the pendulum will swing back when women start suing for unnecessary C-Sections. Let’s hope it doesn’t come to that.
Cyndi, thanks for your comment. It seems that getting up-to-date, accurate data is a real challenge. I think you allude to an important point – unnecessary/wrong site surgeries elicit very strong reactions – why don’t unnecessary c-sections? I think some women go in with an attitude of “I’ll only have a c if it’s really necessary, an emergency.” But are 30-50% of births really emergencies? Somehow I can’t quite believe that.
Great post. We’re (ICAN in MT) going to work on making these rates more transparent in MT as well. I believe there are some orgs/agencies we can work with who already collect this information, and luckily our Director of Women’s and Children’s Services (a nurse) at the local hospital is fairly responsive to queries.
ps – Robin, please DO keep us informed regarding the other initiatives you’ve mentioned
The link for California has some very misleading data, because they’re only listing first-time c-sections. Here’s a much more accurate listing, with stats for 2006, by county, every hospital in California. http://www.oshpd.ca.gov/HID/Products/PatDischargeData/ResearchReports/HospIPQualInd/Vol-Util_IndicatorsRpt/2006Util.pdf
Georgia’s information can also be found at http://www.gahospitalpricecheck.org/. You compare cesarean rates by hospital there and as far as I know, the rates do include repeat cesareans as well as primary cesareans.
The University of Louisville Hospital in KY has a 25% c-section rate.
I am certifying to become a Tn doula, and need sources for stats of Csection rates for my state. YOU GO, Strong women. Keep that info flowing!!
Stats for c-section by hospital in Pennsylvania are available on the Department of Health website. Stats for other things (forceps, vacuum, birth weight…) are posted by county, which is not very helpful when there are multiple hospitals in one county. Ggggrrr..
Utah’s rates have been updated to include 2007 figures at:
I am a birth/ppm doula in San Antonio Tx, would love to see more acurate C-Section rates in my city.
Does anyone know where to find C-section rates for hospitals in Michigan? Thanks!
How do I find C-section rates by hospital in Idaho? Does anybody know why just some states have available stats?
he University of Louisville Hospital in KY has a 25% c-section rate.
Although I realize this article is a bit old, the data is still interesting to look at. Looks like the report for Texas is no longer up, but I found this updated data from 2011:
Can someone fix the link for california. there is no such thing as GO tab. there is no maternity tab either. it takes me to calqualitycare.org
i am looking for a friendly VBA3C hospital near Victorville,california. 2 c-sections, 1 homebirth and 1csection