Vital info if you are a pregnant woman or someone you love is pregnant. It is not easy to look at some of these statistics for NJ. Remember that choice of provider and place of birth impact birth outcomes.
Consumer Reports finds that the rate of cesarean sections vary from hospital to hospital and state to state
Consumer Reports / By Tara Haelle / Last updated: April 13, 2016
The most common surgery performed in U.S. hospitals isn’t on the heart or back or hips or knees. It’s a C-section. Roughly one of every three babies born in this country, or about 1.3 million children each year, are now delivered by cesarean section.
While a number of factors can increase the chance of having a C-section—being older or heavier or having diabetes, for example—the biggest risk “may simply be which hospital a mother walks into to deliver her baby,” says Neel Shah, M.D., an assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School, who has studied C-section rates in this country and around the world.
A new Consumer Reports investigation of more than 1,200 hospitals across the country supports that. It found that C-section rates for low-risk deliveries among U.S. hospitals vary dramatically, even in the same communities and among similar institutions, and that in most hospitals the rates are above national targets.
In many cases, cesarean sections are absolutely necessary. But often they are not: Researchers estimate that almost half of the C-sections performed in the U.S. are done in situations when babies could be safely delivered vaginally instead. And performing a surgical birth when it isn’t necessary poses avoidable risks to the mother and her child and needlessly raises costs, research shows.
Alarmed by that trend, the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM)—the nation’s two leading medical organizations that focus on childbirth—issued recommendations in 2014 aimed at safely reining in unnecessary cesareans.
“No one is saying that C-sections are never necessary, and no woman should feel guilty or somehow bad if they end up needing one,” says Elliott Main, M.D., the medical director of the California Maternal Quality Care Collaborative, a nonprofit organization that works to improve outcomes for mothers and babies in that state. “But mothers shouldn’t be coerced, directly or indirectly, into having a cesarean either, and making C-section rates public can give women the information they need when choosing where to deliver their babies,” he says.
Too Many C-Sections
Consumer Reports’ analysis focuses on first-time mothers-to-be who should be at low risk of needing a cesarean: pregnant women expecting just one child (not twins, triplets, or other multiples) whose babies are delivering at full-term in the proper position, which means coming out head first.
The target C-section rate for those births, set by the Department of Health and Human Services, is 23.9 percent or less. That’s 10 percent less than the rate for such births in 2007, which the government uses as a baseline from which to improve.
But many experts say that the ideal C-section rate for those births is even lower. “Getting under 24 percent for low-risk births is something all hospitals should be able to do, but for those deliveries, hospitals should be aiming even lower,” Main says.
Yet nearly six in 10 of the hospitals we looked at had C-section rates above the national target for low-risk births. That means that 40 percent of hospitals already achieved this goal. “This sends a message that almost all hospitals should be able to achieve this rate,” Main says.
The risk of having a C-section also varied depending on where in the country women lived. In general, rates were higher in the Northeast and South, and lower in the West and Midwest.
Go to www.consumerreports.org for more of the story. Read about high and low rates in your state and what hospitals have to say.
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