Where You Give Birth Matters

Cesarean section rates at hospitals vary greatly throughout the United States

(RxWiki News) The two ways women give birth are vaginally or by cesarean section. But C-sections are usually reserved only for women who have birth complications or have high-risk pregnancies.

Yet a recent study has found that the rates of C-sections across the US varied a great deal from one hospital to the next.

The national rate is somewhere around 33 percent. However, this study found that rates range from less than 10 percent all the way up to 70 percent.

The authors concluded that this large variation must be related to different practices that are used at different hospitals.

"Attend all prenatal visits."

The study, led by Katy Backes Kozhimannil, an assistant professor in the School of Public Health at the University of Minnesota in Minneapolis, looked at the rates of C-sections in the US.

The researchers collected data from 2009 on 593 hospitals across the US. They only included hospitals that had at least 100 baby deliveries in 2009. Overall, their data analysis represented 817,318 deliveries.

The results showed that the rates of C-section at these hospitals varied widely. The range of C-section rates went from 7.1 percent at one hospital to 69.9 percent at another hospital.

Most of the hospitals fell in the 20 to 40 percent range for their C-section rates. That means 20 to 40 percent of all women giving birth at most hospitals deliver their baby via C-section.

The researchers then did a second analysis that was limited only to women who had low-risk pregnancies. Women with a low-risk pregnancy should be much less likely to require a C-section.

Low-risk pregnancies were those that did not involve preterm delivery (delivery before 37 weeks of pregnancy), multiples (twins, triplets, etc.) or a baby facing the wrong direction for delivery. They also excluded women who had previously had a C-section for this analysis.

Most hospitals had C-section rates in the range of 7 to 17 percent for women with low-risk pregnancies. However, the researchers still found significant variations across hospitals in C-section rates: from 2.4 percent to 36.5 percent at hospitals across the US.

The researchers concluded that the reason must therefore be related to "vast differences in practice patterns." In other words, different hospitals must be using different practices for similar situations.

The authors went on to discuss several different ways that the variation in C-sections might be reduced so that hospitals have more consistent practices and rates.

In addition to calling for more data, the authors suggested that better coordination of women's maternity care across health providers might help reduce these rates.

The study was published in the March issue of the journal Health Affairs. The research was funded by the University of Minnesota’s Building Interdisciplinary Research Careers in Women’s Health Program and the Minnesota Population Center, both funded by the Eunice Kennedy Shriver National Institute for Child Health and Human Development.

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Review Date: 
March 5, 2013