Advice to pregnant women: Choose your hospital carefully

Consumer Reports News: March 04, 2013 04:09 PM

Where you deliver your baby is a big factor in determining whether you'll have a Cesarean section. Researchers who looked at nearly 600 hospitals nationwide found that C-section rates varied widely, from a low of 7 percent of all deliveries to 70 percent.

Women with low-risk pregnancies are much less likely to need a C-section, so you would expect smaller variations in that group. But the researchers, from the University of Minnesota and the University of British Columbia, found those numbers were even worse. Some low-risk women were 15 times more likely to undergo a C-section than others, depending on where they gave birth. And it's not just that a few hospitals were outliers. Researchers found striking variation in all sizes and types of hospitals and in all regions.

For advice on how to avoid unnecessary C-sections and other childbirth interventions, as well as tips on how to have the healthiest possible pregnancy, see our report What To Reject When You're Expecting.

The numbers matter because C-sections that are not medically necessary increase risks for both moms and babies and drive up health care costs. It's a situation in which no one wins, except perhaps hospitals and providers, who often make far more money from a surgical procedure than a routine vaginal delivery. The study points out that the average cost for a C-section in 2010 was $12,739 compared with $9,048 for a vaginal delivery.

Unfortunately, the study did not identify the hospitals with high and low C-section rates. But many states now publish C-section rates and other maternal-health data by hospital on the web. The study authors also list other websites that report on hospital performance, including, Choices in Childbirth, and the International Cesarean Awareness Network.

Cesarean delivery rates vary tenfold among US hospitals; reducing variation may address quality and cost issues [Health Affairs]

Teresa Carr

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