Cesarean rates vary by hospital, and here I thought it was by risk.

By Bobjgalindo (Own work) GFDL
Don’t want an unnecessary c-section, but still plan to birth in a hospital? Then, you owe it to yourself to find out the cesarean section rate  at the hospital where you anticipate delivering your child. According to an article published in the medical journal Health Affairs this month, “vast differences in practice patterns are likely to be driving the costly overuse of cesarean delivery in many US hospitals.”

Among the Everything Birth community, the findings should not come as a shock. The actual numbers and significant variance of unwarranted cesarean sections though, still surprised me.

According to the study, cesarean delivery rates varied tenfold throughout the United States. Hospital c-section rates were as low as 7.1 percent in some hospitals while as high as 69.9 percent in others.

The study’s lead author Katy B. Kozhimannil, Ph.D., could give no justifiable reason for this variance either:

“We were surprised to find greater variation in hospital cesarean rates among lower-risk women. The variations we uncovered were striking in their magnitude, and were not explained by hospital size, geographic location, or teaching status. The scale of this variation signals potential quality issues that should be quite alarming to women, clinicians, hospitals and policymakers.”

Yes, even low-risk mothers were at extreme risk for unnecessary surgery depending on where they delivered. One sample studied involved low-risk pregnancies that were not preterm, breech, multiples, or VBAC. We would all rightfully expect very little variance among this group. In fact, this group had an even higher variance simply depending on which hospital they chose. Some hospitals were able to manage a c-section rate of only 2.4 percent among low-risk pregnancies, while others in this category had an inexcusable c-section rate of 36.5 percent.

High-risk pregnant women would be wise to check their hospital’s track record. If it’s unacceptable, looking at other hospitals would be a good idea if possible. Low-risk pregnant women might just want to forgo the hospital all together and opt for a midwife assisted birth.  Available statistics show that in low-risk pregnancies, a home birth assisted by a certified midwife is the safest plan anyway. Read this previous post if you have your doubts.




  1. Ariel

    I love the message of this post. For those who want a hospital birth, it truly does matter which hospital you pick. I didn’t care about my hospital’s dumb policies or statistics, I was just worried about worst case scenario, so I wanted a hospital birth at the nearest hospital. I figured it would be fine since I was educated and willing to stand up for myself. It most definitely wasn’t fine as several things were done to my baby after delivery without my consent (in a non-emergency situation).

    Some hospitals have an appalling lack of respect for patients and regard for their health (as hard as that is to understand/fathom), and thankfully statistics like you referenced can help moms avoid those hospitals. Thanks for your great posts!

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