While this infographic is California specific, it goes to show how an individual person, having a low-risk pregnancy with a first baby, is likely to have a very different birthing experience depending on the norms of the hospital/practice they choose. I know people are limited by location, insurance coverage, and other needs, but doing some research into the intervention rates at local hospitals can make a big difference in setting expectations. So can working with a local doula who knows what the norms of various local birth sites are!
I recently finished Jen Kamel’s class The Truth About VBAC and learned, among other things, how hard it can be for an individual provider to calculate their own rates of cesarean section. While an individual may have a low rate of intervention, those rates may double during the weekends when that particular provider is non on-call. Ideally, any consumer of OB/Midwifery care should get to know the rates of intervention between every provider in a practice they choose.
While the World Health Organization states that the ideal rate for necessary cesarian births should be around 10-15% (with more recent studies showing that rates above 10% do not decrease mortality rates for parents or for babies), the US Office of Disease Prevention and Health Promotion (Department of Health and Human Services) sets our goal at 23.9%. Since this goal was set (as 10% lower than the average in 2007), approximately 60% of hospitals in the United States do not yet meet this goal.
Another doula and I were chatting about experiences at a local hospital where a client of mine awaited a planned cesarian for a suspected big baby. This doula mentioned that the birth site we were discussing was on the top of a list of local hospitals who perform medically unnecessary cesarian sections. She shared with me the consumer report on cesarian rates for low-risk babies. The report does not include cesarian statistics from anyone who has a prior cesarian, is carrying more than one baby, or who has a baby in anything but a head-down position. This data also doesn’t include anyone with a chronic health condition, heart problems, high blood pressure or obesity. Truly, this is a thorough compilation of comparative unnecessary cesarian rates, state-by-state.
Some takeaways about Boston-area birth sites:
The lowest cesarian section rates come from:
- Cambridge Health Alliance (which includes Cambridge Birth Center and Cambridge Hospital)
- Mount Auburn (don’t think any Boston-area birth worker is surprised about this)
- Massachusetts General Hospital
The worse-than-average cesarian section rates come from:
- Tufts Medical Center
- St. Elizabeth’s
- Newton-Wellesley Hospital
- Brigham and Women’s Hospital
- Boston Medical Center
The highest cesarian section rates come from:
- South Shore Hospital
- Brockton Hospital
- Melrose Wakefield Hospital (Hallmark Medical System)
Just something else to consider when choosing where to give birth around Boston!