More Evidence Points To Big Differences In C-Section Rates At Mass. Hospitals

There’s no question that some women need a Cesarean section for the safe delivery of their child. (I’m one of them.) But there’s widespread agreement that too many women in the U.S. have C-sections, increasing the risks for the mother and baby — as well as the costs of their care.

The employer-backed group Leapfrog is out with a national comparison of C-section rates. It says a C-section rate of 23.9 percent is a reasonable standard. Massachusetts ranks 19th among all states, with an average C-section rate of 26.2 percent.

Source: Leapfrog (Click to enlarge)

Source: Leapfrog (Click to enlarge)

“The first thing you should look at in selecting a hospital or doctor is the C-section rate, and your chances of needing a C-section when you deliver,” said Leapfrog President and CEO Leah Binder. “It’s very important to investigate that right away.”

Here are the three hospitals in Massachusetts with the lowest C-section rates, as reported to Leapfrog:

  • Harrington Memorial Hospital in Southbridge — 14.3 percent
  • Fairview Hospital in Great Barrington — 15.2 percent
  • Cambridge Health Alliance in Cambridge — 18.5 percent

And the three Massachusetts hospitals with the highest C-section rates:

  • Holy Family Hospital in Methuen — 42.7 percent
  • Steward Good Samaritan Medical Center in Brockton —  36.4 percent
  • Tufts Medical Center in Boston — 36.3 percent

You can see how all Massachusetts hospitals that report to Leapfrog compare here, as well as which hospitals decline to report their C-section rates — something that raises a red flag for Binder.

“The hospitals to worry about most are those that decline to report this data,” Binder said. “There are hospitals in Massachusetts that decline to report and you have to wonder why they did that.”

So why the big differences?

Some teaching hospitals will tell you that their rates are higher because they handle more high-risk births. But you can see in the abbreviated list above that the lowest and highest rates occur at both community and teaching hospitals.

The Leapfrog data only includes C-sections that occurred even though the baby was in position for a normal vaginal birth (NTSV), which eliminates many of the high risk births, Binder said.

Note: Readers of CommonHealth might recall that we post and update childbirth quality data, including C-section rates. For our tool, we use C-section rates reported to the state’s Department of Public Health. Some OBs would argue Leapfrog’s NTSV C-section data is more accurate than the broader first time C-section rates reported to DPH. But not all hospitals send information to Leapfrog, and we want information on all Massachusetts hospitals so we use the DPH data on C-sections.

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