By Richard Knox
The risk of a major complication of childbirth can be up to five times higher at one hospital versus another, a new study finds. But there’s no way expectant mothers can tell the high-risk hospitals from the low — at least, not yet.
A study in this month’s Health Affairs is the first ever to examine hospitals’ childbirth complication rates on a national basis. Authors looked at a representative sample of more than 750,000 deliveries that took place in 2010 at hospitals large and small, urban and rural, including both teaching and community institutions.
Major complications include hemorrhaging, infections, vaginal lacerations and blood clots. Unlike major complications from, say, cardiac surgery, these obstetrical glitches are not generally life-threatening.
On the other hand, as Dr. Laurent Glance, the study’s lead author, tells CommonHealth: “The vast majority of women of childbearing age are fairly healthy people. They can reasonably expect to have a baby without any complications.”
The study found that for women delivering vaginally, the risk of a major complication can be more than double at a “low-performing” hospital (23 percent) than a “high-performing” institution (10 percent).
When it comes to cesarean deliveries, the disparities are even greater — 21 percent at a low-performing hospital versus a little over 4 percent at a high-performing obstetrical unit.
The study doesn’t provide Massachusetts-specific complication rates, but the researchers found no significant differences between Northeast hospitals and other regions. “It’s reasonable to assume there is a similar amount of variation [among Massachusetts hospitals], but we can’t say for sure,” Glance says.
If you think of the results in a big-picture way, it means that among the roughly 4 million American births a year, hundreds of thousands of women could avoid childbirth complications if somehow low-performing hospitals could raise their outcomes to those of their betters. Extrapolating from the new study, about 520,000 new mothers suffer a major complication.
The wide disparities in childbirth complications care are especially striking when you consider how big a slice obstetrics represents of the total health care pie. Continue reading