There’s no denying that rates of C-sections have skyrocketed over the past few decades, owing to a combination of convenience for moms, who may want more control over when she delivers, to malpractice concerns, which may drive doctors toward the surgery rather than risk potential complications with more lengthy and unpredictable vaginal deliveries. Since 1970, C-sections rates have climbed from 5% to 33% in 2012, according to the Centers for Disease Control.
But it’s hard for expectant women to determine whether their hospital of choice is more or less likely to perform a C-section. Although state health departments collect this data, it’s not that easy to navigate. And increasingly, there’s evidence that many of Cesareans performed are not the last resort procedures to save mom or baby, as they were intended to be, but done on low-risk births. And there’s some data suggesting that C-sections may be linked to later health issues for the baby, including a higher risk of obesity and type 1 diabetes.
Consumer Reports pooled the data from public billing records from more than 1500 hospitals in 22 states and compiled the largest ranking of C-section data in the U.S. to date.
“The thing that was shocking was the variation in rates,” says Doris Peter, director of Consumer Reports Health Ratings Center. “We saw a low of 5% to a high of 57%, so the variation was enormous.”
The message from the data, she says, is that there weren’t any real patterns or characteristics that distinguished the hospitals with the higher C-section rates from those with the lowest. Even in the same city, hospitals four miles apart with similar patient populations could have widely different rates. That’s even after Peter and the Consumer Reports analysts accounted for factors such as the percentage of patients on Medicaid, the number of births, the number of neonatal intensive care units beds, and other potential confounders.
While the data could not determine if some hospitals had more patients with higher risk factors for C-section, such as heart problems or other chronic diseases, the fact that neighboring hospitals, presumably with similar patient populations, had different rates, showed that C-sections rates are likely dependent on the culture of the specific hospital.
To see how the hospital nearest you ranked, go to consumerreports.org.