Consumer Reports recently published an article with some excellent advice on choosing a birth location. They discuss a study that looks at Cesarean rates in 600 hospitals across the U.S. and discovers that the rate of surgical birth varies from as low as 7% to as high as 70%, depending on the hospital.
There are some who would argue that this is a direct result of the patients hospitals choose to serve, that hospitals with higher c-section rates serve higher risk populations. This would seem like a rational explanation, except that the numbers for only low-risk mothers were even worse. Depending on birth location, some low-risk moms were 15 times more likely to undergo a c-section than moms at different hospitals.
Each hospital has it's own administration and insurance company that sets protocol, which is not always based on what current research shows to have the best outcomes but what the policy makers perceive to best mitigate risk and potential litigation. Within these protocols there is some autonomy for each provider (choose your provider carefully also!), but at some point they have to defer to the policy of the facility they are working in.
When choosing a hospital, do your research. Are you choosing a facility because it's where your current gynecologist has privileges? Because it's 8 miles closer to your home than the next one? Because that's where your sister/friend/mother had her babies? Look for other information instead. What is the c-section rate compared to other area hospitals? Are they supportive of breastfeeding? Do they offer midwifery care? Out of hospital birth is also a valid consideration. The Seattle area has beautiful birth centers and amazing homebirth midwife choices.
The full article from Consumer Reports is available here, and the Delivery Statistics Reports for Washington hospitals is available here.
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