Cesarean Rates for Washington State Hospitals - 2009

 

Charts below: 

Rankings: Seattle area hospitals, ranked from lowest to highest cesarean rate, 2009

Trends over time: Seattle area hospitals, 2003 – 2008

Alphabetical: All Washington state hospitals, 2008

 

Rankings: Seattle area hospitals, ranked from lowest to highest cesarean rate, 2009

total births

c-s rate

rank

Group Health Central Hospital

1712

24%

1

Northwest Hospital

1047

29%

2

Stevens Healthcare

1134

30%

3

Providence Everett Medical Center

3674

30%

4

Tacoma General Hospital

3804

31%

5

Valley General (Monroe)

372

31%

6

Swedish Medical Center (both)

7316

33%

7

Valley Medical Center (Renton)

3864

35%

8

Auburn Regional Medical Center

958

36%

9

University Of Washington Med Ctr

2201

37%

10

Overlake Hospital Medical Center

4109

38%

11

Evergreen Hospital Medical Center

4080

38%

12

Data source: Washington State Department of Health, Comprehensive Hospital Abstract Reporting System

http://www.doh.wa.gov/EHSPHL/hospdata/CHARS/2009/2009FYHospitalCensusandChargesbyDRG.xls

Methodology: For total births, tallied DRG categories: 370 – cesarean with complications, 371 – cesarean rate without, 372 – vaginal delivery with complicating conditions, 373 – vaginal delivery without cc, 374 – vaginal delivery with sterilization, 375 – vaginal delivery with OR procedures. The CS total was category 370 + 371. Rate was calculated as CS Total / Total Births.  Rank is a comparison between the hospitals on this list, with 1 being lowest cesarean rate, and 12 being highest. Calculations done by Kim James

 

Trends over time: Seattle area hospitals, 2003 – 2008, alphabetical

 

 

2003

2004

2005

2006

2008

2009

Auburn

982 / 29.94%

1000 / 32%

996 / 34.4%

943 / 31%

1090 / 36%

958 / 36%

Evergreen

3983 / 29.68%

4303 / 33.7%

4336 / 34.9%

4574 / 35%

4572 / 40%

4080 / 38%

Group Health

1311 / 16.55%

1206 / 19.57%

1284 / 19.5%

1400 / 23%

1720 / 23%

1712 / 24%

Highline

1316 / 24.09%

1339 / 28.16%

1291 / 27.8%

1235 / 32%

 

 

Northwest

992 / 27.82%

980 / 32.14%

999 / 30.9%

994 / 30%

1070 / 28%

1047 / 29%

Overlake

3813 / 29.03%

3736 / 30.19%

3780 / 30.7%

4032 / 33%

4119 / 38%

4109 / 38%

Stevens

1219 / 24.12%

1138 / 24.96%

1228 / 27%

1199 / 27%

1152 / 33%

1134 / 30%

Swedish

 

7025 / 28.44%

7201 / 30.22%

7472 / 31%

7259 / 34%

7316 / 33%

UWMC

1843 / 35.81%

1986 / 37.56%

2049 / 36.4%

2040 / 36%

2200 / 38%

2201 / 37%

Valley

2456 / 27.12%

2742 / 30.56%

2697 / 29.6%

3386 / 34%

3984 / 35%

3864 / 35%

 

Data from CHARS. 2003 and 2004 calculations from http://www.seattlebirthnet.com/stats.html

2005 and 2006 calculations by Janelle Durham, 2008 and 2009 by Kim James
 

What is the recommended rate for cesareans?

Nationwide, our cesarean rate has been escalating to record high levels every year for the past several years. Cesareans are still done for the same reasons as they have always been done (maternal health concerns, fetal well-being, failure to progress in labor); however, care providers seem to be making the choice much earlier for milder health concerns than they ever did in the past.

Cesareans are a vital tool for improving maternity outcomes, but they should only be used when the benefits outweigh the risks of the surgery. Many maternal advocates argue that we are currently over-using cesarean, and thus creating unnecessary risks for mothers and babies.

CIMS, WHO, and “Healthy People 2010” recommendations are for an overall cesarean rate around 15%. WHO’s research clearly showed that if a developing country does not have sufficient medical resources, and their cesarean rate is below 10%, maternal mortality and infant mortality go up. But, it also showed that if a country’s rate is too high (over 15%), maternal and infant mortality go up.

For the best overview of all the issues surrounding cesarean, see ChildbirthConnection.org

 

Why do rates range so much from birth place to birth place?

Different populations:  Rural hospitals often only accept low-risk clients who are not expected to need substantial interventions, and refer clients who are known to be higher risk to larger, regional hospitals or research/teaching hospitals which have the facilities to deal with potential complications. Therefore, it is natural for these regional hospitals and teaching hospitals to have higher rates of interventions because they serve a higher-risk population.

Different caregiver philosophies/training: Midwives are typically trained to minimize interventions, and typically have lower rates than obstetricians, who are trained surgeons. Thus, birthplaces which use midwives and family practice doctors typically have lower rates than hospitals where obstetricians perform most of the deliveries.

Prevalence of other interventions: Hospital protocols also vary, with some birthplace philosophies leading to lower cesarean rates. Other medical interventions in the labor and birth process may increase the prevalence of cesarean, so if interventions are common at a birthplace, then the cesarean rate may be higher.  For example, induction of labor increases the relative risk of cesarean, so a hospital with a high induction rate would be likely to have a high cesarean rate.

 

These statistics tell the average for a birth place. How would I find out what my doctor or midwife’s rates are?

All the statistics given here are averages amongst all the care providers practicing at a birthplace. If you look at any particular care provider or group of providers, their practices may differ significantly from this average.

The best way to find out about the practices of a specific caregiver is to ask him or her directly. Rather than just asking for his/her rate, ask the caregiver to explain his/her rationale. Ask questions like: what could I do to minimize the chance of needing a cesarean? What do you as the caregiver do to minimize my need for cesarean? How would you decide when it was necessary to perform surgery?

 

Alphabetical: All Washington state hospitals, 2008

 

Ranked By Cesarean Birth Rate

Total Births

Total C/S

C/S Rate

% Vaginal deliveries w/complicated diagnoses

% Cesarean birth w/complications

% Complicated Deliveries

City

C/S Rank

Evergreen Hospital Medical Center

4572

1840

40%

6%

15%

21%

Kirkland

1

University of Washington Med. Cntr

2200

842

38%

18%

24%

42%

Seattle

2

Overlake Hospital

4119

1552

38%

5%

10%

15%

Bellevue

3

Auburn Regional Medical Center

1090

389

36%

8%

10%

18%

Auburn

4

Providence Sacred Heart Medical Cntr

2777

963

35%

9%

12%

21%

Spokane

5

Valley Medical Center

3984

1379

35%

7%

12%

19%

Renton

6

Capital Medical Center

736

260

35%

5%

8%

13%

Olympia

7

Swedish Medical Center - First Hill

7259

2433

34%

10%

14%

24%

Seattle

8

Tacoma General Hospital

3059

995

33%

10%

13%

23%

Tacoma

9

Whidbey General Hospital

197

65

33%

13%

9%

22%

Coupeville

10

Stevens

1152

375

33%

8%

9%

17%

Edmonds

11

PeaceHealth St. Joseph Hospital

1940

627

32%

11%

12%

23%

Bellingham

12

Deaconess Medical Center

2091

653

31%

10%

11%

21%

Spokane

13

Harrison Memorial Hospital

2085

686

31%

12%

8%

20%

Bremerton

14

PeaceHealth Saint John Medical Center

1276

400

31%

12%

12%

24%

Longview

15

Providence Regional Medical Center

3909

1177

30%

12%

11%

23%

Everett

16

Legacy Salmon Creek Hospital

1963

585

30%

9%

13%

22%

Vancouver

17

Kadlec Medical Center

2226

635

29%

9%

12%

21%

Richland

18

Valley General Hospital

444

130

29%

5%

5%

10%

Monroe

19

Wall Walla General Hospital

321

94

29%

13%

9%

22%

Walla Walla

20

Northwest Hospital

1070

298

28%

12%

9%

21%

Seattle

21

St. Joseph Medical Center

3694

1030

28%

9%

8%

17%

Tacoma

22

St. Francis Hospital

1560

436

28%

9%

8%

17%

Federal Way

23

Central Washington Hospital

1436

381

27%

8%

8%

16%

Wenatchee

24

Good Samaritan Hospital

2128

580

27%

6%

6%

12%

Puyallup

25

Providence St. Peter Hospital

2094

554

26%

12%

9%

21%

Olympia

26

Skagit Valley Hospital

1235

320

26%

9%

6%

15%

Mt. Vernon

27

Southwest Washington Med. Cntr

3636

909

25%

9%

10%

19%

Vancouver

28

Samaritan Hospital

1102

320

25%

9%

7%

16%

Moses Lake

29

Providence Holy Family Hospital

1217

298

24%

9%

7%

16%

Spokane

30

Group Health Central Hospital

1720

403

23%

12%

9%

21%

Seattle

31

Valley Hospital and Medical Center

541

103

19%

11%

4%

15%

Spokane

32

Yakima Valley Memorial Hospital

2988

516

17%

9%

6%

15%

Yakima

33

 

More information on cesareans.

More information on VBAC, including VBAC rates in Seattle area hospitals, and VBAC friendly midwives and doctors.

For more information about hospitals in Seattle, and how they compare, check out the Great Starts Guide.