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.