In Cesarean Surgery

The Leapfrog Group, a non-profit organization promoting hospital safety standards, has published 2014 cesarean rates by hospital in low-risk 1st-time mothers (> 37 wk, one, head-down baby)—and it’s not pretty. The Miami Herald used the data to bemoan the extremely high cesarean rate in South Florida hospitals, several with rates over 50% and the highest topping out at 68%. Leapfrog’s report finds that 60% of reporting hospitals exceeded the 24% rate established as the U.S. 2020 Healthy People goal.

As concerning as that news is, the real situation is probably worse. Participation in Leapfrog’s survey is voluntary, and many hospitals declined to submit their data. Unwillingness to participate might well indicate hospitals with unfavorable statistics.

Furthermore, the 24% target is based on nothing more than achieving a 10% decrease off the 2007 rate of 27%, not on any number related to an optimal cesarean rate in this population. Based on data from home births and free-standing birth centers, the optimal rate in low-risk 1st-time mothers is much more likely to be something like 10%. Leapfrog lists all hospitals according to state as well as providing a tool to search for a particular hospital here.

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