Nebraska Hospital Cesarean Rates
As a birth doula and a co-leader with ICAN, and more recently as an Evidence Based Birth® Instructor, I have been searching for hospital-level Cesarean rates for several years. I recently learned about the Nebraska Hospital Association's Care Compare website. Although intended for procedure cost comparisons between facilities, the website does include how many patients were discharged from every facility following Cesarean and vaginal births (with and without sterilization) for July 2015-June 2016.
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With this information, I was able to calculate hospital-level Cesarean rates for every hospital in the state of Nebraska that provides maternity care. You can look up this information yourself at NHACareCompare.com, and I have compiled the rates here for you as well. Below, I have included a bar graph for a visual representation of the data, and subscribers to my newsletter (enter your email address in the script above to subscribe) will receive a PDF with the raw data.
EDIT 8/19/2017 ***I have been asked by several people what this rate includes. As far as the source website indicates, this is overall rate. All Cesareans divided by All Births, regardless of gestational age, complications, indications for Cesarean, primary or repeat Cesarean, etc. If your facility tracks this information, I urge you to share the data with your communities so patients have a clearer picture of what goes into your hospital's numbers. Also, this information is only one piece of information that you should be using to make your decision on where to give birth.***
Below are all 50 Nebraska hospitals who cared for any births in the designated time period, and their Cesarean Rates. I have put an asterisk (*) on all bars representing fewer than 100 births, as low numbers are more difficult to interpret (for example, all 5 births at Children's Hospital in Omaha were Cesarean births). For reference, the CDC reports Nebraska's 2014 Cesarean rate at 30.8%, and for 2015 at 31.1%, but has not yet released 2016 rates. CHI Lakeside in Omaha has a rate of 30.4%, just under 2014's state rate, and Faith Regional in Norfolk has a rate of 31.1%, the same as the 2015 state rate.
Why should you care about a hospital's Cesarean rate? Numerous public health organizations, including ACOG and the Society for Maternal-Fetal Medicine, the CDC, and the WHO have issued calls to reduce the Cesarean rate so that mothers and babies do not take on the risks of Cesarean birth unnecessarily. Research suggests that nearly half of all Cesareans are unnecessary, and the largest risk factor for a woman to give birth by Cesarean is not any health or demographic characteristic; it is the hospital where she goes for care. Despite national and international efforts to reduce the Cesarean rate and prevent unnecessary Cesareans, Nebraska's overall Cesarean rate has been rising since at least 2013.
Are you a consumer? Call your hospital, and let them know what you think about their Cesarean rate. If you have a choice of birthing hospital, and you want to avoid an unnecessary Cesarean, choose the hospital with the lowest rate, and tell them that is why you gave them your business. If you have had a Cesarean, whether it was necessary or preventable, get support as you heal and process your birth. ICAN is a great, safe place to do that.
Are you a maternity caregiver? Calculate your own Cesarean rate, as well as the rates of the facilities where you work. Look at the research examining why the Cesarean rate is so high. Educate yourself on the risks and benefits of both Cesareans and VBAC so you can adequately and truthfully counsel your patients to make an informed choice. If you choose not to offer VBAC care, refer your patients desiring VBAC to a provider who does.
Are you a hospital administrator? Seriously examine your facility's practices and procedures that may be contributing to unnecessary Cesareans. You can help reduce your facility's Cesarean rate. Hoag Memorial Hospital Presbyterian in Orange County, CA did, you can do it too.
For those who are also searching for hospital-level information in their area, here are some other sources I utilized in my search process. They were unfortunately fruitless for my search for current data, but these and their equivalents in other states may be useful for others: