Pennsylvania Department of Health Releases 2008 Hospital Cesarean Rates

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The Pennsylvania Department of Health released its 2008 Birth and Death Statistics. Of the 148,464 total live births in Pennsylvania in 2008, 45,822 were cesarean sections and 2,486 of the births were vaginal births after a previous cesarean. The state’s overall cesarean rate in 2008 was 30.9 percent.

Fifty hospitals in Pennsylvania had a cesarean rate higher than the national average of 31.8 percent, with eleven hospitals performing cesarean sections on 40 percent or more of their patients. Two hospitals, The Children’s Hospital of Philadelphia and Clarion Hospital in Clarion County exceeded a 50 percent cesarean rate in 2008, reporting rates of 66 percent and 53.6 percent, respectively.

At Jennersville Regional Hospital in Chester, 78.8 percent of women delivered vaginally, giving the hospital the distinction of having the highest vaginal birth rate after freestanding birth centers and other out of hospital births.

Hospital	Births	Total C/S	VBAC	C/S Rate
	148,464	45,822	2,486	30.9%
Childrens Hospital of Philadelphia	94	62	1	66.0%
Clarion Hospital	375	201	0	53.6%
Allegheny General Hospital	1,316	638	23	48.5%
Bradford Regional Medical Center	305	139	0	45.6%
Geisinger Wyoming Valley	1,116	471	10	42.2%
Main Line Hospital Lankenau	2,220	929	19	41.8%
Lower Bucks Hospital	1,137	475	8	41.8%
Nesbitt Memorial Hospital	1,408	585	17	41.5%
Berwick Hospital Center	126	52	1	41.3%
Doylestown Hospital	1,327	544	3	41.0%
Ellwood City Hospital	285	114	1	40.0%
Elk Regional Health Center	197	78	0	39.6%
Main Line Hospital Paoli	2,232	859	17	38.5%
Montgomery Hospital	693	265	11	38.2%
Armstrong County Memorial Hospital	691	262	9	37.9%
St Clair Memorial Hospital	1,170	441	7	37.7%
Saint Vincent Health Center	2,389	899	46	37.6%
Hamot Medical Center	1,014	381	9	37.6%
Milton S Hershey Medical Center	1,709	640	29	37.4%
Geisinger Medical Center	1,677	628	19	37.4%
PA Hospital of the University of PA	4,986	1,864	99	37.4%
Evangelical Community Hospital	1,056	393	18	37.2%
Ohio Valley General Hospital	308	114	0	37.0%
Heart of Lancaster Reg Medical Center	244	89	1	36.5%
Tyler Memorial Hospital	209	76	1	36.4%
St Luke’s Hospital Bethlehem	2,788	1,002	54	35.9%
Mercy Suburban Hospital Norristown	640	230	2	35.9%
Dubois Regional Medical Center	1,026	368	8	35.9%
UPMC Bedford	290	104	6	35.9%
Heritage Valley Sewickley	888	318	9	35.8%
St Mary Medical Center	1,775	635	8	35.8%
Easton Hospital	636	226	4	35.5%
Holy Redeemer Hospital & Medical Center	2,842	1,008	30	35.5%
Hazleton General Hospital	614	216	3	35.2%
St Luke’s Hospital Allentown	1,417	496	23	35.0%
Bloomsburg Hospital	303	106	5	35.0%
Grand View Hospital	1,459	509	2	34.9%
Abington Memorial Hospital	5,143	1,778	85	34.6%
Mercy Jeannette Hospital	113	39	0	34.5%
Crozer Chester Medical Center	2,053	705	31	34.3%
Main Line Hospital Bryn Mawr	1,921	653	16	34.0%
Brandywine Hospital	239	81	0	33.9%
Carlisle Regional Medical Center	395	133	2	33.7%
York Hospital	3,065	1,031	57	33.6%
Grove City Medical Center	257	86	2	33.5%
Punxsutawney Area Hospital	135	45	0	33.3%
Moses Taylor Hospital	2,805	934	40	33.3%
UPMC Mercy	1,390	457	18	32.9%
Riddle Memorial Hospital	905	297	13	32.8%
Windber Hospital	312	102	3	32.7%
Williamsport Hospital & Medical Center	1,168	373	21	31.9%
Memorial Hospital Inc Towanda	193	61	0	31.6%
Uniontown Hospital	959	303	12	31.6%
Pottstown Memorial Medical Center	761	239	13	31.4%
Western Pennsylvania Hospital	2,684	841	66	31.3%
Meadville Medical Center	559	175	1	31.3%
Schuylkill Medical Ctr-S Jackson St	1,178	368	6	31.2%
Soldiers & Sailors Memorial Hospital	298	93	0	31.2%
Lancaster General Hospital	5,077	1,556	83	30.6%
Sacred Heart Hospital	291	89	3	30.6%
Thomas Jefferson University Hospital	2,123	649	53	30.6%
Temple University Hospital	2,493	761	45	30.5%
Western PA Hospital Forbes Regional Campus	944	286	10	30.3%
Lewistown Hospital	560	168	14	30.0%
Pinnacle Health Hospitals	4,344	1,302	15	30.0%
Millcreek Community	218	65	3	29.8%
Nason Hospital	546	162	7	29.7%
Central Montgomery Medical Center	349	103	1	29.5%
Good Samaritan Hospital	999	293	19	29.3%
Barnes-Kasson County Hospital	58	17	0	29.3%
Gnaden Huetten Memorial Hospital	456	132	6	28.9%
Chester County Hospital	2,550	734	47	28.8%
Heritage Valley Beaver	1,097	314	14	28.6%
Phoenixville Hospital Company LLC	1,020	291	29	28.5%
Excela Hospital Health Latrobe Hospital	256	73	1	28.5%
Albert Einstein Medical Center	2,810	799	91	28.4%
Hospital of the University of PA	4,326	1,211	149	28.0%
Shenango Valley Medical Center	660	184	7	27.9%
UPMC Northwest Seneca	500	139	8	27.8%
Hahnemann University Hospital	1,936	538	27	27.8%
Butler Memorial Hospital	763	212	4	27.8%
Ephrata Community Hospital	843	234	47	27.8%
Sharon Regional Health System	390	108	7	27.7%
JC Blair Memorial Hospital	372	103	14	27.7%
Reading Hospital & Medical Center	3,629	1,001	104	27.6%
Altoona Regional Health System	1,211	334	19	27.6%
Delaware County Memorial Hospital	1,729	476	48	27.5%
Conemaugh Valley Memorial Hospital	1,332	365	33	27.4%
Magee Womens Hospital of UPMC HealthSys	9,818	2,671	206	27.2%
Lock Haven Hospital	188	50	0	26.6%
Mount Nittany Medical Center	1,268	336	6	26.5%
Lehigh Valley Hospital	3,865	1,022	120	26.4%
Hanover Hospital	634	166	3	26.2%
Warren General Hospital	374	97	2	25.9%
Gettysburg Hospital	558	144	1	25.8%
Wayne Memorial Hospital	346	89	5	25.7%
Jameson Memorial Hospital	432	111	5	25.7%
Pocono Medical Center	773	197	14	25.5%
St Joseph Medical Center Reading	795	200	15	25.2%
Chambersburg Hospital	1,496	376	26	25.1%
Robert Packer Hospital	747	186	9	24.9%
Memorial Hospital York	791	195	6	24.7%
Chestnut Hill Hospital	804	189	21	23.5%
Charles Cole Memorial Hospital	254	59	2	23.2%
Holy Spirit Hospital	1,164	270	35	23.2%
Northeastern Hospital	1,820	420	15	23.1%
Clearfield Hospital	231	53	1	22.9%
Excela Health Westmoreland Reg Hospital	1,590	364	24	22.9%
Waynesboro Hospital	497	113	10	22.7%
Indiana Regional Medical Center	639	145	8	22.7%
Titusville Area Hospital	233	52	8	22.3%
Somerset Hospital	389	86	4	22.1%
Washington Hospital	1,096	241	18	22.0%
Jennersville Regional Hospital	373	79	13	21.2%
Alle-Kiski Medical Center	1	0	0	0.0%
UPMC Presbyterian Shadyside	1	0	0	0.0%
UPMC St Margaret	1	0	0	0.0%
Corry Memorial Hospital	1	0	0	0.0%
Southwest Regional Medical Center	1	0	0	0.0%
Frankford Hospital-Torresdale	4	0	0	0.0%
St Luke’s Miners Memorial Hospital	1	0	1	0.0%
Montrose General Hospital	1	0	0	0.0%
Excela Health Frick Hospital	1	0	0	0.0%
Freestanding Birth Center	1,525	0	28	0.0%
Other (Clinic, Doctor’s Office, Home)	2,375	1	83	0.0%

Data from the report, Birth and Death Statistics, 1990-2008. These data were provided by the Bureau of Health Statistics and Research, Pennsylvania Department of Health. The Department specifically disclaims responsibility for any analyses, interpretations or conclusions.

Via Knitted in the Womb Childbirth Education and Labor Services

       

Comments

[Christa]

To be fair, the only reason that someone would give birth at CHoP is if the child had a severe, life threatening condition. OTOH, I am so saddened to read that both major hospitals in the Erie County area (St. Vincent, and Hamot) have C-Section rates of almost 40%. I am not surprised by this at all. Women have NO WHERE ELSE to turn. It's sad.

[Amy]

Yeah - CHOP only does high risk births, from what I hear, so that cesarean rate doesn't really surprise me. Jennersville is in Chester County - there's a separate city of Chester about 30 miles away. Gets confusing :) Births there are primarily attended by CNMs - I think there's only one group that attends there with 1 OB/GYN and the rest CNMs. I have a friend who had a VBAC with twins there!

[Sara]

I understand that COHP only handles high risk situations, but just because the child has a high risk condition does not mean that a c-section is necessary. I can't imagine that even in the situation of high risk births a full 2/3 of them call for open-uterus surgery.

[Erin]

CHOP is a HUGE hospital that delivered less than 100 babies in all. Even high risk births would generally happen across the breezeway at HUP, there is a corridor for passing patients from one hospital to the other. The situation has to be crazy for the delivery to even happen there. It's not really a good hospital to get statistics from to judge PA births. Not making any excuses for anyone else, but I completely understand CHOP.

[Jill]

I was surprised to see any deliveries happen at a children's hospital. I imagined it must be for very high-risk cases that need immediate access to a top NICU.

[sandra]

Sara - the reason why so many babies would be born via section at CHoP is that some of those babies could not handle labor/cannot stay in the womb until term - many are taken earlier then full term and for the health of the baby and the reduced stress levels on mama they often times do sections.
From what i understand there is only one or two OB groups that still deliver at (Chester County Hospital) CCH as everyone i know in the West Chester area seems to go to the same doctors for pregnancy before going back to their own GYN after the delivery...finding OB's in the CCH area is really hard to say the least....but i am glad to see that CCH is under the Commonwealth avg but i would love to see it go down even more...

[Kathy]

Re: Children's Hospital of Pennsylvania's high C/s rate -- I can see that if a woman knew that her child was going to need immediate surgery after the birth, that she would give birth there. And since many conditions requiring urgent or immediate surgery as soon as the baby was born might make vaginal birth risky or downright dangerous for the baby (perhaps something like spina bifida?), that could be a reason for part of the high rate. Also, if the baby is going to need specialized care including surgery or trained nurses, it would make sense to ensure that the baby was born at a time when those doctors would be there (and not being woken up out of deep sleep and perhaps operating while groggy). If I knew my baby needed immediate heart surgery as soon as he was born, even if the labor or birth itself might not be a risk, I would be more willing to have a C-section just so he could have a smoother, quicker, and/or safer transfer into the pediatric OR, rather than waiting until midnight when a whole team of doctors would have to be assembled. Even if I were not already inclined that way, it would be very easy to see that women might be pressured to make that choice -- how many stories are there of women coerced into unwanted C-sections just because the OR is ready and the paperwork has been signed, even though the baby's heartbeat is fine and the mother is tolerating labor? -- how much more pressure must a woman feel to not inconvenience the team of doctors and nurses who will be working to save her baby's life?

[Dou-la-la]

I just moved to Erie about a year ago - all I can say is that I'm SO GLAD I started attending ICAN meetings there. Hope we get some new members from this, at the very least.

[doctorjen]

I think most births at CHOP would be for babies who have such a high risk condition that even delivering very close by would be too risky for them, so their cesarean rate makes good sense to me. They also likely do some of the more technical procedures that would involve babies going directly to surgery, or directly on ECHMO (like for diaphragmatic hernia) that aren't available anywhere else, and require very planned timing of the birth. Interesting that one of their vaginal births was a VBAC! There are several fetal conditions that make vaginal birth worse for baby - spina bifida being a big one that I think CHOP would handle a lot of. In my experience, in most congenital cardiac disese, they encourage vaginal birth if at all possible. Our congenital heart babies in my referral tertiary care hospital are almost always born vaginally.
I was fascinated, too, by all the hospitals at the bottom of the list with 1 birth. These must be hospitals with no labor and delviery unit, so these would be walk-in, or amublance-brought emergency births. Interesting that one of those was a VBAC, too - I wonder what that story is!
I assume the freestanding birth centers do not perform cesareans, not that their clients truly had a 0% rate. I was wondering about the 1 cesarean done at a clinic/home/dr's office, that must be a story too!

[Knitted in the Womb]

LOL. You "scooped" me. I was going to do this tonight. Spent much too many hours last night doing the analysis of my local hospitals. ;-)

BTW, I do want to confirm that the situation with CHOP is that women quite simply do not go there expecting to labor, I'd be willing to guess that the few vaginal births that occur are by accident. In 2007 they actually had a 100% cesarean rate--only 16 births.