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Monday
Dec212009

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, 1990-2008These 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

 

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Reader Comments (21)

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.

December 21, 2009 | Unregistered CommenterChrista

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!

December 21, 2009 | Unregistered CommenterAmy

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.

December 21, 2009 | Unregistered CommenterSara

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.

December 21, 2009 | Unregistered CommenterErin

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.

December 21, 2009 | Registered CommenterJill

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...

December 21, 2009 | Unregistered Commentersandra

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?

December 21, 2009 | Unregistered CommenterKathy

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.

December 21, 2009 | Unregistered CommenterDou-la-la

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!

December 21, 2009 | Unregistered Commenterdoctorjen

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.

December 21, 2009 | Unregistered CommenterKnitted in the Womb
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