Virginia Cesarean Rates by Hospital, 2006

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By Jill

Although its 2006 data is now out of date, Virginia Health Information’s Obstetrical Services Guide provides the public with rates of cesareans, VBAC and episiotomies, plus length of hospital stay and average charges. While this alone sets it apart from the majority of states in the U.S. in terms of transparency, Virginia Health Information also provides a database of the intervention rates of individual physicians, who were allowed to review data and comment on their 2006 deliveries before and after the ratings were produced. 

Hospital	Total Births	Total C/S	C/S Rate
Augusta Medical Center	1111	394	35.5%
Bedford Memorial Hospital	207	56	27.1%
Bon Secours DePaul Medical Center	974	185	19.0%
Bon Secours Mary Immaculate Hospital	944	272	28.8%
Bon Secours Maryview Medical Center	1012	294	29.1%
Bon Secours Memorial Regional Medical Center	1804	518	28.7%
Bon Secours St. Francis Medical Center	1077	349	32.4%
Bon Secours St. Mary’s Hospital	2726	974	35.7%
CJW Medical Center	3263	1170	35.9%
Carilion Franklin Memorial Hospital	253	80	31.6%
Carilion Medical Center	3305	1050	31.8%
Carilion New River Valley Medical Center	1027	372	36.2%
Centra Health	2318	616	26.6%
Chesapeake General Hospital	3100	1139	36.7%
Clinch Valley Medical Center	478	140	29.3%
Community Memorial Healthcenter	340	83	24.4%
Culpeper Regional Hospital	444	98	22.1%
Danville Regional Medical Center	1055	216	20.5%
Fauquier Hospital	741	215	29.0%
Halifax Regional Hospital	410	151	36.8%
Henrico Doctors’ Hospital	3431	1409	41.1%
Inova Alexandria Hospital	3563	1354	38.0%
Inova Fair Oaks Hospital	3559	1355	38.1%
Inova Fairfax Hospital	11673	4783	41.0%
Inova Loudoun Hospital	2227	654	29.4%
Johnston Memorial Hospital	638	171	26.8%
Lewis-Gale Medical Center	615	223	36.3%
Martha Jefferson Hospital	1700	582	34.2%
Mary Washington Hospital	3702	1279	34.5%
Memorial Hospital of Martinsville & Henry County	571	188	32.9%
Montgomery Regional Hospital	526	185	35.2%
Norton Community Hospital	453	122	26.9%
Potomac Hospital	2644	718	27.2%
Prince William Hospital	2642	652	24.7%
Reston Hospital Center	3014	1330	44.1%
Riverside Regional Medical Center	2922	848	29.0%
Rockingham Memorial Hospital	1760	504	28.6%
Sentara Leigh Hospital	2602	894	34.4%
Sentara Norfolk General Hospital	2717	1134	41.7%
Sentara Obici Hospital	1289	367	28.5%
Sentara Virginia Beach General Hospital	1838	596	32.4%
Sentara Williamsburg Regional Medical Center	958	243	25.4%
Shore Memorial Hospital	566	174	30.7%
Smyth County Community Hospital	304	94	30.9%
Southampton Memorial Hospital	287	81	28.2%
Southside Community Hospital	393	97	24.7%
Southside Regional Medical Center	1286	414	32.2%
Twin County Regional Hospital	400	113	28.3%
University of Virginia Medical Center	1712	526	30.7%
VCU Health System	2135	669	31.3%
Virginia Hospital Center	3248	1315	40.5%
Warren Memorial Hospital	259	80	30.9%
Wellmont Lonesome Pine Hospital	268	80	29.9%
Winchester Medical Center	2197	815	37.1%
Wythe County Community Hospital	250	123	49.2%

Overall Cesarean Rates in Descending Order by Rate

Hospital	Total Births	Total C/S	C/S Rate
Wythe County Community Hospital	250	123	49.2%
Reston Hospital Center	3014	1330	44.1%
Sentara Norfolk General Hospital	2717	1134	41.7%
Henrico Doctors’ Hospital	3431	1409	41.1%
Inova Fairfax Hospital	11673	4783	41.0%
Virginia Hospital Center	3248	1315	40.5%
Inova Fair Oaks Hospital	3559	1355	38.1%
Inova Alexandria Hospital	3563	1354	38.0%
Winchester Medical Center	2197	815	37.1%
Halifax Regional Hospital	410	151	36.8%
Chesapeake General Hospital	3100	1139	36.7%
Lewis-Gale Medical Center	615	223	36.3%
Carilion New River Valley Medical Center	1027	372	36.2%
CJW Medical Center	3263	1170	35.9%
Bon Secours St. Mary’s Hospital	2726	974	35.7%
Augusta Medical Center	1111	394	35.5%
Montgomery Regional Hospital	526	185	35.2%
Mary Washington Hospital	3702	1279	34.5%
Sentara Leigh Hospital	2602	894	34.4%
Martha Jefferson Hospital	1700	582	34.2%
Memorial Hospital of Martinsville & Henry County	571	188	32.9%
Sentara Virginia Beach General Hospital	1838	596	32.4%
Bon Secours St. Francis Medical Center	1077	349	32.4%
Southside Regional Medical Center	1286	414	32.2%
Carilion Medical Center	3305	1050	31.8%
Carilion Franklin Memorial Hospital	253	80	31.6%
VCU Health System	2135	669	31.3%
Smyth County Community Hospital	304	94	30.9%
Warren Memorial Hospital	259	80	30.9%
Shore Memorial Hospital	566	174	30.7%
University of Virginia Medical Center	1712	526	30.7%
Wellmont Lonesome Pine Hospital	268	80	29.9%
Inova Loudoun Hospital	2227	654	29.4%
Clinch Valley Medical Center	478	140	29.3%
Bon Secours Maryview Medical Center	1012	294	29.1%
Riverside Regional Medical Center	2922	848	29.0%
Fauquier Hospital	741	215	29.0%
Bon Secours Mary Immaculate Hospital	944	272	28.8%
Bon Secours Memorial Regional Medical Center	1804	518	28.7%
Rockingham Memorial Hospital	1760	504	28.6%
Sentara Obici Hospital	1289	367	28.5%
Twin County Regional Hospital	400	113	28.3%
Southampton Memorial Hospital	287	81	28.2%
Potomac Hospital	2644	718	27.2%
Bedford Memorial Hospital	207	56	27.1%
Norton Community Hospital	453	122	26.9%
Johnston Memorial Hospital	638	171	26.8%
Centra Health	2318	616	26.6%
Sentara Williamsburg Regional Medical Center	958	243	25.4%
Southside Community Hospital	393	97	24.7%
Prince William Hospital	2642	652	24.7%
Community Memorial Healthcenter	340	83	24.4%
Culpeper Regional Hospital	444	98	22.1%
Danville Regional Medical Center	1055	216	20.5%
Bon Secours DePaul Medical Center	974	185	19.0%

Primary Cesareans

Hospital	Total Primary C/S	Primary C/S Rate	Risk Adjusted Primary C/S Rate
Augusta Medical Center	229	24.5%	26.7%
Bedford Memorial Hospital	39	20.7%	16.5%
Bon Secours DePaul Medical Center	127	14.3%	17.8%
Bon Secours Mary Immaculate Hospital	169	20.3%	21.4%
Bon Secours Maryview Medical Center	172	19.6%	18.1%
Bon Secours Memorial Regional Medical Center	332	21.0%	21.2%
Bon Secours St. Francis Medical Center	216	23.3%	22.4%
Bon Secours St. Mary’s Hospital	652	27.6%	25.8%
CJW Medical Center	705	25.6%	20.7%
Carilion Franklin Memorial Hospital	43	20.0%	23.4%
Carilion Medical Center	652	23.0%	25.9%
Carilion New River Valley Medical Center	235	26.9%	27.6%
Centra Health	377	18.6%	21.1%
Chesapeake General Hospital	674	25.8%	25.4%
Clinch Valley Medical Center	91	21.3%	19.5%
Community Memorial Healthcenter	51	17.2%	20.5%
Culpeper Regional Hospital	57	14.6%	18.4%
Danville Regional Medical Center	132	13.9%	17.5%
Fauquier Hospital	132	21.0%	18.2%
Halifax Regional Hospital	102	28.7%	25.2%
Henrico Doctors’ Hospital	784	28.2%	23.6%
Inova Alexandria Hospital	863	28.4%	26.1%
Inova Fair Oaks Hospital	763	26.1%	24.4%
Inova Fairfax Hospital	2913	30.1%	25.5%
Inova Loudoun Hospital	367	19.2%	24.9%
Johnston Memorial Hospital	96	17.1%	19.1%
Lewis-Gale Medical Center	154	28.7%	21.9%
Martha Jefferson Hospital	353	24.4%	27.2%
Mary Washington Hospital	774	24.5%	24.2%
Memorial Hospital of Martinsville & Henry County	114	23.0%	14.3%
Montgomery Regional Hospital	109	24.5%	18.5%
Norton Community Hospital	75	18.5%	20.8%
Potomac Hospital	406	17.9%	21.4%
Prince William Hospital	373	16.3%	24.6%
Reston Hospital Center	832	33.5%	31.5%
Riverside Regional Medical Center	497	19.7%	21.9%
Rockingham Memorial Hospital	295	19.4%	22.2%
Sentara Leigh Hospital	540	24.1%	27.3%
Sentara Norfolk General Hospital	702	31.9%	33.0%
Sentara Obici Hospital	206	18.7%	20.7%
Sentara Virginia Beach General Hospital	362	22.9%	24.9%
Sentara Williamsburg Regional Medical Center	140	16.5%	19.1%
Shore Memorial Hospital	88	18.8%	18.6%
Smyth County Community Hospital	61	22.5%	21.6%
Southampton Memorial Hospital	37	15.4%	18.8%
Southside Community Hospital	46	13.7%	13.0%
Southside Regional Medical Center	258	23.0%	19.4%
Twin County Regional Hospital	72	20.1%	16.9%
University of Virginia Medical Center	338	22.6%	28.6%
VCU Health System	423	23.0%	29.5%
Virginia Hospital Center	827	30.7%	29.8%
Warren Memorial Hospital	47	21.3%	20.5%
Wellmont Lonesome Pine Hospital	43	18.6%	13.8%
Winchester Medical Center	470	25.6%	22.1%
Wythe County Community Hospital	85	40.1%	27.0%

Repeat Cesareans

Hospital	# Repeat C/S	RCS “Actual Rate”	RCS “Expected Rate”
Augusta Medical Center	165	92.7%	88.7%
Bedford Memorial Hospital	17	89.5%	N/A
Bon Secours DePaul Medical Center	58	69.9%	84.2%
Bon Secours Mary Immaculate Hospital	103	92.0%	86.0%
Bon Secours Maryview Medical Center	122	89.7%	88.2%
Bon Secours Memorial Regional Medical Center	186	83.0%	90.6%
Bon Secours St. Francis Medical Center	133	89.9%	90.8%
Bon Secours St. Mary’s Hospital	322	88.7%	91.3%
CJW Medical Center	465	91.5%	90.8%
Carilion Franklin Memorial Hospital	37	97.4%	92.3%
Carilion Medical Center	398	84.5%	86.5%
Carilion New River Valley Medical Center	137	90.1%	89.2%
Centra Health	239	83.0%	89.2%
Chesapeake General Hospital	465	96.3%	89.0%
Clinch Valley Medical Center	49	98.0%	88.4%
Community Memorial Healthcenter	32	74.4%	83.4%
Culpeper Regional Hospital	41	75.9%	89.1%
Danville Regional Medical Center	84	78.5%	86.8%
Fauquier Hospital	83	74.1%	87.0%
Halifax Regional Hospital	49	90.7%	86.1%
Henrico Doctors’ Hospital	625	95.9%	90.4%
Inova Alexandria Hospital	491	93.2%	90.1%
Inova Fair Oaks Hospital	592	93.2%	90.7%
Inova Fairfax Hospital	1870	93.7%	91.2%
Inova Loudoun Hospital	287	91.1%	90.8%
Johnston Memorial Hospital	75	98.7%	91.1%
Lewis-Gale Medical Center	69	87.3%	88.9%
Martha Jefferson Hospital	229	90.5%	89.9%
Mary Washington Hospital	505	92.7%	89.6%
Memorial Hospital of Martinsville & Henry County	74	98.7%	90.8%
Montgomery Regional Hospital	76	93.8%	92.7%
Norton Community Hospital	47	100.0%	90.0%
Potomac Hospital	312	84.3%	88.5%
Prince William Hospital	279	78.6%	88.3%
Reston Hospital Center	498	93.8%	92.4%
Riverside Regional Medical Center	351	88.4%	89.7%
Rockingham Memorial Hospital	209	87.8%	89.1%
Sentara Leigh Hospital	354	97.3%	90.0%
Sentara Norfolk General Hospital	432	84.1%	88.7%
Sentara Obici Hospital	161	85.6%	89.6%
Sentara Virginia Beach General Hospital	234	90.0%	89.9%
Sentara Williamsburg Regional Medical Center	103	92.8%	89.0%
Shore Memorial Hospital	86	86.9%	86.2%
Smyth County Community Hospital	33	100.0%	91.1%
Southampton Memorial Hospital	44	93.6%	90.5%
Southside Community Hospital	51	91.1%	87.1%
Southside Regional Medical Center	156	95.1%	90.6%
Twin County Regional Hospital	41	100.0%	90.0%
University of Virginia Medical Center	188	87.0%	89.0%
VCU Health System	246	82.3%	86.9%
Virginia Hospital Center	488	87.9%	90.8%
Warren Memorial Hospital	33	86.8%	90.2%
Wellmont Lonesome Pine Hospital	37	100.0%	88.8%
Winchester Medical Center	345	95.8%	89.4%
Wythe County Community Hospital	38	100.0%	91.2%

Episiotomies

Hospital	Vaginal Births	# of Epis	Epis Rate
Augusta Medical Center	717	68	9.5%
Bedford Memorial Hospital	151	7	4.6%
Bon Secours DePaul Medical Center	789	20	2.5%
Bon Secours Mary Immaculate Hospital	672	102	15.2%
Bon Secours Maryview Medical Center	718	83	11.6%
Bon Secours Memorial Regional Medical Center	1286	137	10.7%
Bon Secours St. Francis Medical Center	728	118	16.2%
Bon Secours St. Mary’s Hospital	1752	344	19.6%
CJW Medical Center	2093	457	21.8%
Carilion Franklin Memorial Hospital	173	13	7.5%
Carilion Medical Center	2255	544	24.1%
Carilion New River Valley Medical Center	655	223	34.0%
Centra Health	1702	131	7.7%
Chesapeake General Hospital	1961	323	16.5%
Clinch Valley Medical Center	338	166	49.1%
Community Memorial Healthcenter	257	23	8.9%
Culpeper Regional Hospital	346	66	19.1%
Danville Regional Medical Center	839	43	5.1%
Fauquier Hospital	526	153	29.1%
Halifax Regional Hospital	259	29	11.2%
Henrico Doctors’ Hospital	2022	465	23.0%
Inova Alexandria Hospital	2209	441	20.0%
Inova Fair Oaks Hospital	2204	490	22.2%
Inova Fairfax Hospital	6890	1413	20.5%
Inova Loudoun Hospital	1573	255	16.2%
Johnston Memorial Hospital	467	169	36.2%
Lewis-Gale Medical Center	392	209	53.3%
Martha Jefferson Hospital	1118	57	5.1%
Mary Washington Hospital	2423	298	12.3%
Memorial Hospital of Martinsville & Henry County	383	115	30.0%
Montgomery Regional Hospital	341	29	8.5%
Norton Community Hospital	331	55	16.6%
Potomac Hospital	1926	323	16.8%
Prince William Hospital	1990	399	20.1%
Reston Hospital Center	1684	304	18.1%
Riverside Regional Medical Center	2074	348	16.8%
Rockingham Memorial Hospital	1256	169	13.5%
Sentara Leigh Hospital	1708	255	14.9%
Sentara Norfolk General Hospital	1583	101	6.4%
Sentara Obici Hospital	922	63	6.8%
Sentara Virginia Beach General Hospital	1242	192	15.5%
Sentara Williamsburg Regional Medical Center	715	78	10.9%
Shore Memorial Hospital	392	49	12.5%
Smyth County Community Hospital	210	67	31.9%
Southampton Memorial Hospital	206	36	17.5%
Southside Community Hospital	296	26	8.8%
Southside Regional Medical Center	872	260	29.8%
Twin County Regional Hospital	287	86	30.0%
University of Virginia Medical Center	1186	49	4.1%
VCU Health System	1466	37	2.5%
Virginia Hospital Center	1933	392	20.3%
Warren Memorial Hospital	179	34	19.0%
Wellmont Lonesome Pine Hospital	188	70	37.2%
Winchester Medical Center	1382	286	20.7%
Wythe County Community Hospital	127	34	26.8%

Comments

[Andrea von Schoening]

Wow - this is good information to have, if you live in Virginia! The thing that shocked me most was the episiotomy rates ... there is one place with an episiotomy rate over 50%! What's their excuse for that? You can easily see that WHERE you go will have a huge influence on what happens to you. Thanks for posting!

[Erin]

In some ways, the statistics here help me understand the limitations of statistics. I mean, we talk here a lot about hospital policies (sometimes versus OB or midwifery care/requirements), but sometimes it's not the hospital, but the practitioner. I guess a'll I'm trying to say is that it's difficult to discern just by looking at the numbers how much is a "hospital" problem and how much is an "OB" problem (that said I would NEVER birth at a hospital with a C/S rate over 30%, no matter who's "fault" it is). This issue occurs to me because I birthed at Martha Jefferson hospital, which is a small private hospital, with no NICU. It deals primarily with low risk women - in fact you have to be of certain gestation etc or you get moved to the hospital in town with a NICU. It has what I would call very mother-baby friendly policies (eating and drinking during labor- there's actually a "snack" room for laboring moms), option of doppler monitoring, rooming-in, on-site lactation consultant, and just general little interference as one often reads about). And it's primary C-section rate is STILL 25%, with very high repeat C-section rate (which means very few VBACs). I had a midwife (there's only one midwife with admitting privileges there), and she made sure I moved around, didn't need an IV, ate and drank, got into the tub, labored in a squatting position, maintained low lights and low voices in the room at all times, etc etc. But if no OB will do a breech, even a baby B twin breech, or vaginal birth of twins, and VBACs aren't supported, there's only so far the C-section rate can fall, I guess, even without hospital "bans" on them.

[Jill]

"In some ways, the statistics here help me understand the limitations of statistics."

Yes!

My longstanding promise is that I *will* address context with regards to c/s rates. :)

[Emily]

Wow, the individual provider info is amazing! I also appreciate knowing what they are charging (and comparing to my birth center birth).

[Sara]

Erin- do you live in Charlottesville area? I live 5 minutes from Martha Jefferson Hospital, and about 2 minutes from University of Virginia hospital. I think it's interesting that everyone talks up MJH maternity services, and I'm sure that their maternity ward is "nicer" than UVA, but the c-section rate is 4% points higher. (Although, the episiotomy rate is only 4% and 5%, which is pretty awesome for a hospital, if you ask me!) Very interesting numbers; I will be sure to save this for my friends who are pregnant around the state. Also I'm working through Doula training, so this is really valuable information!

I am currently auditing a childbirth prep class sponsored by Martha Jefferson Hospital, and while it seems that they're *trying* to teach women how to give birth as normally as possible, it also seems like they don't want to push it too much, probably for financial reasons. The maternity ward is really the bread and butter of that hospital. It's frustrating because the teacher is very wishy-washy when it comes to questions about the c-section rate and hospital policies like birthing within 24 hours of your water breaking. Not a whole lot of evidence or statistics are mentioned, just "this terrible thing happened when policy wasn't followed", and "hmm...sometimes the c-section rate is really high because of twins and preemies..." (umm...you are not a level 3 NICU and twins and preemies don't have to be born by c-section. I am living proof).

That said, I get the impression that Martha Jefferson Hospital is a good place to go, but only if you're informed in the first place, or, if you walk in with the baby crowning, like I did. The doctor that was on call had no problem waiting to clamp the cord, and I even co-slept with my daughter the first night in the hospital, and no one said anything about it. The only thing that irritated me is that they insisted upon raising her body temperature with a warmer, even though I wanted to hold her. Also the one day I was in there was bloody expensive...

[Sara]

Yeah, see....how the HECK is a VAGINAL delivery only 3000$ less than a CESAREAN delivery?! The doctor who was there at my birth (I caught her, but thanks anyway, doc) averages over 6000$ for a vaginal delivery, and over 9000 for c-section. He has a 23% cesarean rate, which I guess isn't bad for most OBs.

I'm going to be plugging names into this thing ALL DAY. Now to check on the one who gave my friend her surgical delivery at 4:30 pm after 8 hours of "labor"...

[Sara]

Sorry to be posting AGAIN, but this is so COOL. The statistics show that my instincts were right! The one doctor that I liked the most out of the practice that I went to has a 1% episiotomy rate and 18% c-section rate! He would have been on call if I had been in labor just a few hours later, bummer. Now I know who I want to do my shadow OB coverage with when we have another baby. He was also the one who first signed off on my birth plan and told me that he never did internal exams starting at 37 weeks until he was with this practice, and that they were fairly useless until one was having contractions.

So, if you're in Charlottesville and want a good doctor, check out Dr. Heider at Jefferson OB/Gyn. I notice that he also does VBACs.

[Erin]

Sara, I was in Charlottesville when my baby was born. I had Donna Vinal, and working with her was amazing, and I'm sure changes the experience of being at the hospital, because she totally owned that room. What I mean is, everything was done her way in terms of normal birth. Unfortunately, she's the only midwife with admitting privileges, and she's *very* difficult to get an appointment with as a result. MJH is one of those weird places that attracts the "birth spa" folks and the natural birth folks. It's nice to know that there are other normal-birth friendly OBs in Cville! So my impression of MJH is that it's the *provider* that makes the experience. But they have the facilities to support normal birth. While UVA's C-section rates might be lower, I wonder about the possibilities of a non-interventionist birth there. Do they do doppler? Tubs? Let you eat and drink? etc. I liked the nurses at MJH and felt like it was a place where my views were respected, and nobody tried to do anything to me or my baby without my permission. And also, that's so funny that two of Jill's readers had babies born at MJH!

[Sara]

Erin- I tried to get in with Donna Vidal, but as you already know, it's very difficult! She didn't have any openings when I was pregnant. In my case, however, I don't think it would have mattered much. I'm glad to hear that you had such a positive experience there. I think that next time I will use the local homebirth midwives, even though insurance won't cover them currently. Last labor was 5 hours start to finish and probably would have been shorter had we not had to drive to the hospital, so who knows what will happen next time?

I agree with you- it probably is the provider that is much more important than the hospital. The hospital is equipped to handle non-interventatice birth, but if the mother isn't aware of her options, and the doctor and/or nurses don't offer, she may get the same experience as any other hospital.

My mother delivered my sister and I in 1982 at UVA, at 31 weeks gestation. She had a lot of interventions, of course, since they tried to stop labor, then when they couldn't, sped it up with Pitocin (?!) but we were born vaginally, and my mom was very supported in breastfeeding us even though we were so early. I don't know if that has changed much since then. It seems like many moms of preemies here in town don't end up breastfeeding, which I think is so sad.

[Crystal]

I live in Northern Virginia and am set to give birth in Spring 2011 with my 2nd child (VBAC attempt), and these statistics reaffirm my choice in selecting a Home Birth Midwife and opting out of the hospital experience alltogether. I knew the C-Section rates at Inova et al. were nearing 40%, but had no clue about the also high episiotomy rate. Basically, whether you birth via surgery or vaginally, you're doomed to get cut either way it seems. HELL NO, not going near those hospitals! Thank God for Midwives!