Tennessee Cesarean Rates by Hospital, 2008

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Facility	# of C/S	Total Births	C/S Rate
Baptist Treatment Center of Murfreesboro	157	184	85.3%
Hardin Medical Center	174	334	52.1%
Baptist Hospital - West	31	61	50.8%
Hillside Hospital	115	242	47.5%
Saint Mary’s Jefferson Memorial Hospital	6	13	46.2%
Harton Regional Medical Center	380	831	45.7%
Athens Regional Medical Center	215	493	43.6%
McNairy Regional Hospital	79	183	43.2%
Centennial Medical Center	1349	3314	40.7%
Methodist Healthcare - Germantown	1581	3902	40.5%
Saint Francis Hospital - Bartlett	319	793	40.2%
Fort Sanders Regional Medical Center	1129	2823	40.0%
Baptist Memorial Hospital for Women	1980	5082	39.0%
Erlanger Medical Center	1075	2760	38.9%
Williamson Medical Center	498	1291	38.6%
Baptist Memorial Hospital - Union City	122	318	38.4%
Johnson City Medical Center	472	1250	37.8%
Baptist Hospital	2534	6732	37.6%
University Medical Center	265	713	37.2%
Parkwest Medical Center	542	1465	37.0%
University of Tennessee Memorial Hospital	849	2296	37.0%
Sweetwater Hospital Association	112	304	36.8%
Wellmont Holston Valley Medical Center	385	1057	36.4%
Langhlin Memorial Hospital	118	325	36.3%
Parkridge East Hospital	766	2123	36.1%
Middle Tennessee Medical Center	858	2379	36.1%
Southern Hills Medical Center	133	370	35.9%
Henry County Medical Center	107	301	35.5%
Sycamore Shoals Hospital	170	485	35.1%
Johnson City Specialty Hospital	358	1022	35.0%
Indian Path Medical Center	335	963	34.8%
Erlanger East	745	2152	34.6%
StoneCrest Medical Center	501	1457	34.4%
Jellico Community Hospital	77	227	33.9%
Maury Regional Hospital	544	1633	33.3%
Jackson - Madison County General Hospital	1019	3070	33.2%
Saint Francis Hospital	577	1762	32.7%
Livingston Regional Hospital	120	371	32.3%
Baptist Memorial Hospital - Tipton	143	446	32.1%
Hendersonville Medical Center	191	599	31.9%
Regional Medical Center at Memphis	1634	5167	31.6%
Wellmont Bristol Regional Medical Center	280	896	31.3%
Vanderbilt University Hospital	823	2635	31.2%
Summit Medical Center	522	1678	31.1%
Saint Mary’s Medical Center	674	2171	31.0%
Gateway Medical Center	565	1830	30.9%
Jamestown Regional Medical Center	29	94	30.9%
Fort Sanders Sevier Medical Center	312	1020	30.6%
Dyersburg Regional Medical Center	180	600	30.0%
Metro Nashville General Hospital	346	1156	29.9%
Southern Tennessee Medical Center	154	519	29.7%
Skyridge Medical Center	317	1079	29.4%
Cumberland Medical Center	187	641	29.2%
Riverview Regional Medical Center - North	37	130	28.5%
Methodist Medical Center	242	854	28.3%
Cookeville Regional Medical Center	434	1536	28.3%
Lincoln Medical Center	91	323	28.2%
Baptist Hospital of Cocke County	89	327	27.2%
Crockett	96	355	27.0%
River Park Hospital	156	580	26.9%
Regional Hospital of Jackson	172	640	26.9%
Methodist Healthcare - South	325	1212	26.8%
Morristown - Hamblen Healthcare System	211	787	26.8%
Lakeway Regional Hospital	122	472	25.8%
Horizon Medical Center	115	456	25.2%
Blount Memorial Hospital	212	852	24.9%
Methodist Healthcare - North	82	350	23.4%
NorthCrest Medical Center	193	836	23.1%
Heritage Medical Center	38	166	22.9%
Scott County Hospital	32	142	22.5%
Takoma Regional Hospital	69	322	21.4%
Sumner Regional Medical Center	170	839	20.3%
Total	30040	86791	34.6%

Data is derived from the Joint Annual Report of Hospitals filed with the Tennessee Department of Health for 2008. Data for each hospital is based on the fiscal year ending in 2008 for the hospital.

Special thanks to Keith Reisman, Esq., for compiling this data.

Comments

[RachelW]

It was interesting to me, as someone who grew up in Morristown, TN, to see Morristown Hamblen and Lakeway Regional right next to one another in the list - those are both in my hometown, and the only two hospitals in that town - I feel like there's a "community standards" comment in there somewhere... ;) I'd be very interested in whether anyone knowledgeable about Baptist in Murfreesboro could comment on that, if the number is just wrong, or what. That facility is just a county over from Vanderbilt, Southern Hills, Centennial, Metro general and others that are more in the 30-40% range.

[Jess]

One thing to keep in mind is the type of hospital, which is not identified in the list. A tertiary care center, such as Erlanger or Johnson City Medical Center, takes high risk transfers and has a high percentage of deliveries that are high risk. These deliveries, often babies who are severely premature or have fetal abnormalities, should have a higher cesarean delivery rate than a small community hospital that has mostly low risk deliveries.

[Kathy]

It looks like all the Memphis hospitals are around 40%. :-( I keep rereading it, hoping I'll recognize one that's lower.

Methodist Healthcare - Germantown, Saint Francis Hospital - Bartlett, and one of the "Baptist" hospitals, which is known as "Baptist East" in our area, but is probably "Baptist Memorial Hospital for Women." Ugh, ugh, ugh.

[Karen]

Thanks so much for posting this information!!!

I think it should be noted that CPMs are legal to practice in Tennessee, and with there being less than half the number of births reported as in AL for the same year, can we assume that there were a significant number of births occurring in private homes? So were 34% of *all* births by cesarean, or were 34% of *hospital* births by cesarean? A small distinction, but important in terms of women's decision-making.

I know for example that Ina May Gaskin is quoted as having <2% cesarean rate.

[Karen]

Oops, don't crucify me. It's late and I can't read. :P 86K births - um, that's MORE than in AL for 2008. It's the "new math"... yeah, that's it. :::blush:::

In any case, I still am curious to know how the home birth rate compares.

[Kathy]

I doubt that there would be a statistically significant difference in C/s rates due to home birth in TN. I just checked the CDC Wonder query for 2005, and there were fewer than 800 out-of-hospital births in TN, compared to over 80,000 in-hospital births. These o-o-h births could have been anything from precipitous births at 24 weeks to births on the side of the road at 38 weeks to planned midwife-attended home births. Even if 100% of the o-o-h births had been by C-section (had the mothers chosen a hospital birth), that would only raise the state total C/s rate from 32% to 33% [note that this was in 2005, not the latest figures].

[Karen]

Thanks, Kathy. I didn't know how to find that information! My individual perception was of there being more out-of-hospital births in TN, perhaps because I know AL families travel across the state line to birth with a midwife. Thanks for indulging my curiosity!

[Kathy]

You're welcome!

It is a valid assumption to make -- that there would be more home-births in TN than elsewhere, being the home of Ina May Gaskin and also having AL families cross the state line; unfortunately, that's not the case. :-( Even here in MS where you don't have to be a CPM to practice midwifery, there aren't that many home births -- only about 0.2% of all births in 2005. It's more the culture of the South than anything else. You'd think with midwifery having a much stronger presence for longer than most of the rest of the country (due to poverty and being so rural), that it would have remained more prominent, but that doesn't seem to be the case.