Washington State Cesarean Rates by Hospital, 2009

By Jill—Unnecesarean

Hospital Name	City	Total C/S	Total Births	C/S Rate
Mid-Valley Hospital	Omak	107	261	41.0%
Evergreen Hospital Medical Center	Kirkland	1551	4080	38.0%
Overlake Hospital Medical Center	Bellevue	1547	4109	37.6%
Providence Centralia Hospital	Centralia	246	654	37.6%
Grays Harbor Community Hospital	Aberdeen	225	603	37.3%
University Of Washington Med Ctr	Seattle	821	2201	37.3%
Pullman Regional Hospital	Pullman	128	346	37.0%
Auburn Regional Medical Center	Auburn	340	958	35.5%
Providence Sacred Heart Med Ctr	Spokane	992	2797	35.5%
Valley Medical Center	Renton	1339	3865	34.6%
Capital Medical Center	Olympia	240	694	34.6%
Cascade Valley Hospital	Arlington	141	413	34.1%
Whidbey General Hospital	Coupeville	55	162	34.0%
Swedish Medical Center - First Hill	Seattle	2436	7316	33.3%
Legacy Salmon Creek Hospital	Vancouver	643	1969	32.7%
Highline Community Hospital	Burien	309	950	32.5%
PeaceHealth Saint Joseph Hospital	Bellingham	645	1999	32.3%
Valley General Hospital	Monroe	116	371	31.3%
Newport Community Hospital	Newport	30	96	31.3%
Lourdes Medical Center	Pasco	115	369	31.2%
Tacoma General Allenmore Hospital	Tacoma	956	3084	31.0%
PeaceHealth Saint John Medical Center	Longview	361	1165	31.0%
Kittitas Valley Hospital	Ellensburg	113	366	30.9%
Coulee Community Hospital	Grand Coulee	20	66	30.3%
Deaconess Medical Center	Spokane	568	1879	30.2%
Providence Regional Med Ctr Everett	Everett	1098	3674	29.9%
Stevens Healthcare	Edmonds	338	1134	29.8%
Kadlec Medical Center	Richland	699	2346	29.8%
Island Hospital	Anacortes	115	386	29.8%
Sunnyside Community Hospital	Sunnyside	157	529	29.7%
Harrison Memorial Hospital	Bremerton	563	1899	29.6%
Providence Saint Mary Medical Center	Walla Walla	169	572	29.5%
Saint Joseph Medical Center	Tacoma	1083	3683	29.4%
Northwest Hospital	Seattle	303	1047	28.9%
North Valley Hospital	Tonasket	15	52	28.8%
Good Samaritan Hospital	Puyallup	625	2202	28.4%
Skagit Valley Hospital	Mount Vernon	380	1356	28.0%
Providence Saint Peter Hospital	Olympia	629	2251	27.9%
Othello Community Hospital	Othello	176	635	27.7%
Saint Francis Hospital	Federal Way	367	1366	26.9%
Olympic Medical Center	Port Angeles	128	483	26.5%
Lake Chelan Community Hospital	Chelan	28	106	26.4%
Providence Saint Joseph’s Hospital	Chewelah	17	65	26.2%
Prosser Memorial Hospital	Prosser	88	338	26.0%
Mason General Hospital	Shelton	71	273	26.0%
Central Washington Hospital	Wenatchee	365	1407	25.9%
Skyline Hospital	White Salmon	16	62	25.8%
Samaritan Hospital	Moses Lake	271	1075	25.2%
Southwest Washington Medical Center	Vancouver	829	3302	25.1%
Morton General Hospital	Morton	8	32	25.0%
Whitman Hospital & Medical Center	Colfax	10	40	25.0%
Walla Walla General Hospital	Walla Walla	67	269	24.9%
Jefferson Hospital	Port Townsend	31	127	24.4%
Group Health Central Hospital	Seattle	417	1712	24.4%
Forks Community Hospital	Forks	23	97	23.7%
Kennewick General Hospital	Kennewick	343	1455	23.6%
Providence Holy Family Hospital	Spokane	288	1239	23.2%
Enumclaw Community Hospital	Enumclaw	52	228	22.8%
Okanogan-Douglas Hospital	Brewster	42	193	21.8%
Providence Mount Carmel Hospital	Colville	38	185	20.5%
Valley Hospital and Medical Center	Spokane	101	527	19.2%
Toppenish Community Hospital	Toppenish	91	516	17.6%
Yakima Valley Memorial Hospital	Yakima	520	3098	16.8%
Yakima Regional Med & Heart Ctr	Yakima	0	1	0.0%
Willapa Harbor Hospital	South Bend	0	2	0.0%
		24605	80837	30.4%

SOURCE: 2009 Full Year CHARS Standard Reports, Hospital Census and Charges by DRG, http://www.doh.wa.gov/ehsphl/hospdata/CHARS/Default.htm

Cesarean rates calculated by dividing total cesarean deliveries by total deliveries. 

2009 Fact Sheet: Controlling C-section growth (Washington State Department of Social and Health Services- pdf)

 

Thank you to SereneDoulas.com and Tranquil Haven Day Spa.

Comments

[Roxanne]

I truly do not understand why there is such a HUGE difference between Yakima (good job!) and little Omak (scary!). Are the women truly that different? Or is it because Yakima still supports VBACs and Omak has banned them? Craziness. Can't even believe they can get away with this crap.

[The Deranged Housewife]

I'm going to go out on a limb here. I could be totally wrong, but I bet location/geography has something to do with it. Historically, a smaller town meant less access to epidurals, etc. and an anesthesiologist, which meant smaller hospitals usually had a lower c-section rate. Now, with lawsuits, etc. they probably schedule c-sections more (especially when they know when they will need an anesthesiologist). I wonder, what percentage of their c-sections are done without a trial of labor? Which ones are repeat c-sections without a TOL?

Also, I did read this link from another source and they said Puget Sound had the highest c-section rate at around 60 percent. I wonder - if you look at the map, Puget Sound (I've never been there) is surrounded by water, which means a substantial ferry ride to get to the mainland. It also has limited access with one major and one minor highway. If you're in labor and have to depend on either a ferry ride or one of two roadways to get to a hospital, heavy traffic, holiday season, blah blah blah I bet your doctor is going to suggest an induction - which may contribute to that 60 percent c-section rate - or just go to a scheduled c/s without even going into labor first and "taking a chance." I'd be curious if that were the reasoning behind it.

[Birth Unplugged]

Wow, we have great rates here in Yakima! It's kind of crazy because there are NO independent childbirth education classes in this area (yet!). And the closest homebirth midwife is in Prosser, about an hour away, so our options are pretty limited. I wonder if the lack of alternatives keeping all low risk women in the hosptial makes the hosptial c-section rates lower, since they have low risk women who could have given birth at home or in a birth center included? The general culture here is relatively pro-natural childbirth compared to other places I've lived (Provo, Utah...) I know a lot of people who have had natural births. I don't know how long epidurals have been available here. Probably recently enough that a lot of the medical personnel are more supportive of natural birth and alternative pain relief methods. My own experience with a hospital birth here was wonderful. I have heard that VBACs tend to be discouraged, though Yakima Valley Memorial does do them (Toppenish doesn't, so women who want one down there have to come up to YVMH) Oh, and Yakima Regional doesn't have an L&D department...interesting that they still had one birth--must have been somebody who walked in to the ER pushing.

Thanks for posting these!

[Roxanne]

HI Birth unplugged, can you please email me at newmommy604@yahoo.com ? I live in Wenatchee (central Washington hospital has banned VBACS), and am trying to figure out my options for a 2nd VBAC (due in April). Wondering about Yakima. I drove to Spokane last time, but my labor was only 5 hours, and I'm scared to drive that far this time! ;) Thanks!

[erinmidwife]

Every hospital has their own unique web of VBAC and birth politics, staff, and patient base. These things all contribute to the range in c-section rates among seemingly similar locations and demographics. Yes the large, urban, university or tertiary hospitals often have a disproportionate amount of high-risk births, but in some areas these hospitals may also have the lowest c-section rates in town -- as was the case when I was practicing in Albuquerque.

[Diana]

The Puget Sound is not an island, it's called that as a designation of a specific part of Washington. There are some small Islands, sure, like the San Juan Islands and also Camano Island. But honestly I've lived here and traveled around the state for 27 years and have never had a 'can't get to the mainland' type of thing. There is no 'mainland'- this is a normal state just like any other that happens to have a little more water. I can take an hour ferry ride to Seattle or hop in my car and drive about as long and also get there. Although there would never really be a need since I have 2 large hospitals within 15 minutes of me and also a Trauma hospital with a world class NICU less than 45 minutes away. The high c-sect rates in WA are disgusting and particularly in the puget sound. It's like, what has to happen for things to change?

[The Deranged Housewife]

Diana,
We have a similar area where I live - a small island that has one access on and off. In the event of accidents, it is a nightmare because you have such limited access.

I did wonder, though, if for some in the area might be convinced to just go ahead and schedule ahead of time if they are seemingly more remote than people who live 'on the mainland,' as I've heard it called. I don't know what the demographics are of the area - an even mix, wealthy and more educated, mostly retirees or whatever - any excuse, basically! *sigh*

[Diana]

Here we have tons of access in and out of the puget sound area. The bridge alone has several lanes of traffic each way. http://en.wikipedia.org/wiki/Tacoma_Narrows_Bridge . There are also tons of ferry boats and different take off locations. To my knowledge we've never had a situation where people were stuck and couldn't get where they needed to go. On September 11th I couldn't get back to Seattle by ferry for college for a few days, but in a labor situation it wouldn't have mattered since this side of the water has many birthing hospitals available, too.
Something interesting that I have noticed about the puget sound is that some women are scheduling inductions or c-sects because a spouse is military and will be leaving soon (the puget sound is a military area). This is of course very controversial. I feel that the safety of the mother and baby should take priority but I also can't say how I'd feel knowing my spouse may not meet our child for 6-18 months- it must be very difficult. I've also had friends schedule a c-sect because the dr was going on vacation (!), they were 'tired of being pregnant', etc. Why this is acceptable in the medical community I don't understand.

The other friends of mine that have had c-sects were because high blood pressure, previous c-sects (and only one dr in my HUGE county will do a VBAC, it's crazy), and other things of that nature. We are surrounded more by hospitals I would say, than by water :) So it seems to be to not be an issue at all of the area and feasibility of access, but rather the dr's themselves and their acceptance of C-sects for non emergent reasons.

I had a cousin do a homebirth last month because she lives an hour from the military hospital and labors very quickly- I'd say that's a much better response than scheduling a c-sect :)
And a friend of mine had her baby in her car 4 months ago even though she only lived 15 minutes from the birthing center- just a very quick laborer!

[Kathryn T.]

One thing I'll point out -- not to defend or excuse, because these are ludicrously high, but just to point out -- is that there's a strong alternative birth culture in the Puget Sound region, which includes Seattle and its wealthy suburbs. There are several freestanding birth centers in the area, and there's a lot of homebirth. It's possible that a lot of the low-risk birth in this area (I live here) is happening outside of hospitals. My birth story (which you can read in the sidebar, under "My Awesome OB missed the first night of her family's vacation for me!") happened at Overlake, and Evergreen is the hospital that handles emergency transfers for the FSBC where I'm planning to have my current baby.

Like I said, they're still unacceptably high. But for folks wondering why the percentages are SO high in the urban Puget Sound reason. . . I honestly think that the strong alternative birth culture here might be a reason, because folks are more likely to only choose the hospital if they have a reason to.

[Alisa]

Seems about right. Had my two csections at the 2nd highest csection rate hospital and most of my csection friends also went there. Good portion of my vaginal birth friends went to Providence Everett, 25th highest.