Cesarean Birth Rate (NTSV) (Data Source: CMQCC 07/01/2022 -- 06/30/2023)
This measure reflects the percentage of cesarean births among mothers whose pregnancies were nulliparous, term, singleton and vertex (NTSV) — which means the delivery of a single baby [versus twins or triplets] in a head-down position after 37 weeks gestational age to women having their first baby. Unless there is a specific medical complication, cesareans should be avoided in this relatively low-risk population.
For the baby, cesareans are associated with a higher risk of respiratory issues that require admission to an intensive care unit. For mothers, cesareans carry an increased risk of complications such as post-surgical infection and hemorrhage. Compared to vagin*l birth, cesareans are also associated with longer recovery times and can impede the mother-infant breastfeeding relationship. Importantly, women with prior cesarean births also have significantly higher risks of complications in their subsequent pregnancies.
Hospitals with an NTSV Cesarean Birth rate higher than 23.6% are performing cesareans above the statewide target. A woman who prefers a vagin*l birth for her first baby should look for a hospital with a low NTSV C-section rate and discuss her delivery options with her maternity care provider.
The NTSV Cesarean Birth rate compares how often each hospital performs cesareans on its patients with relatively “low risk” pregnancies. However, this measure does not adjust for every single medical complication that may lead a physician to recommend a cesarean. As such, hospitals that routinely treat very high-risk patients may have higher cesarean birth rates.
Breastfeeding Rate (CDPH) (Data Source: CDPH 01/01/2020 -- 12/31/2020)
This measure shows the percentage of newborns that were breastfed during their hospital stay. Research indicates that exclusive breastfeeding is beneficial and is generally recommended for women and their babies–as long as they do not have specific complications. Although there are many reasons breastfeeding rates vary, hospital staff can help new mothers begin to breastfeed before they leave the hospital.
Episiotomy Rate (Data Source: CMQCC 07/01/2022 -- 06/30/2023)
An episiotomy is a surgical cut in the vagin*l opening to make more space for the birth of a baby. It was once a routine procedure; however, many recent studies show that this cut does not make the birth easier and actually may lead to more short- and long-term harm in women. Providers and hospitals generally aim to do fewer episiotomies.
This measure reflects the number of episiotomies performed on women delivering vagin*lly at the hospital (but excludes cases of shoulder dystocia—when the baby’s shoulder position can impede delivery). In general, a lower rate is better.
VBAC Routinely Available (Data Source: CMQCC 07/01/2022 -- 06/30/2023)
Some women that had a cesarean in a prior delivery are interested in having theoptionto attempt avagin*lbirth in their current pregnancy. This measure indicates whether a hospital has a policy of allowing “vagin*l Birth after Cesarean” (VBAC). Hospitals showing “yes” do offer VBAC services for eligible women who previously had cesareans.
This information was collected from a survey of hospitals conducted by the Hospital Quality Institute in 2016 and is regularly updated by the California Maternal Quality Care Collaborative upon hospital request. However, policies can change, so please contact the hospital directly to learn their current policy on VBACs.
VBAC Rate (Data Source: CMQCC 07/01/2022 -- 06/30/2023)
A vagin*l Birth after Cesarean section (“VBAC”) is when a woman who has had a prior C-section delivers vagin*lly in a subsequent pregnancy (that is, without needing a repeat C-section). There are situations where women who have had a prior C-section may be eligible to deliver future babies vagin*lly—which has fewer post-delivery complications.
This measure represents the percentage of vagin*l births amongallwomen with a prior C-section for each hospital.Note that this measure is based on all women delivering at the hospital who had a prior cesarean, and not just those actively seeking a VBAC or those deemed as good candidates for a VBAC.
Deliveries by Certified Nurse Midwives (Data Source: CMQCC 07/01/2022 -- 06/30/2023)
This statistic represents the percent of births at each hospital that were attended by Certified Nurse Midwives (CNMs). CNMs—often called “nurse-midwives”—are advanced practice nurses who are masters or doctorallyeducated and are licensed by the state to manage uncomplicated pregnancy and childbirth.The statistic is based on the provider type (e.g., physician, CNM, nurse) listed as the “Attending Provider” on all California Birth Certificates.
Some women have a personal preference to be attended by a CNM.Reporting each hospital’sCNM Delivery Ratecan help women identify which hospitals have integrated CNMs into their maternity care unit. If you are interested in having your labor and birth attended by a nurse-midwife, contact the maternity unit at your preferred hospital(s) to identify the provider groups with CNMs.
Reporting Period for other Mother & Baby Measures (listed below):
The ratings reflect July 2022–June 2023 hospital discharge and birth certificate data from 207 California hospitals that offer maternity services and participate in the California Maternal Quality Care Collaborative’s Maternal Data Center (CMQCC’s MDC). These 207 hospitals submitted data to the CMQCC Maternal Data Center to enable rapid-cycle reporting and quality improvement. One hospital listed in this section did not submit data to the CMQCC Maternal Data Center; their results represent Calendar Year 2021 data available from the California Department of Health Care Access and Information. Nine other hospitals have closed. These hospitalsare listedhere.
For more information, please access the Ratings & Data Sources section of this websitehere.
